diff --git a/.github/ISSUE_TEMPLATE/feature_request.md b/.github/ISSUE_TEMPLATE/feature_request.md
index 4578c6b09b8..4809d566709 100644
--- a/.github/ISSUE_TEMPLATE/feature_request.md
+++ b/.github/ISSUE_TEMPLATE/feature_request.md
@@ -17,6 +17,7 @@ A clear and concise description of what you want to happen.
 A clear and concise description of any alternative solutions or features you've considered.
 
 **Acceptance Criteria**
+
 1.  
    GIVEN [a precondition]
     AND [another precondition]
diff --git a/.github/workflows/reindex.yml b/.github/workflows/reindex.yml
new file mode 100644
index 00000000000..96cfe74d954
--- /dev/null
+++ b/.github/workflows/reindex.yml
@@ -0,0 +1,47 @@
+name: Reindex - Integration Tests
+
+on:
+  pull_request:
+    paths-ignore:
+      - 'docs/**'
+      - 'demo/**'
+      - '.github/workflows/site.yml'
+      - '.github/workflows/release.yml'
+
+jobs:
+  reindex:
+    runs-on: ubuntu-latest
+    if: "!contains(github.event.pull_request.labels.*.name, 'ci-skip')"
+    strategy:
+      matrix:
+        datastore: [ 'db2', 'derby', 'postgres' ]
+      fail-fast: false
+    steps:
+    - name: Checkout source code
+      uses: actions/checkout@v2.3.4
+    - name: Set up java
+      uses: joschi/setup-jdk@v2.3.0
+      with:
+        java-version: 11
+    - name: Setup prerequisites
+      env:
+        WORKSPACE: ${{ github.workspace }}
+      run: bash build/reindex/bin/setup-prerequisites.sh ${{matrix.datastore}}
+    - name: Integration Tests
+      env:
+        WORKSPACE: ${{ github.workspace }}
+      run: |
+        bash build/reindex/bin/pre-integration-test.sh ${{matrix.datastore}}
+        bash build/reindex/bin/integration-test.sh ${{matrix.datastore}}
+        bash build/reindex/bin/post-integration-test.sh ${{matrix.datastore}}
+    - name: Gather error logs
+      if: failure()
+      env:
+        WORKSPACE: ${{ github.workspace }}
+      run: bash build/common/gather-logs.sh reindex ${{matrix.datastore}}
+    - name: Upload logs
+      if: always()
+      uses: actions/upload-artifact@v2.2.0
+      with:
+        name: integration-test-results-${{ matrix.datastore }}
+        path: build/reindex/integration-test-results
diff --git a/CONTRIBUTING.md b/CONTRIBUTING.md
index cc361367bb1..7f8f0bbc565 100644
--- a/CONTRIBUTING.md
+++ b/CONTRIBUTING.md
@@ -26,9 +26,9 @@ pull request so it can be tracked.
 
 ### Merge approval
 
-The project maintainers use LGTM (Looks Good To Me) in comments on the code
-review to indicate acceptance. A change requires LGTMs from two of the
-maintainers of each component affected.
+The project maintainers use [GitHub reviews](https://github.com/features/code-review) to indicate acceptance.
+A change requires approval from two of the maintainers of each component affected.
+Sometimes, reviewers will leave a comment "LGTM" to indicate that the change "looks good to me".
 
 For a list of the maintainers, see the [MAINTAINERS.md](MAINTAINERS.md) page.
 
@@ -86,7 +86,7 @@ The IBM FHIR Server has been written by many individuals over many years. Format
 
 2. Use comments. Preferably javadoc.
 
-3. Keep the documentation up-to-date. Project documentation exists under the docs directory. We have a CHANGELOG for tracking user-visible changes, a Conformance page for documenting conformance to the specification, and a User Guide for FHIR Server administrators.
+3. Keep the documentation up-to-date. Project documentation exists under the docs directory. We have a Conformance page for documenting conformance to the specification, a User Guide for FHIR Server administrators, and other guides for select topics of interest. In addition to the project site, we also have README.md files for many of the modules.
 
 4. Use spaces (not tabs) in java source. For this we have a checkstyle rule which will fail the build if you're using tabs. We also prefer spaces over tabs in JSON and XML, but its not strictly enforced.
 
diff --git a/README.md b/README.md
index 8d1bbd1747c..3ba8687cdf1 100644
--- a/README.md
+++ b/README.md
@@ -102,14 +102,15 @@ The IBM FHIR Server is modular and extensible. The following tables provide an o
 |fhir-operation-document|Basic support for the Composition `$document` operation defined at https://www.hl7.org/fhir/operation-composition-document.html |false|
 |fhir-operation-healthcheck|The `$healthcheck` operation checks for a valid connection to the database and returns the server status|false|
 |fhir-operation-term|[Terminology service](https://www.hl7.org/fhir/terminology-service.html) operations which use the default fhir-term TerminologyServiceProvider to implement $expand, $lookup, $subsumes, $closure, $validate and $translate|false|
+|fhir-operation-term-cache|Add-on module that provides operations for clearing the terminology subsystem caches for non-production scenarios|false|
 |fhir-operation-validate|An implementation of the FHIR resource [$validate operation](https://www.hl7.org/fhir/R4/operation-resource-validate.html)|false|
 |fhir-operation-everything|An implementation of the FHIR patient [`$everything`](https://www.hl7.org/fhir/operation-patient-everything.html) operation|false|
+|fhir-operation-erase|A hard delete operation for resource instances referred to as the `$erase` operation. See the [README.md](operation/fhir-operation-erase/README.md)|false|
 
 #### Client
 |Module|Description|Java API-stable|
 |------|-----------|----------|
 |fhir-client|A FHIR Client that re-uses the IBM FHIR Server model and its JAX-RS Providers|false|
-|fhir-cli|Experimental command line interface utility for working with the IBM FHIR Server client from the command line|false|
 
 #### Tools and Utilities
 |Module|Description|Java API-stable|
diff --git a/build/audit/kafka/pre-integration-test.sh b/build/audit/kafka/pre-integration-test.sh
index 7ecea87111d..fe57602e6cc 100644
--- a/build/audit/kafka/pre-integration-test.sh
+++ b/build/audit/kafka/pre-integration-test.sh
@@ -39,6 +39,7 @@ config(){
     mkdir -p $USERLIB
     find ${WORKSPACE}/conformance -iname 'fhir-ig*.jar' -not -iname 'fhir*-tests.jar' -not -iname 'fhir*-test-*.jar' -exec cp -f {} ${USERLIB} \;
     cp -pr ${WORKSPACE}/operation/fhir-operation-test/target/fhir-operation-*-tests.jar ${USERLIB}
+    cp -pr ${WORKSPACE}/operation/fhir-operation-term-cache/target/fhir-operation-*.jar ${USERLIB}
     echo "Finished copying fhir-server dependencies..."
 
     # Move over the test configurations
diff --git a/build/common/gather-logs.sh b/build/common/gather-logs.sh
new file mode 100644
index 00000000000..a6ab5e53e5d
--- /dev/null
+++ b/build/common/gather-logs.sh
@@ -0,0 +1,74 @@
+#!/usr/bin/env bash
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -ex
+
+# Gathers the logs
+package_logs(){
+    workflow="${1}"
+    job="${2}"
+    echo "Gathering logs for [${workflow}/${job}]"
+
+    it_results=${WORKSPACE}/build/${workflow}/integration-test-results
+    if [ ! -d ${it_results} ]
+    then
+        rm -fr ${it_results} 2>/dev/null
+    fi
+
+    mkdir -p ${it_results}
+    mkdir -p ${it_results}/server-logs
+    mkdir -p ${it_results}/fhir-server-test
+
+    # Runtime Date
+    echo $(date) > ${it_results}/runtime.txt
+
+    # Look for the FHIR Server Container
+    containerId=$(docker ps -a | grep ibm-fhir-server | cut -d ' ' -f 1)
+    if [ -z "${containerId}" ]
+    then
+        echo "Warning: Could not find fhir container!!!"
+    else
+        echo "fhir container id: $containerId"
+        # Grab the container's console log
+        docker logs $containerId  >& ${it_results}/docker-console.txt
+        
+        echo "Gathering post-test server logs from docker container: $containerId"
+        docker cp -L $containerId:/logs ${it_results}/server-logs
+    fi
+
+    echo "Gathering integration test output"
+    if [ -d ${WORKSPACE}/fhir-server-test/target/surefire-reports ]
+    then
+        cp -pr ${WORKSPACE}/fhir-server-test/target/surefire-reports/* ${it_results}/fhir-server-test
+    fi
+
+    if [ -f ${WORKSPACE}/build/${workflow}/${job}/workarea/${job}-test1.log ]
+    then
+        echo "Move the '${job}' Elements to the output area'"
+        cp -pr build/${workflow}/${job}/workarea/${job}-test*.log ${it_results}
+    fi
+}
+
+###############################################################################
+# Check if the workspace is set.
+if [ -z "${WORKSPACE}" ]
+then 
+    echo "The WORKSPACE value is unset"
+    exit -1
+fi 
+
+# Store the current directory to reset to
+pushd $(pwd) > /dev/null
+
+package_logs "${1}" "${2}"
+
+# Reset to Original Directory
+popd > /dev/null
+
+# EOF
+###############################################################################
\ No newline at end of file
diff --git a/build/docker/copy-test-operations.sh b/build/docker/copy-test-operations.sh
index 24bfb1fcce7..c8fdcfc548a 100755
--- a/build/docker/copy-test-operations.sh
+++ b/build/docker/copy-test-operations.sh
@@ -19,5 +19,6 @@ mkdir -p $USERLIB
 echo "Copying test artifacts to install location..."
 find ${WORKSPACE}/conformance -iname 'fhir-ig*.jar' -not -iname 'fhir*-tests.jar' -not -iname 'fhir*-test-*.jar' -exec cp -f {} ${USERLIB} \;
 cp -pr ${WORKSPACE}/operation/fhir-operation-test/target/fhir-operation-*-tests.jar ${USERLIB}
+cp -pr ${WORKSPACE}/operation/fhir-operation-term-cache/target/fhir-operation-*.jar ${USERLIB}
 
 echo "Finished copying test operations."
diff --git a/build/notifications/kafka/pre-integration-test.sh b/build/notifications/kafka/pre-integration-test.sh
index 0799a1468a4..8687fbec4d7 100644
--- a/build/notifications/kafka/pre-integration-test.sh
+++ b/build/notifications/kafka/pre-integration-test.sh
@@ -38,6 +38,7 @@ config(){
     mkdir -p $USERLIB
     find ${WORKSPACE}/conformance -iname 'fhir-ig*.jar' -not -iname 'fhir*-tests.jar' -not -iname 'fhir*-test-*.jar' -exec cp -f {} ${USERLIB} \;
     cp -pr ${WORKSPACE}/operation/fhir-operation-test/target/fhir-operation-*-tests.jar ${USERLIB}
+    cp -pr ${WORKSPACE}/operation/fhir-operation-term-cache/target/fhir-operation-*.jar ${USERLIB}
     echo "Finished copying fhir-server dependencies..."
 
     # Move over the test configurations
diff --git a/build/persistence/postgres/pre-integration-test.sh b/build/persistence/postgres/pre-integration-test.sh
index b6fb9e3abcb..81d7a2b5222 100644
--- a/build/persistence/postgres/pre-integration-test.sh
+++ b/build/persistence/postgres/pre-integration-test.sh
@@ -64,6 +64,7 @@ copy_server_config(){
     echo "Copying test artifacts to install location..."
     find ${WORKSPACE}/conformance -iname 'fhir-ig*.jar' -not -iname 'fhir*-tests.jar' -not -iname 'fhir*-test-*.jar' -exec cp -f {} ${USERLIB} \;
     cp -pr ${WORKSPACE}/operation/fhir-operation-test/target/fhir-operation-*-tests.jar ${USERLIB}
+    cp -pr ${WORKSPACE}/operation/fhir-operation-term-cache/target/fhir-operation-*.jar ${USERLIB}
     echo "Finished copying fhir-server dependencies..."
 }
 
diff --git a/build/pre-integration-test.ps1 b/build/pre-integration-test.ps1
index 6a57310b951..2550bf8282d 100644
--- a/build/pre-integration-test.ps1
+++ b/build/pre-integration-test.ps1
@@ -118,6 +118,9 @@ If (!(Test-Path -Path $USERLIB_DIR) ) {
 }
 Copy-Item $CP_ITEM -Destination $USERLIB_DST
 
+$CP_ITEM=[string]$DIR_WORKSPACE + '\operation\fhir-operation-term-cache\target\fhir-operation-term-cache-*.jar'
+Copy-Item $CP_ITEM -Destination $USERLIB_DST
+
 # Start up the fhir server
 $DATE_PS=[System.TimeZoneInfo]::ConvertTimeBySystemTimeZoneId((Get-Date), 'Greenwich Standard Time').ToString('t')
 Write-Host '>>> Current time: ' $DATE_PS
diff --git a/build/pre-integration-test.sh b/build/pre-integration-test.sh
index 3619aea566b..fe1f809620c 100755
--- a/build/pre-integration-test.sh
+++ b/build/pre-integration-test.sh
@@ -74,6 +74,7 @@ cp -p ${WORKSPACE}/fhir-server/liberty-config/configDropins/disabled/datasource-
 echo "Copying test artifacts to install location..."
 rm -rf ${SIT}/wlp/usr/servers/fhir-server/userlib/fhir-operation-*-tests.jar
 cp -pr ${WORKSPACE}/operation/fhir-operation-test/target/fhir-operation-*-tests.jar ${SIT}/wlp/usr/servers/fhir-server/userlib/
+cp -pr ${WORKSPACE}/operation/fhir-operation-term-cache/target/fhir-operation-*.jar ${SIT}/wlp/usr/servers/fhir-server/userlib/
 find ${WORKSPACE}/conformance -iname 'fhir-ig*.jar' -not -iname 'fhir*-tests.jar' -not -iname 'fhir*-test-*.jar' -exec cp -f {} ${SIT}/wlp/usr/servers/fhir-server/userlib/ \;
 
 # Start up the fhir server
diff --git a/build/reindex/.gitignore b/build/reindex/.gitignore
new file mode 100644
index 00000000000..2af40aabb04
--- /dev/null
+++ b/build/reindex/.gitignore
@@ -0,0 +1,2 @@
+**/integration-test-results
+**/workarea
\ No newline at end of file
diff --git a/build/reindex/README.md b/build/reindex/README.md
new file mode 100644
index 00000000000..4b25fa3841a
--- /dev/null
+++ b/build/reindex/README.md
@@ -0,0 +1,48 @@
+# Integration Test Framework for the $reindex Operation
+
+This document outlines the end-to-end reindex automation framework. 
+
+The automation runs with these steps: 
+
+- **Checkout source code** - Checks out the git code and populates the `github` environment variables.
+- **Set up java** - Downloads and setup for Java 11
+- **Setup prerequisites** - This step builds the required artifacts necessary to test the build with the reindex. 
+- **Integration Tests** - The step executes the pre-integration-docker, then integration-test-docker and runs the post-integration-docker scripts.
+- **Gather error logs** - This step only runs upon a failure condition. 
+- **Upload logs** - The step uploads the results of the integration tests and the operational logs are posted to the job. 
+
+The GitHub Action is parameterized with a matrix for each new `$reindex` tests. Each additional entry in the array ends up creating multiple automation steps which must complete successfully for the workflow.
+
+``` yaml
+strategy:
+  matrix:
+    datastore: [ 'db2', 'derby', 'postgres' ]
+```
+
+Each datastore layer that is tested as part of the framework uses the default build files and the files that match the `matrix.datastore` name added to the `reindex.yml`.
+
+|Filename|Purpose|
+|----------|----------------|
+|bin/gather-logs.sh|Gathers the logs from the build|
+|bin/integration-test.sh|Run after the tests complete to release resources and package tests results|
+|bin/setup-prerequisites.sh|Builds the fhir-server|
+|bin/pre-integration-test.sh|Call the pre-integration-test step for `<datastore>`|
+|bin/post-integration-test.sh|Call the post-integration-test step for `<datastore>`|
+|`<datastore>`/integration-test.sh|if exists, overrides bin/integration-test.sh, replacing the prior test behavior.|
+|`<datastore>`/pre-integration-test.sh|Run before integration-test.sh to startup image and services for the integration testing|
+|`<datastore>`/post-integration-test.sh|if exists, runs after integration-test.sh to stop image and services from the integration testing|
+|`<datastore>`/.gitignore|Ignores files related to the reindex layer's tests|
+|`README.md`|This file describing the reindex framework|
+
+Note, `<datastore>` is replaced with your reindex layer such as `db2`. 
+
+Transaction Timeout is 300 seconds.
+
+Consult the reference implementation (`db2`) to start a new reindex tests. The minimum that must be implemented are the `pre-integration-test.sh` and `.gitignore`.
+
+## Test the Automation
+
+To test the build, be sure to pre-set the environment variable `WORKSPACE` with `export WORKSPACE=$(pwd)`.
+You must also start Docker, so the image is built that supports the IBM FHIR Server.
+
+If you have any questions, please reach out on Zulip.
\ No newline at end of file
diff --git a/build/reindex/bin/integration-test.sh b/build/reindex/bin/integration-test.sh
new file mode 100644
index 00000000000..4d6d9c95179
--- /dev/null
+++ b/build/reindex/bin/integration-test.sh
@@ -0,0 +1,120 @@
+#!/usr/bin/env bash
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -ex
+set -o pipefail
+
+# spins for a set time until the server is up
+wait_for_it(){
+    # Wait until the fhir server is up and running...
+    echo "Waiting for fhir-server to complete initialization..."
+    healthcheck_url='https://localhost:9443/fhir-server/api/v4/$healthcheck'
+    tries=0
+    status=0
+    while [ $status -ne 200 -a $tries -lt 30 ]; do
+        tries=$((tries + 1))
+
+        set +o errexit
+        cmd="curl -k -o ${WORKSPACE}/health.json --max-time 5 -I -w "%{http_code}" -u fhiruser:change-password $healthcheck_url"
+        echo "Executing[$tries]: $cmd"
+        status=$($cmd)
+        set -o errexit
+
+        echo "Status code: $status"
+        if [ $status -ne 200 ]
+        then
+            echo "Sleeping 30 secs..."
+            sleep 30
+        fi
+    done
+
+    if [ $status -ne 200 ]
+    then
+        echo "Could not establish a connection to the fhir-server within $tries REST API invocations!"
+        exit 1
+    fi
+
+    echo "The fhir-server appears to be running..."
+}
+
+run_tests(){
+    # The integration tests may be overriden completely, or fall through to the default. 
+    reindex="${1}"
+
+    if [ ! -z "${reindex}" ] && [ -f "build/reindex/${reindex}/integration-test.sh" ]
+    then 
+        echo "Running [${reindex}] specific integration tests"
+        bash build/reindex/${reindex}/integration-test.sh
+    else
+        # Go to the Default
+        echo "Executing the default integration tests"
+        sed -i -e 's/test.reindex.enabled = false/test.reindex.enabled = true/g' ${WORKSPACE}/fhir-server-test/src/test/resources/test.properties
+
+        # Test 1 - Basic Tests for Reindex
+        mvn -B test -f fhir-server-test -DskipWebSocketTest=true --no-transfer-progress \
+            -DskipTests=false -Dtest="com.ibm.fhir.server.test.operation.ReindexOperationTest" | tee build/reindex/${reindex}/workarea/${reindex}-test1.log
+
+        # Test 2 - Long Run Tests *895 Resources*
+        mvn -B test -f fhir-server-test -DskipWebSocketTest=true --no-transfer-progress \
+            -DskipTests=false -Dtest="com.ibm.fhir.server.test.operation.ReindexOperationLongRunTest" | tee build/reindex/${reindex}/workarea/${reindex}-test2.log
+
+        # Test 3 Phase 1
+        mvn -B test -f fhir-server-test -DskipWebSocketTest=true --no-transfer-progress \
+            -DskipTests=false -Dtest="com.ibm.fhir.server.test.operation.ReindexOperationPhase1Test" | tee build/reindex/${reindex}/workarea/${reindex}-test3.log
+
+        # Update SPs
+        cp -pr ${WORKSPACE}/fhir-server-test/src/test/resources/testdata/reindex-operation/extension-search-parameters-test1.json \
+            ${WORKSPACE}/build/reindex/${reindex}/workarea/volumes/dist/config/default/extension-search-parameters.json
+
+        # Restart
+        cd build/reindex/${reindex}
+        docker-compose restart --timeout 30 fhir
+        cd -
+        wait_for_it
+
+        # Test 3 Phase 2
+        mvn -B test -f fhir-server-test -DskipWebSocketTest=true --no-transfer-progress \
+            -DskipTests=false -Dtest="com.ibm.fhir.server.test.operation.ReindexOperationPhase2Test" | tee build/reindex/${reindex}/workarea/${reindex}-test4.log
+
+        # Update SPs
+        cp -pr ${WORKSPACE}/fhir-server-test/src/test/resources/testdata/reindex-operation/extension-search-parameters-test2.json \
+            ${WORKSPACE}/build/reindex/${reindex}/workarea/volumes/dist/config/default/extension-search-parameters.json
+
+        # Restart
+        cd build/reindex/${reindex}
+        docker-compose restart --timeout 30 fhir
+        cd -
+        wait_for_it
+
+        # Test 3 Phase 3
+        mvn -B test -f fhir-server-test -DskipWebSocketTest=true --no-transfer-progress \
+            -DskipTests=false -Dtest="com.ibm.fhir.server.test.operation.ReindexOperationPhase3Test" | tee build/reindex/${reindex}/workarea/${reindex}-test5.log
+    fi
+}
+
+###############################################################################
+# Check if the workspace is set.
+if [ -z "${WORKSPACE}" ]
+then 
+    echo "The WORKSPACE value is unset"
+    exit -1
+fi 
+
+# Store the current directory to reset to
+pushd $(pwd) > /dev/null
+
+# Change to the reindex/bin directory
+cd "${WORKSPACE}"
+
+run_tests "${1}"
+
+# Reset to Original Directory
+popd > /dev/null
+
+# EOF
+###############################################################################
\ No newline at end of file
diff --git a/build/reindex/bin/post-integration-test.sh b/build/reindex/bin/post-integration-test.sh
new file mode 100644
index 00000000000..9d102ee6755
--- /dev/null
+++ b/build/reindex/bin/post-integration-test.sh
@@ -0,0 +1,43 @@
+#!/usr/bin/env bash
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -ex
+
+# reindex_post - executes for each reindex post integration steps
+reindex_post(){
+    reindex="${1}"
+    if [ ! -z "${reindex}" ] && [ -f build/reindex/${reindex}/post-integration-test.sh ]
+    then 
+        echo "Running [${reindex}] post-integration-test"
+        bash build/reindex/${reindex}/post-integration-test.sh
+    else
+        cd build/reindex/${reindex}
+        docker-compose down --remove-orphans --rmi local -v --timeout 30
+    fi
+}
+
+###############################################################################
+# Check if the workspace is set.
+if [ -z "${WORKSPACE}" ]
+then 
+    echo "The WORKSPACE value is unset"
+    exit -1
+fi 
+
+# Store the current directory to reset to
+pushd $(pwd) > /dev/null
+
+cd "${WORKSPACE}"
+
+reindex_post ${1}
+
+# Reset to Original Directory
+popd > /dev/null
+
+# EOF 
+###############################################################################
\ No newline at end of file
diff --git a/build/reindex/bin/pre-integration-test.sh b/build/reindex/bin/pre-integration-test.sh
new file mode 100755
index 00000000000..b4713d3feda
--- /dev/null
+++ b/build/reindex/bin/pre-integration-test.sh
@@ -0,0 +1,41 @@
+#!/usr/bin/env bash
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -ex
+
+# reindex_pre - executes for each reindex pre integration steps
+reindex_pre(){
+    reindex="${1}"
+    if [ ! -z "${reindex}" ] && [ -f build/reindex/${reindex}/pre-integration-test.sh ]
+    then 
+        echo "Running [${reindex}] pre-integration-test"
+        bash build/reindex/${reindex}/pre-integration-test.sh
+    fi
+}
+
+###############################################################################
+# Check if the workspace is set.
+if [ -z "${WORKSPACE}" ]
+then 
+    echo "The WORKSPACE value is unset"
+    exit -1
+fi 
+
+# Store the current directory to reset to
+pushd $(pwd) > /dev/null
+
+# Change to the reindex_pre
+cd "${WORKSPACE}"
+
+reindex_pre "${1}"
+
+# Reset to Original Directory
+popd > /dev/null
+
+# EOF 
+###############################################################################
\ No newline at end of file
diff --git a/build/reindex/bin/setup-prerequisites.sh b/build/reindex/bin/setup-prerequisites.sh
new file mode 100644
index 00000000000..0c87d88ccea
--- /dev/null
+++ b/build/reindex/bin/setup-prerequisites.sh
@@ -0,0 +1,71 @@
+#!/usr/bin/env bash
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -ex
+
+# required_build - executes for every build
+required_build(){
+    # Clean up the packages and docker files not on the Mac
+    if [[ "$OSTYPE" != "darwin"* ]]
+    then
+        sudo apt clean
+        docker rmi $(docker image ls -aq)
+        df -h
+    fi
+
+    # build binaries
+    mvn -T2C -B install --file fhir-examples --no-transfer-progress
+    mvn -T2C -B install --file fhir-parent -DskipTests -P include-fhir-igs,integration --no-transfer-progress
+
+    # create and remove a 1 GB file to make sure we have the room needed later
+    df -h
+    dd if=/dev/urandom oflag=direct of=balloon.dat bs=1024k count=1000
+    rm -f balloon.dat
+    sudo apt clean
+    docker system prune -f
+    df -h
+
+    docker version
+
+    # Build dockerfile
+    cd fhir-install
+    docker build -t ibmcom/ibm-fhir-server:latest .
+    cd ..
+}
+
+# reindex_build - executes for each reindex type.
+reindex_build(){
+    reindex="${1}"
+    if [ -f "build/reindex/${reindex}/setup-prerequisites.sh" ]
+    then
+        echo "Running [${reindex}] setting setup prerequisites"
+        bash build/reindex/${reindex}/setup-prerequisites.sh
+    fi
+}
+
+###############################################################################
+# Store the current directory to reset to
+pushd $(pwd) > /dev/null
+
+if [ -z "${WORKSPACE}" ]
+then 
+    echo "The WORKSPACE value is unset"
+    exit -1
+fi 
+
+# Change to the release directory
+cd "${WORKSPACE}"
+
+required_build
+reindex_build "${1}"
+
+# Reset to Original Directory
+popd > /dev/null
+
+# EOF 
+###############################################################################
\ No newline at end of file
diff --git a/build/reindex/db2/.fhir.env b/build/reindex/db2/.fhir.env
new file mode 100644
index 00000000000..6612c66eb1e
--- /dev/null
+++ b/build/reindex/db2/.fhir.env
@@ -0,0 +1,3 @@
+# Environment values for FHIR
+BOOTSTRAP_DB=false
+FHIR_TRANSACTION_MANAGER_TIMEOUT=240s
\ No newline at end of file
diff --git a/build/reindex/db2/Dockerfile b/build/reindex/db2/Dockerfile
new file mode 100644
index 00000000000..da6e21732fc
--- /dev/null
+++ b/build/reindex/db2/Dockerfile
@@ -0,0 +1,21 @@
+# ----------------------------------------------------------------------------
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+# ----------------------------------------------------------------------------
+
+FROM ibmcom/db2
+
+# Create a non-admin user for the FHIR server to use to access db2
+RUN groupadd -g 1002 fhir && \
+    useradd -u 1002 -g fhir -M -d /database/config/fhirserver fhirserver && \
+    echo "change-password" | passwd --stdin fhirserver
+
+# Indicate that we expect to connect to the Db2 service on port 50000
+EXPOSE 50000
+
+# Set up the database configuration and build to be run by the main Db2 container configuration
+# per https://hub.docker.com/r/ibmcom/db2
+RUN mkdir /var/custom
+COPY create-database.sh /var/custom
+RUN chmod +x /var/custom/create-database.sh
diff --git a/build/reindex/db2/create-database.sh b/build/reindex/db2/create-database.sh
new file mode 100644
index 00000000000..3ce2b22ed79
--- /dev/null
+++ b/build/reindex/db2/create-database.sh
@@ -0,0 +1,38 @@
+#!/usr/bin/env bash
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+# Set the instance_memory and enable to trial license to avoid memory allocation failures.
+echo "Adding the 90-day trial license..."
+/opt/ibm/db2/V11.5/adm/db2licm -a /var/db2/db2trial.lic
+
+echo "Configuring automatic memory managment..."
+su - db2inst1 -c "db2 update dbm cfg using INSTANCE_MEMORY AUTOMATIC"
+
+# Create the FHIR database and give fhirserver access
+# Note Update transaction log file size (logfilsiz) to avoid
+# Note 32K pagesize is required
+
+# Create the database if it doesn't yet exist
+echo "Creating FHIRDB..."
+if [[ $(su - db2inst1 -c "db2 list db directory" | grep alias | grep FHIRDB | awk '{print $4}') == "FHIRDB" ]]; then
+  echo "FHIRDB exists - skipping create"
+else
+  su - db2inst1 -c "db2 CREATE DB FHIRDB using codeset UTF-8 territory us PAGESIZE 32768"
+  # See https://www.ibm.com/support/knowledgecenter/SSEPGG_11.1.0/com.ibm.db2.luw.admin.config.doc/doc/r0000338.html
+  # Was: CATALOGCACHE_SZ 300 1.2M
+  # Now: CATALOGCACHE_SZ 3000 12M
+  su - db2inst1 -c "db2 update db cfg for fhirdb using CATALOGCACHE_SZ 3000"
+  # Added log size 4K x 50 = 200M and configured logprimary and logsecond which should be sufficient
+  su - db2inst1 -c "db2 update db cfg for fhirdb using logfilsiz 50000"
+  su - db2inst1 -c "db2 update db cfg for fhirdb using logprimary 3"
+  su - db2inst1 -c "db2 update db cfg for fhirdb using logsecond 10"
+fi
+
+# To be properly idempotent, we always want to execute this, just in case it failed the first time
+su - db2inst1 -c "db2 \"connect to fhirdb\" && db2 \"grant connect on database TO USER fhirserver\""
+
+# EOF
\ No newline at end of file
diff --git a/build/reindex/db2/docker-compose.yml b/build/reindex/db2/docker-compose.yml
new file mode 100644
index 00000000000..12c61f06858
--- /dev/null
+++ b/build/reindex/db2/docker-compose.yml
@@ -0,0 +1,61 @@
+version: '3.9'
+services:
+  db:
+    image: test/fhir-db2
+    hostname: db2
+    privileged: true
+    tty: true
+    environment:
+      - LICENSE=accept
+      - DB2INST1_PASSWORD=change-password
+    ports:
+      - 50000:50000
+    volumes:
+      - type: bind
+        source: ./workarea/volumes/dist/db
+        target: /database
+        read_only: false
+    healthcheck:
+      test: id db2inst1 && su - db2inst1 -c 'db2 list db directory && exit 0' || exit -1
+      interval: 1m30s
+      timeout: 10s
+      retries: 3
+      start_period: 120s
+    networks:
+      - fhir
+  fhir:
+    image: ibmcom/ibm-fhir-server:latest
+    depends_on:
+      db:
+        condition: service_healthy
+    hostname: fhir
+    volumes:
+      - type: bind
+        source: ./workarea/volumes/dist/config
+        target: /opt/ol/wlp/usr/servers/defaultServer/config
+        read_only: true
+      - type: bind
+        source: ./workarea/volumes/dist/overrides
+        target: /opt/ol/wlp/usr/servers/defaultServer/configDropins/overrides
+        read_only: true
+      - type: bind
+        source: ./workarea/volumes/dist/userlib/
+        target: /opt/ol/wlp/usr/servers/defaultServer/userlib
+        read_only: true
+      - ./resources/startup.sh:/opt/ol/wlp/usr/servers/defaultServer/startup.sh
+    command: sh -c "chmod +x /opt/ol/wlp/usr/servers/defaultServer/startup.sh && /opt/ol/wlp/usr/servers/defaultServer/startup.sh"
+    healthcheck:
+      start_period: 120s
+      interval: 10s
+      timeout: 10s
+      retries: 2
+      test: curl --max-time 5 -v -f -k -u 'fhiruser:change-password' 'https://localhost:9443/fhir-server/api/v4/$$healthcheck'
+    ports:
+      - 9443:9443
+    env_file:
+      - ./.fhir.env
+    networks:
+      - fhir
+networks:
+  fhir:
+    driver: bridge
\ No newline at end of file
diff --git a/build/reindex/db2/pre-integration-test.sh b/build/reindex/db2/pre-integration-test.sh
new file mode 100644
index 00000000000..efc685e62ce
--- /dev/null
+++ b/build/reindex/db2/pre-integration-test.sh
@@ -0,0 +1,173 @@
+#!/usr/bin/env bash
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -ex
+
+# pre_integration
+pre_integration(){
+    cleanup
+    setup_docker
+    config
+    bringup
+}
+
+# setup_docker - setup docker
+setup_docker(){
+    docker build -t test/fhir-db2 .
+}
+
+# config - update configuration
+config(){
+    DIST="${WORKSPACE}/build/reindex/db2/workarea/volumes/dist"
+
+    echo "Create the db volume..."
+    mkdir -p ${DIST}/db
+
+    # Setup the Configurations for Reindex
+    echo "Copying fhir configuration files..."
+    mkdir -p ${DIST}/config
+    cp -pr ${WORKSPACE}/fhir-server/liberty-config/config $DIST
+    cp -pr ${WORKSPACE}/fhir-server/liberty-config-tenants/config/* $DIST/config
+
+    echo "Copying test artifacts to install location..."
+    USERLIB="${DIST}/userlib"
+    mkdir -p "${USERLIB}"
+    find ${WORKSPACE}/conformance -iname 'fhir-ig*.jar' -not -iname 'fhir*-tests.jar' -not -iname 'fhir*-test-*.jar' -exec cp -f {} ${USERLIB} \;
+
+    echo "Copying over the overrides for the datasource"
+    mkdir -p ${DIST}/overrides
+    cp ${WORKSPACE}/fhir-server/liberty-config/configDropins/disabled/datasource-db2.xml ${DIST}/overrides
+
+    # Move over the test configurations
+    echo "Copying over the fhir-server-config.json and updating publishing"
+    jq '.fhirServer.notifications.nats.enabled = false' ${DIST}/config/default/fhir-server-config-db2.json > ${DIST}/config/default/fhir-server-config-t.json
+    jq '.fhirServer.persistence.datasources.default.tenantKey = "change-password"' ${DIST}/config/default/fhir-server-config-t.json > ${DIST}/config/default/fhir-server-config.json
+
+    if [ $(jq -r '.fhirServer.core.serverRegistryResourceProviderEnabled' ${DIST}/config/default/fhir-server-config.json) = 'true' ]
+    then 
+        echo "serverRegistryResourceProviderEnabled is true"
+    else 
+        echo "serverRegistryResourceProviderEnabled is false, tests cannot run"
+        exit 1;
+    fi
+}
+
+# cleanup - cleanup existing docker
+cleanup(){
+    # Stand up a docker container running the fhir server configured for integration tests
+    echo "Bringing down any containers that might already be running as a precaution"
+    docker-compose kill
+    docker-compose rm -f
+}
+
+# bringup
+bringup(){
+    echo "Bringing up containers >>> Current time: " $(date)
+    # Startup db
+    docker-compose up --remove-orphans -d db
+    cx=0
+    while [ $(docker container inspect db2_db_1 | jq -r '.[] | select (.Config.Hostname == "db2").State.Status' | wc -l) -gt 0 ] && [ $(docker container inspect db2_db_1 | jq -r '.[] | select (.Config.Hostname == "db2").State.Running' | grep false | wc -l) -eq 1 ]
+    do
+        echo "Waiting on startup of db ${cx}"
+        cx=$((cx + 1))
+        if [ ${cx} -ge 300 ]
+        then
+            echo "Failed to start"
+        fi
+        sleep 1
+    done
+
+    # Startup FHIR
+    docker-compose up --remove-orphans -d fhir
+    cx=0
+    while [ $(docker container inspect db2_fhir_1 | jq -r '.[] | select (.Config.Hostname == "fhir").State.Status' | wc -l) -gt 0 ] && [ $(docker container inspect db2_fhir_1  | jq -r '.[] | select (.Config.Hostname == "fhir").State.Running' | grep false | wc -l) -eq 1 ]
+    do
+        echo "Waiting on startup of fhir ${cx}"
+        cx=$((cx + 1))
+        if [ ${cx} -ge 300 ]
+        then
+            echo "Failed to start fhir"
+        fi
+        sleep 1
+    done
+
+    # Gather up all the server logs so we can trouble-shoot any problems during startup
+    pre_it_logs=${WORKSPACE}/pre-it-logs
+    rm -rf ${pre_it_logs} 2>/dev/null
+    mkdir -p ${pre_it_logs}
+
+    zip_file=${WORKSPACE}/pre-it-logs.zip
+    rm -f ${zip_file}
+
+    echo ""
+    echo "Docker container status:"
+    docker ps -a
+
+    containerId=$(docker ps -a | grep db2_fhir_1 | cut -d ' ' -f 1)
+    if [[ -z "${containerId}" ]]
+    then
+        echo "Warning: Could not find the fhir container!!!"
+    else
+        echo "fhir container id: ${containerId}"
+
+        # Grab the container's console log
+        docker logs ${containerId} > ${pre_it_logs}/docker-console.txt
+
+        echo "Gathering pre-test server logs from docker container: ${containerId}"
+        docker cp -L ${containerId}:/logs ${pre_it_logs}
+    fi
+
+    # Wait until the fhir server is up and running...
+    echo "Waiting for fhir-server to complete initialization..."
+    healthcheck_url='https://localhost:9443/fhir-server/api/v4/$healthcheck'
+    tries=0
+    status=0
+    while [ $status -ne 200 -a $tries -lt 30 ]; do
+        tries=$((tries + 1))
+
+        set +o errexit
+        cmd="curl -k -o ${WORKSPACE}/health.json --max-time 5 -I -w "%{http_code}" -u fhiruser:change-password $healthcheck_url"
+        echo "Executing[$tries]: $cmd"
+        status=$($cmd)
+        set -o errexit
+
+        echo "Status code: $status"
+        if [ $status -ne 200 ]
+        then
+            echo "Sleeping 30 secs..."
+            sleep 30
+        fi
+    done
+
+    if [ $status -ne 200 ]
+    then
+        echo "Could not establish a connection to the fhir-server within $tries REST API invocations!"
+        exit 1
+    fi
+
+    echo "The fhir-server appears to be running..."
+}
+
+# is_ready_to_run - is this ready to run?
+is_ready_to_run(){
+    echo "Preparing environment for fhir-server integration tests..."
+    if [ -z "${WORKSPACE}" ]
+    then
+        echo "ERROR: WORKSPACE environment variable not set!"
+        exit 1
+    fi
+}
+
+###############################################################################
+is_ready_to_run
+
+cd build/reindex/db2
+pre_integration
+
+# EOF
+###############################################################################
diff --git a/build/reindex/db2/resources/startup.sh b/build/reindex/db2/resources/startup.sh
new file mode 100755
index 00000000000..2170f335958
--- /dev/null
+++ b/build/reindex/db2/resources/startup.sh
@@ -0,0 +1,27 @@
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -ex
+set -o pipefail
+
+if [ ! -f /opt/ibm-fhir-server/tools/tenant.key ]
+then
+    echo 'change-password' > /opt/ibm-fhir-server/tools/tenant.key
+    java -jar /opt/ibm-fhir-server/tools/fhir-persistence-schema-*-cli.jar \
+        --db-type db2 --prop db.host=db2 --prop db.port=50000 --prop db.database=fhirdb --prop user=db2inst1 --prop password=change-password \
+        --create-schemas
+    java -jar /opt/ibm-fhir-server/tools/fhir-persistence-schema-*-cli.jar \
+        --db-type db2 --prop db.host=db2 --prop db.port=50000 --prop db.database=fhirdb --prop user=db2inst1 --prop password=change-password \
+        --update-schema
+    java -jar /opt/ibm-fhir-server/tools/fhir-persistence-schema-*-cli.jar \
+        --db-type db2 --prop db.host=db2 --prop db.port=50000 --prop db.database=fhirdb --prop user=db2inst1 --prop password=change-password \
+        --allocate-tenant default --tenant-key-file /opt/ibm-fhir-server/tools/tenant.key --grant-to fhirserver
+fi
+
+/opt/ol/wlp/bin/server run
+
+# EOF
\ No newline at end of file
diff --git a/build/reindex/derby/.fhir.env b/build/reindex/derby/.fhir.env
new file mode 100644
index 00000000000..146d3a83ca8
--- /dev/null
+++ b/build/reindex/derby/.fhir.env
@@ -0,0 +1,3 @@
+# Environment values for FHIR
+BOOTSTRAP_DB=true
+FHIR_TRANSACTION_MANAGER_TIMEOUT=240s
\ No newline at end of file
diff --git a/build/reindex/derby/docker-compose.yml b/build/reindex/derby/docker-compose.yml
new file mode 100644
index 00000000000..b4d5c4363ae
--- /dev/null
+++ b/build/reindex/derby/docker-compose.yml
@@ -0,0 +1,25 @@
+version: '3.9'
+services:
+  fhir:
+    image: ibmcom/ibm-fhir-server:latest
+    hostname: fhir
+    volumes:
+      - type: bind
+        source: ./workarea/volumes/dist/config
+        target: /opt/ol/wlp/usr/servers/defaultServer/config
+        read_only: true
+      - type: bind
+        source: ./workarea/volumes/dist/userlib/
+        target: /opt/ol/wlp/usr/servers/defaultServer/userlib
+        read_only: true
+    command: bash -c "/opt/ol/wlp/bin/server run"
+    healthcheck:
+      start_period: 120s
+      interval: 10s
+      timeout: 10s
+      retries: 2
+      test: curl --max-time 5 -v -f -k -u 'fhiruser:change-password' 'https://localhost:9443/fhir-server/api/v4/$$healthcheck'
+    ports:
+      - 9443:9443
+    env_file:
+      - ./.fhir.env
\ No newline at end of file
diff --git a/build/reindex/derby/pre-integration-test.sh b/build/reindex/derby/pre-integration-test.sh
new file mode 100644
index 00000000000..231d37e8e30
--- /dev/null
+++ b/build/reindex/derby/pre-integration-test.sh
@@ -0,0 +1,148 @@
+#!/usr/bin/env bash
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -ex
+
+# pre_integration
+pre_integration() {
+    cleanup
+    config
+    bringup
+}
+
+# config - update configuration
+config() {
+    DIST="${WORKSPACE}/build/reindex/derby/workarea/volumes/dist"
+    echo "Create the db volume..."
+    mkdir -p "${DIST}/db"
+
+    # Setup the Configurations for Reindex
+    echo "Copying fhir configuration files..."
+    mkdir -p "${DIST}/config"
+    cp -pr "${WORKSPACE}/fhir-server/liberty-config/config" "$DIST"
+    cp -pr ${WORKSPACE}/fhir-server/liberty-config-tenants/config/* "$DIST/config"
+
+    echo "Copying test artifacts to install location..."
+    USERLIB="${DIST}/userlib"
+    mkdir -p "${USERLIB}"
+    find "${WORKSPACE}/conformance" -iname 'fhir-ig*.jar' -not -iname 'fhir*-tests.jar' -not -iname 'fhir*-test-*.jar' -exec cp -f {} "${USERLIB}" \;
+
+    # Move over the test configurations
+    echo "Checking dynamic resource provider"
+    if [ "$(jq -r '.fhirServer.core.serverRegistryResourceProviderEnabled' ${DIST}/config/default/fhir-server-config.json)" = "true" ]
+    then 
+        echo "serverRegistryResourceProviderEnabled is true"
+    else 
+        echo "serverRegistryResourceProviderEnabled is false, tests cannot run"
+        exit 1;
+    fi
+
+}
+
+# cleanup - cleanup existing docker
+cleanup() {
+    # Stand up a docker container running the fhir server configured for integration tests
+    echo "Bringing down any containers that might already be running as a precaution"
+    docker-compose kill
+    docker-compose rm -f
+}
+
+# bringup
+bringup() {
+    echo "Bringing up containers"
+    docker-compose up --remove-orphans -d
+    echo ">>> Current time: $(date)"
+
+    # Startup FHIR
+    cx=0
+    while [ $(docker container inspect derby_fhir_1 | jq -r '.[] | select (.Config.Hostname == "fhir").State.Status' | wc -l) -gt 0 ] && [ $(docker container inspect derby_fhir_1 | jq -r '.[] | select (.Config.Hostname == "fhir").State.Running' | grep false | wc -l) -eq 1 ]
+    do
+        echo "Waiting on startup of fhir ${cx}"
+        cx=$((cx + 1))
+        if [ ${cx} -ge 300 ]
+        then
+            echo "Failed to start fhir"
+        fi
+        sleep 1
+    done
+
+    # Gather up all the server logs so we can trouble-shoot any problems during startup
+    pre_it_logs=${WORKSPACE}/pre-it-logs
+    zip_file=${WORKSPACE}/pre-it-logs.zip
+    rm -rf "${pre_it_logs}" 2>/dev/null
+    mkdir -p "${pre_it_logs}"
+    rm -f "${zip_file}"
+
+    echo "Docker container status:"
+    docker ps -a
+
+    containerId=$(docker ps -a | grep derby_fhir_1 | cut -d ' ' -f 1)
+    if [ -z "${containerId}" ]
+    then
+        echo "Warning: Could not find the fhir container!!!"
+    else
+        echo "fhir container id: ${containerId}"
+
+        # Grab the container's console log
+        docker logs ${containerId} > ${pre_it_logs}/docker-console.txt
+
+        echo "Gathering pre-test server logs from docker container: ${containerId}"
+        docker cp -L ${containerId}:/logs ${pre_it_logs}
+    fi
+
+    # Wait until the fhir server is up and running...
+    echo "Waiting for fhir-server to complete initialization..."
+    healthcheck_url='https://localhost:9443/fhir-server/api/v4/$healthcheck'
+    tries=0
+    status=0
+    while [ $status -ne 200 ] && [ $tries -lt 30 ]
+    do
+        tries=$((tries + 1))
+
+        set +o errexit
+        cmd="curl -k -o ${WORKSPACE}/health.json --max-time 5 -I -w "%{http_code}" -u fhiruser:change-password $healthcheck_url"
+        echo "Executing[$tries]: $cmd"
+        status=$($cmd)
+        set -o errexit
+
+        echo "Status code: $status"
+        if [ $status -ne 200 ]
+        then
+            echo "Sleeping 30 secs..."
+            sleep 30
+        fi
+    done
+
+    if [ $status -ne 200 ]
+    then
+        echo "Could not establish a connection to the fhir-server within $tries REST API invocations!"
+        exit 1
+    fi
+
+    echo "The fhir-server appears to be running..."
+    exit 0
+}
+
+# is_ready_to_run - is this ready to run?
+is_ready_to_run() {
+    echo "Preparing environment for fhir-server integration tests..."
+    if [ -z "${WORKSPACE}" ]
+    then
+        echo "ERROR: WORKSPACE environment variable not set!"
+        exit 1
+    fi
+}
+
+###############################################################################
+is_ready_to_run
+
+cd build/reindex/derby
+pre_integration
+
+# EOF
+###############################################################################
diff --git a/build/reindex/postgres/.fhir.env b/build/reindex/postgres/.fhir.env
new file mode 100644
index 00000000000..6612c66eb1e
--- /dev/null
+++ b/build/reindex/postgres/.fhir.env
@@ -0,0 +1,3 @@
+# Environment values for FHIR
+BOOTSTRAP_DB=false
+FHIR_TRANSACTION_MANAGER_TIMEOUT=240s
\ No newline at end of file
diff --git a/build/reindex/postgres/Dockerfile b/build/reindex/postgres/Dockerfile
new file mode 100644
index 00000000000..445c84109d5
--- /dev/null
+++ b/build/reindex/postgres/Dockerfile
@@ -0,0 +1,31 @@
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+FROM postgres:12.6-alpine
+
+# Hard Coded environment values
+ENV POSTGRES_DB fhirdb
+ENV POSTGRES_USER postgres
+ENV PGDATA /db/data
+ENV LANG en_US.utf8
+
+# Create a working data directory
+VOLUME /db
+WORKDIR /db
+
+# Open up the port
+EXPOSE 5432
+
+# Load db resources
+COPY --chown=postgres:postgres resources/db.sql /docker-entrypoint-initdb.d/db.sql
+COPY --chown=postgres:postgres resources/docker-entrypoint.sh /docker-entrypoint.sh
+RUN chmod 755 /docker-entrypoint.sh
+
+# Add the fhiradmin user
+RUN addgroup -S fhir && adduser -S fhiradmin -G fhir
+RUN echo "fhiradmin:change-password" | chpasswd
+
+ENTRYPOINT ["/docker-entrypoint.sh"]
\ No newline at end of file
diff --git a/build/reindex/postgres/docker-compose.yml b/build/reindex/postgres/docker-compose.yml
new file mode 100644
index 00000000000..c88022621b7
--- /dev/null
+++ b/build/reindex/postgres/docker-compose.yml
@@ -0,0 +1,70 @@
+version: '3.9'
+services:
+  db:
+    image: test/fhir-pg
+    shm_size: 256MB
+    tty: true
+    stdin_open: true
+    hostname: postgres_postgres_1
+    volumes:
+      - type: bind
+        source: ./workarea/volumes/dist/db
+        target: /db
+    # Stop Grace Period - 30 seconds
+    stop_grace_period: 30s
+    sysctls:
+      net.core.somaxconn: 256
+      net.ipv4.tcp_syncookies: 0
+      # To use all of 2 gigabytes
+      kernel.shmmax: 1055092736
+      kernel.shmall: 257591
+    privileged: true
+    command: tail -f /dev/null
+    environment:
+      PG_TRUST_LOCALNET: 'true'
+    healthcheck:
+      start_period: 21s
+      test: ["CMD-SHELL", "pg_isready -d fhirdb -U fhiradmin"]
+      interval: 10s
+      timeout: 5s
+      retries: 3
+    networks:
+      - fhir
+    ports:
+      - 5432:5432
+  fhir:
+    image: ibmcom/ibm-fhir-server:latest
+    hostname: fhir
+    volumes:
+      - type: bind
+        source: ./workarea/volumes/dist/config
+        target: /opt/ol/wlp/usr/servers/defaultServer/config
+        read_only: true
+      - type: bind
+        source: ./workarea/volumes/dist/overrides
+        target: /opt/ol/wlp/usr/servers/defaultServer/configDropins/overrides
+        read_only: true
+      - type: bind
+        source: ./workarea/volumes/dist/userlib/
+        target: /opt/ol/wlp/usr/servers/defaultServer/userlib
+        read_only: true
+    command: bash -c "
+      java -jar /opt/ibm-fhir-server/tools/fhir-persistence-schema-*-cli.jar --db-type postgresql --prop db.host=postgres_postgres_1 --prop db.port=5432 --prop db.database=fhirdb --prop user=fhiradmin --prop password=change-password --update-schema --grant-to fhirserver &&
+      /opt/ol/wlp/bin/server run"
+    healthcheck:
+      start_period: 32s
+      interval: 30s
+      timeout: 5s
+      retries: 3
+      test: curl -k -u 'fhiruser:change-password' 'https://localhost:9443/fhir-server/api/v4/$$healthcheck'
+    ports:
+      - 9080:9080
+      - 9443:9443
+    depends_on:
+      db:
+        condition: service_healthy
+    networks:
+      - fhir
+networks:
+  fhir:
+    driver: bridge
\ No newline at end of file
diff --git a/build/reindex/postgres/pre-integration-test.sh b/build/reindex/postgres/pre-integration-test.sh
new file mode 100644
index 00000000000..2822a700fb9
--- /dev/null
+++ b/build/reindex/postgres/pre-integration-test.sh
@@ -0,0 +1,175 @@
+#!/usr/bin/env bash
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -ex
+
+DIST="${WORKSPACE}/build/reindex/postgres/workarea/volumes/dist"
+
+# pre_integration
+pre_integration(){
+    cleanup
+    setup_docker
+    config
+    bringup
+}
+
+# setup_docker - setup docker
+setup_docker(){
+    docker build -t test/fhir-pg .
+}
+
+# config - update configuration
+config(){
+    DIST="${WORKSPACE}/build/reindex/postgres/workarea/volumes/dist"
+
+    echo "Create the db volume..."
+    mkdir -p ${DIST}/db
+
+    # Setup the Configurations for Reindex
+    echo "Copying fhir configuration files..."
+    mkdir -p ${DIST}/config
+    cp -pr ${WORKSPACE}/fhir-server/liberty-config/config $DIST
+    cp -pr ${WORKSPACE}/fhir-server/liberty-config-tenants/config/* $DIST/config
+
+    echo "Copying test artifacts to install location..."
+    USERLIB="${DIST}/userlib"
+    mkdir -p "${USERLIB}"
+    find ${WORKSPACE}/conformance -iname 'fhir-ig*.jar' -not -iname 'fhir*-tests.jar' -not -iname 'fhir*-test-*.jar' -exec cp -f {} ${USERLIB} \;
+
+    echo "Copying over the overrides for the datasource"
+    mkdir -p ${DIST}/overrides
+    cp ${WORKSPACE}/fhir-server/liberty-config/configDropins/disabled/datasource-postgresql.xml ${DIST}/overrides
+
+    # Move over the test configurations
+    echo "Copying over the fhir-server-config.json and updating"
+    mv ${DIST}/config/default/fhir-server-config-postgresql.json \
+        ${DIST}/config/default/fhir-server-config.json
+
+    if [ $(jq -r '.fhirServer.core.serverRegistryResourceProviderEnabled' ${DIST}/config/default/fhir-server-config.json) = 'true' ]
+    then 
+        echo "serverRegistryResourceProviderEnabled is true"
+    else 
+        echo "serverRegistryResourceProviderEnabled is false, tests cannot run"
+        exit 1;
+    fi
+}
+
+# cleanup - cleanup existing docker
+cleanup(){
+    # Stand up a docker container running the fhir server configured for integration tests
+    echo "Bringing down any containers that might already be running as a precaution"
+    docker-compose kill
+    docker-compose rm -f
+}
+
+# bringup
+bringup(){
+    echo "Bringing up containers >>> Current time: " $(date)
+    # Startup db
+    docker-compose up --remove-orphans -d db
+    cx=0
+    while [ $(docker container inspect postgres_db_1 | jq -r '.[] | select (.Config.Hostname == "postgres_postgres_1").State.Status' | wc -l) -gt 0 ] && [ $(docker container inspect postgres_db_1 | jq -r '.[] | select (.Config.Hostname == "postgres_postgres_1").State.Running' | grep false | wc -l) -eq 1 ]
+    do
+        echo "Waiting on startup of db ${cx}"
+        cx=$((cx + 1))
+        if [ ${cx} -ge 300 ]
+        then
+            echo "Failed to start"
+        fi
+        sleep 1
+    done
+
+    # Startup FHIR
+    docker-compose up --remove-orphans -d fhir
+    cx=0
+    while [ $(docker container inspect postgres_fhir_1 | jq -r '.[] | select (.Config.Hostname == "fhir").State.Status' | wc -l) -gt 0 ] && [ $(docker container inspect postgres_fhir_1 | jq -r '.[] | select (.Config.Hostname == "fhir").State.Running' | grep false | wc -l) -eq 1 ]
+    do
+        echo "Waiting on startup of fhir ${cx}"
+        cx=$((cx + 1))
+        if [ ${cx} -ge 300 ]
+        then
+            echo "Failed to start fhir"
+        fi
+        sleep 1
+    done
+
+    # Gather up all the server logs so we can trouble-shoot any problems during startup
+    cd -
+    pre_it_logs=${WORKSPACE}/pre-it-logs
+    zip_file=${WORKSPACE}/pre-it-logs.zip
+    rm -rf "${pre_it_logs}" 2>/dev/null
+    mkdir -p "${pre_it_logs}"
+    rm -f "${zip_file}"
+
+    echo "
+    Docker container status:"
+    docker ps -a
+
+    containerId=$(docker ps -a | grep postgres_fhir-server_1 | cut -d ' ' -f 1)
+    if [[ -z "${containerId}" ]]
+    then
+        echo "Warning: Could not find the fhir container!!!"
+    else
+        echo "fhir container id: ${containerId}"
+
+        # Grab the container's console log
+        docker logs ${containerId} > ${pre_it_logs}/docker-console.txt
+
+        echo "Gathering pre-test server logs from docker container: ${containerId}"
+        docker cp -L ${containerId}:/logs ${pre_it_logs}
+    fi
+
+    # Wait until the fhir server is up and running...
+    echo "Waiting for fhir-server to complete initialization..."
+    healthcheck_url='https://localhost:9443/fhir-server/api/v4/$healthcheck'
+    tries=0
+    status=0
+    while [ $status -ne 200 -a $tries -lt 30 ]; do
+        tries=$((tries + 1))
+
+        set +o errexit
+        cmd="curl -k -o ${WORKSPACE}/health.json --max-time 5 -I -w "%{http_code}" -u fhiruser:change-password $healthcheck_url"
+        echo "Executing[$tries]: $cmd"
+        status=$($cmd)
+        set -o errexit
+
+        echo "Status code: $status"
+        if [ $status -ne 200 ]
+        then
+            echo "Sleeping 30 secs..."
+            sleep 30
+        fi
+    done
+
+    if [ $status -ne 200 ]
+    then
+        echo "Could not establish a connection to the fhir-server within $tries REST API invocations!"
+        exit 1
+    fi
+
+    echo "The fhir-server appears to be running..."
+}
+
+# is_ready_to_run - is this ready to run?
+is_ready_to_run(){
+    echo "Preparing environment for fhir-server integration tests..."
+    if [ -z "${WORKSPACE}" ]
+    then
+        echo "ERROR: WORKSPACE environment variable not set!"
+        exit 1
+    fi
+}
+
+###############################################################################
+is_ready_to_run
+
+cd build/reindex/postgres
+pre_integration
+
+# EOF
+###############################################################################
diff --git a/build/reindex/postgres/resources/db.sql b/build/reindex/postgres/resources/db.sql
new file mode 100644
index 00000000000..ec0c39a3114
--- /dev/null
+++ b/build/reindex/postgres/resources/db.sql
@@ -0,0 +1,36 @@
+-- ##############################################################################
+-- (C) Copyright IBM Corp. 2021
+--
+-- SPDX-License-Identifier: Apache-2.0
+-- ###############################################################################
+
+-- Create the users
+CREATE USER fhirbatch  WITH LOGIN encrypted password 'change-password';
+CREATE USER fhirserver WITH LOGIN encrypted password 'change-password';
+
+GRANT CONNECT ON DATABASE fhirdb TO fhirserver;
+GRANT CONNECT ON DATABASE fhirdb TO fhirbatch;
+
+CREATE SCHEMA IF NOT EXISTS fhirdata;
+CREATE SCHEMA IF NOT EXISTS fhir_admin;
+CREATE SCHEMA IF NOT EXISTS fhir_oauth;
+CREATE SCHEMA IF NOT EXISTS fhir_jbatch;
+
+-- only for the fhiradmin user
+GRANT ALL ON schema fhirdata TO fhiradmin WITH GRANT OPTION;
+GRANT ALL ON schema fhir_admin TO fhiradmin WITH GRANT OPTION;
+GRANT ALL ON schema fhir_oauth TO fhiradmin WITH GRANT OPTION;
+GRANT ALL ON schema fhir_jbatch TO fhiradmin WITH GRANT OPTION;
+
+GRANT USAGE ON SCHEMA fhirdata to fhiradmin;
+GRANT USAGE ON SCHEMA fhir_oauth to fhiradmin;
+GRANT USAGE ON SCHEMA fhir_jbatch to fhiradmin;
+
+GRANT USAGE ON SCHEMA fhirdata to fhirserver;
+GRANT USAGE ON SCHEMA fhir_oauth to fhirserver;
+GRANT USAGE ON SCHEMA fhir_jbatch to fhirserver;
+
+GRANT USAGE ON SCHEMA fhirdata to fhirbatch;
+GRANT USAGE ON SCHEMA fhir_oauth to fhirbatch;
+GRANT USAGE ON SCHEMA fhir_jbatch to fhirbatch;
+-- EOF
diff --git a/build/reindex/postgres/resources/docker-entrypoint.sh b/build/reindex/postgres/resources/docker-entrypoint.sh
new file mode 100644
index 00000000000..73e0af642a2
--- /dev/null
+++ b/build/reindex/postgres/resources/docker-entrypoint.sh
@@ -0,0 +1,51 @@
+#!/usr/bin/env bash
+
+###############################################################################
+# (C) Copyright IBM Corp. 2021
+#
+# SPDX-License-Identifier: Apache-2.0
+###############################################################################
+
+set -o errexit
+set -o nounset
+set -o pipefail
+
+if [ ! -f /db/data/pg_hba.conf ]
+then
+    mkdir -p /db/data
+    chown -R postgres:postgres /db/data
+    su - postgres -c "/usr/local/bin/initdb -D /db/data"
+
+    # Let it listen on all ports
+    sed -ri "s!^#?(listen_addresses)\s*=\s*\S+.*!\1 = '*'!" /db/data/postgresql.conf
+
+    # Configuration
+    sed -i -e "s/^max_connections = .*$/max_connections = 100/" \
+           -e "s/^#max_prepared_transactions = .*$/max_prepared_transactions = 100/" \
+           -e "s/^#max_locks_per_transaction = .*$/max_locks_per_transaction = 128/" \
+           -e "s/^shared_buffers =.*$/shared_buffers = 4GB/" \
+           -e "s/^#effective_cache_size = 128MB.*$/effective_cache_size = 2GB/" \
+           -e "s/^#work_mem = 1MB.*$/work_mem = 1MB/" \
+           -e "s/^#maintenance_work_mem = 16MB.*$/maintenance_work_mem = 512MB/" \
+           -e "s/^#checkpoint_segments = .*$/checkpoint_segments = 32/" \
+           -e "s/^#checkpoint_completion_target = 0.5.*$/checkpoint_completion_target = 0.7/" \
+           -e "s/^#wal_buffers =.*$/wal_buffers = 16MB/" \
+           -e "s/^#default_statistics_target = 100.*$/default_statistics_target = 100/" /db/data/postgresql.conf
+
+    cat << EOF >> /db/data/pg_hba.conf
+
+host    all             all     0.0.0.0/0               md5
+EOF
+
+    su - postgres -c '/usr/local/bin/pg_ctl -D "/db/data" --wait --timeout=120 start'
+    # Create the FHIRADMIN user
+    su - postgres -c "/usr/local/bin/psql -c \"CREATE USER fhiradmin WITH LOGIN encrypted password 'change-password';\""
+    # Create the Database
+    su - postgres -c "/usr/local/bin/psql -c \"CREATE DATABASE fhirdb OWNER 'fhiradmin';\""
+    su - postgres -c '/usr/local/bin/psql --dbname=fhirdb -v ON_ERROR_STOP=1 < /docker-entrypoint-initdb.d/db.sql'
+else
+    su - postgres -c '/usr/local/bin/pg_ctl -D "/db/data" --wait --timeout=120 start'
+fi
+
+exec "$@"
+# EOF
diff --git a/build/release/bin/00_prep/0_install_packages.sh b/build/release/bin/00_prep/0_install_packages.sh
index d10e029babd..43a7a67e35b 100644
--- a/build/release/bin/00_prep/0_install_packages.sh
+++ b/build/release/bin/00_prep/0_install_packages.sh
@@ -11,4 +11,6 @@
 # gh (already installed in ubuntu 20.04)
 # docker tools (already installed in ubuntu 20.04)
 
-# EOF
\ No newline at end of file
+sudo apt-get install -f libxml-xpath-perl
+
+# EOF
diff --git a/build/release/bin/10_build/2_version.sh b/build/release/bin/10_build/2_version.sh
index 107a6667765..0857b5a7ae6 100644
--- a/build/release/bin/10_build/2_version.sh
+++ b/build/release/bin/10_build/2_version.sh
@@ -19,8 +19,13 @@ mvn versions:set  -f "fhir-examples" -DoldVersion="*" -DnewVersion="${BUILD_VERS
 mvn versions:set  -f "fhir-tools" -DoldVersion="*" -DnewVersion="${BUILD_VERSION}"
 mvn versions:set  -f "fhir-parent"  -DoldVersion="*" -DnewVersion="${BUILD_VERSION}"
 
-# Reconcile the versions. 
-mvn org.codehaus.mojo:versions-maven-plugin:2.7:set-property -Dproperty=fhir-examples.version -DnewVersion="${BUILD_VERSION}" -f fhir-parent
+# Reconcile the versions.
+FHIR_PARENT_VERSION=$(cat fhir-parent/pom.xml | xpath -q -e project/properties/fhir-examples.version/text\(\))
+FHIR_EXAMPLES_VERSION=$(cat fhir-examples/pom.xml | xpath -q -e project/version/text\(\))
+if [[ "${FHIR_PARENT_VERSION}" == "${FHIR_EXAMPLES_VERSION}" ]]
+then
+    mvn org.codehaus.mojo:versions-maven-plugin:2.7:set-property -Dproperty=fhir-examples.version -DnewVersion="${BUILD_VERSION}" -f fhir-parent
+fi
 mvn org.codehaus.mojo:versions-maven-plugin:2.7:set-property -Dproperty=fhir-tools.version -DnewVersion="${BUILD_VERSION}" -f fhir-parent
 
 # EOF
\ No newline at end of file
diff --git a/build/release/bin/30_release/0_sonatype.sh b/build/release/bin/30_release/0_sonatype.sh
index 76c183e7b0f..65733e00ee3 100644
--- a/build/release/bin/30_release/0_sonatype.sh
+++ b/build/release/bin/30_release/0_sonatype.sh
@@ -18,11 +18,19 @@ set -eu -o pipefail
 # with gpg:sign
 
 # fhir-examples
-export BUILD_PROFILES=" $(jq -r '.build[] | select(.type == "fhir-examples").profiles | map(.) | join(",")' build/release/config/release.json)"
-export BUILD_PROFILES="${BUILD_PROFILES},deploy-to-sonatype"
-mvn -T2C source:jar source:test-jar javadoc:jar gpg:sign deploy \
-    -DadditionalJOption=-Xdoclint:none \
-    -f fhir-examples -P "${BUILD_PROFILES}" -DskipTests
+# Reconcile the versions.
+FHIR_PARENT_VERSION=$(cat fhir-parent/pom.xml | xpath -q -e project/properties/fhir-examples.version/text\(\))
+FHIR_EXAMPLES_VERSION=$(cat fhir-examples/pom.xml | xpath -q -e project/version/text\(\))
+if [[ "${FHIR_PARENT_VERSION}" == "${FHIR_EXAMPLES_VERSION}" ]]
+then
+    export BUILD_PROFILES=" $(jq -r '.build[] | select(.type == "fhir-examples").profiles | map(.) | join(",")' build/release/config/release.json)"
+    export BUILD_PROFILES="${BUILD_PROFILES},deploy-to-sonatype"
+    mvn -T2C source:jar source:test-jar javadoc:jar gpg:sign deploy \
+        -DadditionalJOption=-Xdoclint:none \
+        -f fhir-examples -P "${BUILD_PROFILES}" -DskipTests
+else 
+    echo "Skipping"
+fi
 
 # fhir-parent
 # we hit 'gpg: signing failed: Cannot allocate memory' when running -T2C
diff --git a/build/release/bin/30_release/1_dockerhub.sh b/build/release/bin/30_release/1_dockerhub.sh
index 0f27e5206ae..1ce7a083b21 100644
--- a/build/release/bin/30_release/1_dockerhub.sh
+++ b/build/release/bin/30_release/1_dockerhub.sh
@@ -14,9 +14,17 @@ docker login -u "${DOCKERHUB_USERNAME}" -p "${DOCKERHUB_TOKEN}"
 export WORKSPACE=$(pwd)
 bash ${WORKSPACE}/fhir-install/src/main/docker/ibm-fhir-schematool/build.sh
 
-mvn dockerfile:build -f fhir-install
+# create and remove a 1 GB file to make sure we have the room needed later
+df -h
+dd if=/dev/urandom oflag=direct of=balloon.dat bs=1024k count=1000
+rm -f balloon.dat
+sudo apt clean
+docker system prune -f
+df -h
+
+mvn -B dockerfile:build -f fhir-install --no-transfer-progress -Dmaven.wagon.http.retryHandler.count=3
 mvn dockerfile:tag@tag-version -f fhir-install
 mvn dockerfile:push@push-version -f fhir-install
 mvn dockerfile:push@push-latest -f fhir-install
 
-# EOF
\ No newline at end of file
+# EOF
diff --git a/build/release/bin/30_release/2_https.sh b/build/release/bin/30_release/2_https.sh
index 712aae291dd..2571b98dd93 100644
--- a/build/release/bin/30_release/2_https.sh
+++ b/build/release/bin/30_release/2_https.sh
@@ -118,11 +118,6 @@ function deploy_via_curl {
 # deploy_zip_files - uploads the release specific zip files. 
 # --- don't add files that could be greater than 300M
 function deploy_zip_files { 
-    FILE=fhir-cli/target/fhir-cli.zip
-    MODULE=fhir-cli
-    FILE_TARGET_PATH="/com/ibm/fhir/${MODULE}/${BUILD_VERSION}/fhir-cli.zip"
-    upload_to_https "${MODULE}" "${FILE}" "${FILE_TARGET_PATH}"
-    
     FILE=fhir-validation/target/fhir-validation-distribution.zip
     MODULE=fhir-validation
     FILE_TARGET_PATH="/com/ibm/fhir/${MODULE}/${BUILD_VERSION}/fhir-validation-distribution.zip"
diff --git a/conformance/fhir-ig-carin-bb/CHANGELOG.md b/conformance/fhir-ig-carin-bb/CHANGELOG.md
index 05083238a82..673a64cefa9 100644
--- a/conformance/fhir-ig-carin-bb/CHANGELOG.md
+++ b/conformance/fhir-ig-carin-bb/CHANGELOG.md
@@ -1,4 +1,25 @@
 30 NOV 2020 - Initial Load
  - remove invalid <br/> tags from between <li> tags in CapabilityStatement-c4bb.json
  - move invalid <sup> tag into subsequent <p> tag in CapabilityStatement-c4bb.json 
- - removed invalid ImplementationGuide parameters `copyrightyear`, `releaselabel`, and more
\ No newline at end of file
+ - removed invalid ImplementationGuide parameters `copyrightyear`, `releaselabel`, and more
+ 
+02 JUN 2021 - service-date fixup
+-  backport CARIN BB 1.1.0 service-date fix to our packaged 1.0.1 version #2456 
+ - changed the FHIRPath expression from 
+   "ExplanationOfBenefit.billablePeriod | ExplanationOfBenefit.item.serviced as Date |  ExplanationOfBenefit.item.serviced as Period" to 
+   "ExplanationOfBenefit.billablePeriod | ExplanationOfBenefit.item.serviced"
+ - see https://jira.hl7.org/browse/FHIR-30443 for more detail
+ 
+ 03 JUN 2021 - updated `adjudication-has-amount-type-slice` constraints per: [https://jira.hl7.org/browse/FHIR-32337](https://jira.hl7.org/browse/FHIR-32337)
+ 
+```json
+{
+    "key": "adjudication-has-amount-type-slice",
+    "severity": "error",
+    "human": "If Adjudication is present, it must have at least one adjudicationamounttype slice",
+    "expression": "adjudication.exists() implies (adjudication.where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())",
+    "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+}
+```
+
+Changed the constraint location from: `ExplanationOfBenefit.item` and `ExplanationOfBenefit.item.adjudication` to `ExplanationOfBenefit` and `ExplanationOfBenefit.item` respectively in the `snapshot` and `differential` for the inpatient and outpatient Institutional EOBs.
diff --git a/conformance/fhir-ig-carin-bb/pom.xml b/conformance/fhir-ig-carin-bb/pom.xml
index 4140f7af953..eca9a059328 100644
--- a/conformance/fhir-ig-carin-bb/pom.xml
+++ b/conformance/fhir-ig-carin-bb/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-ig-carin-bb</artifactId>
diff --git a/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/SearchParameter-explanationofbenefit-service-date.json b/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/SearchParameter-explanationofbenefit-service-date.json
index ded4126c4ef..b88ec8f38d7 100644
--- a/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/SearchParameter-explanationofbenefit-service-date.json
+++ b/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/SearchParameter-explanationofbenefit-service-date.json
@@ -1 +1 @@
-{"resourceType":"SearchParameter","id":"explanationofbenefit-service-date","meta":{"versionId":"1","lastUpdated":"2020-03-31T06:41:13.000+00:00"},"text":{"status":"extensions","div":"<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>Standards Status</b>: trial-use</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-service-date\">http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-service-date</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: ExplanationOfBenefit_ServiceDate</p><p><b>status</b>: active</p><p><b>experimental</b>: false</p><p><b>date</b>: Mar 31, 2020, 9:48:45 AM</p><p><b>publisher</b>: HL7 Financial Management Working Group</p><p><b>contact</b>: HL7 Financial Management Working Group: <a href=\"http://www.hl7.org/Special/committees/fm/index.cfm\">http://www.hl7.org/Special/committees/fm/index.cfm</a>,<a href=\"mailto:fm@lists.HL7.org\">fm@lists.HL7.org</a></p><p><b>description</b>: Date of the service for the EOB. The service-date search parameter simplifies search, since a client doesn't need to know that for inpatient and outpatient institutional EOB dates they need to search by billablePeriod.period.start, for a pharmacy EOB by item.servicedDate, and for a professional and non-clinician EOB - by item.servicedPeriod.period.start.</p><p><b>jurisdiction</b>: <span title=\"Codes: {urn:iso:std:iso:3166 US}\">United States of America</span></p><p><b>code</b>: service-date</p><p><b>base</b>: ExplanationOfBenefit</p><p><b>type</b>: date</p><p><b>expression</b>: ExplanationOfBenefit.billablePeriod | ExplanationOfBenefit.item.serviced as Date |  ExplanationOfBenefit.item.serviced as Period</p><p><b>xpath</b>: f:ExplanationOfBenefit/f:billablePeriod | f:ExplanationOfBenefit/f:item/f:serviced/f:servicedDate | f:ExplanationOfBenefit/f:item/f:serviced/f:servicedPeriod</p><p><b>xpathUsage</b>: normal</p><p><b>comparator</b>: eq, ne, gt, ge, lt, le, sa, eb, ap</p></div>"},"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status","valueCode":"trial-use"}],"url":"http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-service-date","version":"1.0.0","name":"ExplanationOfBenefit_ServiceDate","status":"active","experimental":false,"date":"2020-03-31T09:48:45+00:00","publisher":"HL7 Financial Management Working Group","contact":[{"name":"HL7 Financial Management Working Group","telecom":[{"system":"url","value":"http://www.hl7.org/Special/committees/fm/index.cfm"},{"system":"email","value":"fm@lists.HL7.org"}]}],"description":"Date of the service for the EOB. The service-date search parameter simplifies search, since a client doesn't need to know that for inpatient and outpatient institutional EOB dates they need to search by billablePeriod.period.start, for a pharmacy EOB by item.servicedDate, and for a professional and non-clinician EOB - by item.servicedPeriod.period.start.","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"US"}]}],"code":"service-date","base":["ExplanationOfBenefit"],"type":"date","expression":"ExplanationOfBenefit.billablePeriod | ExplanationOfBenefit.item.serviced as Date |  ExplanationOfBenefit.item.serviced as Period","xpath":"f:ExplanationOfBenefit/f:billablePeriod | f:ExplanationOfBenefit/f:item/f:serviced/f:servicedDate | f:ExplanationOfBenefit/f:item/f:serviced/f:servicedPeriod","xpathUsage":"normal","comparator":["eq","ne","gt","ge","lt","le","sa","eb","ap"]}
\ No newline at end of file
+{"resourceType":"SearchParameter","id":"explanationofbenefit-service-date","meta":{"versionId":"1","lastUpdated":"2020-03-31T06:41:13.000+00:00"},"text":{"status":"extensions","div":"<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>Standards Status</b>: trial-use</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-service-date\">http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-service-date</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: ExplanationOfBenefit_ServiceDate</p><p><b>status</b>: active</p><p><b>experimental</b>: false</p><p><b>date</b>: Mar 31, 2020, 9:48:45 AM</p><p><b>publisher</b>: HL7 Financial Management Working Group</p><p><b>contact</b>: HL7 Financial Management Working Group: <a href=\"http://www.hl7.org/Special/committees/fm/index.cfm\">http://www.hl7.org/Special/committees/fm/index.cfm</a>,<a href=\"mailto:fm@lists.HL7.org\">fm@lists.HL7.org</a></p><p><b>description</b>: Date of the service for the EOB. The service-date search parameter simplifies search, since a client doesn't need to know that for inpatient and outpatient institutional EOB dates they need to search by billablePeriod.period.start, for a pharmacy EOB by item.servicedDate, and for a professional and non-clinician EOB - by item.servicedPeriod.period.start.</p><p><b>jurisdiction</b>: <span title=\"Codes: {urn:iso:std:iso:3166 US}\">United States of America</span></p><p><b>code</b>: service-date</p><p><b>base</b>: ExplanationOfBenefit</p><p><b>type</b>: date</p><p><b>expression</b>: ExplanationOfBenefit.billablePeriod | ExplanationOfBenefit.item.serviced</p><p><b>xpath</b>: f:ExplanationOfBenefit/f:billablePeriod | f:ExplanationOfBenefit/f:item/f:serviced/f:servicedDate | f:ExplanationOfBenefit/f:item/f:serviced/f:servicedPeriod</p><p><b>xpathUsage</b>: normal</p><p><b>comparator</b>: eq, ne, gt, ge, lt, le, sa, eb, ap</p></div>"},"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status","valueCode":"trial-use"}],"url":"http://hl7.org/fhir/us/carin-bb/SearchParameter/explanationofbenefit-service-date","version":"1.0.0","name":"ExplanationOfBenefit_ServiceDate","status":"active","experimental":false,"date":"2020-03-31T09:48:45+00:00","publisher":"HL7 Financial Management Working Group","contact":[{"name":"HL7 Financial Management Working Group","telecom":[{"system":"url","value":"http://www.hl7.org/Special/committees/fm/index.cfm"},{"system":"email","value":"fm@lists.HL7.org"}]}],"description":"Date of the service for the EOB. The service-date search parameter simplifies search, since a client doesn't need to know that for inpatient and outpatient institutional EOB dates they need to search by billablePeriod.period.start, for a pharmacy EOB by item.servicedDate, and for a professional and non-clinician EOB - by item.servicedPeriod.period.start.","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"US"}]}],"code":"service-date","base":["ExplanationOfBenefit"],"type":"date","expression":"ExplanationOfBenefit.billablePeriod | ExplanationOfBenefit.item.serviced","xpath":"f:ExplanationOfBenefit/f:billablePeriod | f:ExplanationOfBenefit/f:item/f:serviced/f:servicedDate | f:ExplanationOfBenefit/f:item/f:serviced/f:servicedPeriod","xpathUsage":"normal","comparator":["eq","ne","gt","ge","lt","le","sa","eb","ap"]}
\ No newline at end of file
diff --git a/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.json b/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.json
index 802fdc834af..e102a4692ad 100644
--- a/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.json
+++ b/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.json
@@ -1 +1,17800 @@
-{"resourceType":"StructureDefinition","id":"C4BB-ExplanationOfBenefit-Inpatient-Institutional","text":{"status":"extensions","div":"<div xmlns=\"http://www.w3.org/1999/xhtml\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the element can appear in the instance\">Card.</a></th><th style=\"width: 100px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the element\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_resource.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit\">ExplanationOfBenefit</a><a name=\"ExplanationOfBenefit\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: black; null\" title=\"This element has or is affected by some invariants (EOB-institutional-item-or-header-adjudication)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"StructureDefinition-C4BB-ExplanationOfBenefit.html\">C4BBExplanationOfBenefit</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of Benefit resource</span><br/><span style=\"font-weight:bold\">EOB-institutional-item-or-header-adjudication: </span>Institutional EOB:  Should have adjudication at the item or header level, but not both</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.type\">type</a><a name=\"ExplanationOfBenefit.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Category or discipline</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck101.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"http://terminology.hl7.org/2.0.0/CodeSystem-claim-type.html\">http://terminology.hl7.org/CodeSystem/claim-type</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">institutional</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.billablePeriod\">billablePeriod</a><a name=\"ExplanationOfBenefit.billablePeriod\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Period\">Period</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Relevant time frame for the claim</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.billablePeriod.start\">start</a><a name=\"ExplanationOfBenefit.billablePeriod.start\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Starting time with inclusive boundary</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.billablePeriod.end\">end</a><a name=\"ExplanationOfBenefit.billablePeriod.end\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">End time with inclusive boundary, if not ongoing</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.created\">created</a><a name=\"ExplanationOfBenefit.created\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Response creation date</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.provider\">provider</a><a name=\"ExplanationOfBenefit.provider\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-C4BB-Organization.html\">C4BB Organization</a>)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Party responsible for the claim</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam\">careTeam</a><a name=\"ExplanationOfBenefit.careTeam\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: black; null\" title=\"This element has or is affected by some invariants (EOB-inst-careTeam-practitioner, EOB-inst-careTeam-organization)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Care Team members</span><br/><span style=\"font-weight:bold\">EOB-inst-careTeam-practitioner: </span>Institutional EOB: Careteam roles refer to a practitioner<br/><span style=\"font-weight:bold\">EOB-inst-careTeam-organization: </span>Institutional EOB:  Careteam roles refer to an organization</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam.role\">role</a><a name=\"ExplanationOfBenefit.careTeam.role\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Function within the team</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimInstitutionalCareTeamRole.html\">C4BB Claim Institutional Care Team Role</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo\">supportingInfo</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"font-style: italic\">1</span><span style=\"font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Supporting information</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by pattern:category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus\" title=\"Slice billingnetworkcontractingstatus\">supportingInfo:billingnetworkcontractingstatus</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">billingnetworkcontractingstatus</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBPayerProviderContractingStatus.html\">C4BB Payer Provider Contracting Status</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admissionperiod\" title=\"Slice admissionperiod\">supportingInfo:admissionperiod</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admissionperiod.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">admissionperiod</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1352.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admissionperiod.timing[x]\">timing[x]</a><a name=\"ExplanationOfBenefit.supportingInfo.timing_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"font-style: italic\">1</span><span style=\"font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">When it occurred</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by type:$this</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admissionperiod.timingPeriod\">timingPeriod</a><a name=\"ExplanationOfBenefit.supportingInfo.timingPeriod\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Period\">Period</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">When it occurred</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate\" title=\"Slice clmrecvddate\">supportingInfo:clmrecvddate</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">clmrecvddate</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]\">timing[x]</a><a name=\"ExplanationOfBenefit.supportingInfo.timing_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">When it occurred</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill\" title=\"Slice typeofbill\">supportingInfo:typeofbill</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">typeofbill</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCTypeOfBill.html\">NUBC Type of Bill Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin\" title=\"Slice pointoforigin\">supportingInfo:pointoforigin</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">pointoforigin</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPointOfOriginForAdmissionOrVisit.html\">NUBC Point Of Origin</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype\" title=\"Slice admtype\">supportingInfo:admtype</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">admtype</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPriorityTypeOfAdmissionOrVisit.html\">NUBC Priority (Type) of Admission or Visit</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status\" title=\"Slice discharge-status\">supportingInfo:discharge-status</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">discharge-status</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPatientDischargeStatus.html\">NUBC Patient Discharge Status Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:drg\" title=\"Slice drg\">supportingInfo:drg</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:drg.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">drg</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:drg.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-CMSMS3MAPAPRDRG.html\">MS-DRGs - AP-DRGs - APR-DRGs</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis\">diagnosis</a><a name=\"ExplanationOfBenefit.diagnosis\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Pertinent diagnosis information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.sequence\">sequence</a><a name=\"ExplanationOfBenefit.diagnosis.sequence\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#positiveInt\">positiveInt</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Diagnosis instance identifier</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.diagnosis[x]\">diagnosis[x]</a><a name=\"ExplanationOfBenefit.diagnosis.diagnosis_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Nature of illness or problem</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-CDCICD910CMDiagnosisCodes.html\">Diagnosis Codes - International Classification of Diseases, Clinical Modification (ICD-9-CM, ICD-10-CM)</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.type\">type</a><a name=\"ExplanationOfBenefit.diagnosis.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Timing or nature of the diagnosis</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimInpatientInstitutionalDiagnosisType.html\">C4BB Claim Inpatient Institutional Diagnosis Type</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.onAdmission\">onAdmission</a><a name=\"ExplanationOfBenefit.diagnosis.onAdmission\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Present on admission</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPresentOnAdmission.html\">NUBC Present On Admission Indicator Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure\">procedure</a><a name=\"ExplanationOfBenefit.procedure\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Clinical procedures performed</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure.sequence\">sequence</a><a name=\"ExplanationOfBenefit.procedure.sequence\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#positiveInt\">positiveInt</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Procedure instance identifier</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure.type\">type</a><a name=\"ExplanationOfBenefit.procedure.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Category of Procedure</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimProcedureType.html\">C4BB Claim Procedure Type</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure.date\">date</a><a name=\"ExplanationOfBenefit.procedure.date\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">When the procedure was performed</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure.procedure[x]\">procedure[x]</a><a name=\"ExplanationOfBenefit.procedure.procedure_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Specific clinical procedure</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-CMSICD910PCSProcedureCodes.html\">Procedure Codes - International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - ICD-10 Procedure Coding System</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.insurance\">insurance</a><a name=\"ExplanationOfBenefit.insurance\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span>..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Patient insurance information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item\">item</a><a name=\"ExplanationOfBenefit.item\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.revenue\">revenue</a><a name=\"ExplanationOfBenefit.item.revenue\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Revenue or cost center code</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCRevenueCodes.html\">NUBC Revenue Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.productOrService\">productOrService</a><a name=\"ExplanationOfBenefit.item.productOrService\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Billing, service, product, or drug code</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AMACPTCMSHCPCSProcedureCodes.html\">Current Procedural Terminology (CPT) -  Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes - Procedure Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.modifier\">modifier</a><a name=\"ExplanationOfBenefit.item.modifier\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Product or service billing modifiers</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AMACPTCMSHCPCSModifiers.html\">Current Procedural Terminology (CPT) -  Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes - Procedure Modifier Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.quantity\">quantity</a><a name=\"ExplanationOfBenefit.item.quantity\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#SimpleQuantity\" title=\"Quantity\">SimpleQuantity</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Count of products or services</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication\">adjudication</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic\" title=\"This element must be supported\">S</span><span style=\"padding-left: 3px; padding-right: 3px; color: black; null; font-style: italic\" title=\"This element has or is affected by some invariants (adjudication-has-amount-type-slice)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Adjudication details</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Closed by pattern:category</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">adjudication-has-amount-type-slice: </span><span style=\"font-style: italic\">If Adjudication is present, it must have at least one adjudicationamounttype slice</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1033.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> adjudication:All Slices<a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudicationCategoryDiscriminator.html\">C4BB Adjudication Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">adjudication:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.item.adjudication.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Monetary amount</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason\" title=\"Slice denialreason\">adjudication:denialreason</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">denialreason</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason.reason\">reason</a><a name=\"ExplanationOfBenefit.item.adjudication.reason\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of adjudication outcome</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes.html\">X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits\" title=\"Slice allowedunits\">adjudication:allowedunits</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck102501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">allowedunits</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits.value\">value</a><a name=\"ExplanationOfBenefit.item.adjudication.value\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#decimal\">decimal</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Non-monitary value</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication\">adjudication</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic\" title=\"This element must be supported\">S</span><span style=\"padding-left: 3px; padding-right: 3px; color: black; null; font-style: italic\" title=\"This element has or is affected by some invariants (adjudication-has-amount-type-slice)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Header-level adjudication</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Closed by pattern:category</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">adjudication-has-amount-type-slice: </span><span style=\"font-style: italic\">If Adjudication is present, it must have at least one adjudicationamounttype slice</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck133.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> adjudication:All Slices<a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudicationCategoryDiscriminator.html\">C4BB Adjudication Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">adjudication:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Header-level adjudication</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.adjudication.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Monetary amount</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason\" title=\"Slice denialreason\">adjudication:denialreason</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Header-level adjudication</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">denialreason</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason.reason\">reason</a><a name=\"ExplanationOfBenefit.adjudication.reason\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of adjudication outcome</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes.html\">X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total\">total</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">1</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Adjudication totals</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by pattern:category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck133.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> total:All Slices<a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1330.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBTotalCategoryDiscriminator.html\">C4BB Total Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#extensible\" title=\"To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.\">extensible</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total.amount\">amount</a><a name=\"ExplanationOfBenefit.total.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Financial total for the category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">total:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication totals</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.total.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Financial total for the category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:inoutnetwork\" title=\"Slice inoutnetwork\">total:inoutnetwork</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication totals</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:inoutnetwork.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBPayerBenefitPaymentStatus.html\">C4BB Payer Benefit Payment Status</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.payment\">payment</a><a name=\"ExplanationOfBenefit.payment\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.payment.date\">date</a><a name=\"ExplanationOfBenefit.payment.date\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Expected date of payment</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.processNote\">processNote</a><a name=\"ExplanationOfBenefit.processNote\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.processNote.text\">text</a><a name=\"ExplanationOfBenefit.processNote.text\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Note explanatory text</span></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"},"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-category","valueString":"Financial.General"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category","valueCode":"patient"}],"url":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional","version":"1.0.0","name":"C4BBExplanationOfBenefitInpatientInstitutional","title":"C4BB ExplanationOfBenefit Inpatient Institutional","status":"active","date":"2020-11-23T16:49:10+00:00","publisher":"HL7 Financial Management Working Group","contact":[{"name":"HL7 Financial Management Working Group","telecom":[{"system":"url","value":"http://www.hl7.org/Special/committees/fm/index.cfm"},{"system":"email","value":"fm@lists.HL7.org"}]}],"description":"The profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for inpatient services, which may include the use of equipment and supplies, laboratory services, radiology services and other charges. Inpatient claims are submitted for services rendered at an institution as part of an overnight stay. \nThe claims data is based on the institutional claim format UB-04, submission standards adopted by the Department of Health and Human \nServices.","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"US"}]}],"fhirVersion":"4.0.1","mapping":[{"identity":"workflow","uri":"http://hl7.org/fhir/workflow","name":"Workflow Pattern"},{"identity":"w5","uri":"http://hl7.org/fhir/fivews","name":"FiveWs Pattern Mapping"},{"identity":"v2","uri":"http://hl7.org/v2","name":"HL7 v2 Mapping"},{"identity":"rim","uri":"http://hl7.org/v3","name":"RIM Mapping"}],"kind":"resource","abstract":false,"type":"ExplanationOfBenefit","baseDefinition":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit","derivation":"constraint","snapshot":{"element":[{"id":"ExplanationOfBenefit","path":"ExplanationOfBenefit","short":"Explanation of Benefit resource","definition":"This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.","alias":["EOB"],"min":0,"max":"*","base":{"path":"ExplanationOfBenefit","min":0,"max":"*"},"constraint":[{"key":"dom-2","severity":"error","human":"If the resource is contained in another resource, it SHALL NOT contain nested Resources","expression":"contained.contained.empty()","xpath":"not(parent::f:contained and f:contained)","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-3","severity":"error","human":"If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource","expression":"contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()","xpath":"not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-4","severity":"error","human":"If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated","expression":"contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()","xpath":"not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-5","severity":"error","human":"If a resource is contained in another resource, it SHALL NOT have a security label","expression":"contained.meta.security.empty()","xpath":"not(exists(f:contained/*/f:meta/f:security))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice","valueBoolean":true},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation","valueMarkdown":"When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."}],"key":"dom-6","severity":"warning","human":"A resource should have narrative for robust management","expression":"text.`div`.exists()","xpath":"exists(f:text/h:div)","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"EOB-institutional-item-or-header-adjudication","severity":"error","human":"Institutional EOB:  Should have adjudication at the item or header level, but not both","expression":"(adjudication.exists() != item.adjudication.exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"Entity. Role, or Act"},{"identity":"workflow","map":"Event"}]},{"id":"ExplanationOfBenefit.id","path":"ExplanationOfBenefit.id","short":"Logical id of this artifact","definition":"The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.","comment":"The only time that a resource does not have an id is when it is being submitted to the server using a create operation.","min":0,"max":"1","base":{"path":"Resource.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta","path":"ExplanationOfBenefit.meta","short":"Metadata about the resource","definition":"The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.","min":1,"max":"1","base":{"path":"Resource.meta","min":0,"max":"1"},"type":[{"code":"Meta"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.id","path":"ExplanationOfBenefit.meta.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.meta.extension","path":"ExplanationOfBenefit.meta.extension","slicing":{"discriminator":[{"type":"value","path":"url"}],"description":"Extensions are always sliced by (at least) url","rules":"open"},"short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.meta.versionId","path":"ExplanationOfBenefit.meta.versionId","short":"Version specific identifier","definition":"The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.","comment":"The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.","min":0,"max":"1","base":{"path":"Meta.versionId","min":0,"max":"1"},"type":[{"code":"id"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.lastUpdated","path":"ExplanationOfBenefit.meta.lastUpdated","short":"When the resource version last changed","definition":"When the resource last changed - e.g. when the version changed.","comment":"Defines the date the Resource was created or updated, whichever comes last (163). Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last","min":1,"max":"1","base":{"path":"Meta.lastUpdated","min":0,"max":"1"},"type":[{"code":"instant"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.source","path":"ExplanationOfBenefit.meta.source","short":"Identifies where the resource comes from","definition":"A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.","comment":"In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. \n\nThis element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.","min":0,"max":"1","base":{"path":"Meta.source","min":0,"max":"1"},"type":[{"code":"uri"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.profile","path":"ExplanationOfBenefit.meta.profile","short":"Profiles this resource claims to conform to","definition":"A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).","comment":"CPCDS data element (190)","min":1,"max":"*","base":{"path":"Meta.profile","min":0,"max":"*"},"type":[{"code":"canonical","targetProfile":["http://hl7.org/fhir/StructureDefinition/StructureDefinition"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.security","path":"ExplanationOfBenefit.meta.security","short":"Security Labels applied to this resource","definition":"Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.","comment":"The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.","min":0,"max":"*","base":{"path":"Meta.security","min":0,"max":"*"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"SecurityLabels"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"extensible","description":"Security Labels from the Healthcare Privacy and Security Classification System.","valueSet":"http://hl7.org/fhir/ValueSet/security-labels"}},{"id":"ExplanationOfBenefit.meta.tag","path":"ExplanationOfBenefit.meta.tag","short":"Tags applied to this resource","definition":"Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.","comment":"The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.","min":0,"max":"*","base":{"path":"Meta.tag","min":0,"max":"*"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Tags"}],"strength":"example","description":"Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\".","valueSet":"http://hl7.org/fhir/ValueSet/common-tags"}},{"id":"ExplanationOfBenefit.implicitRules","path":"ExplanationOfBenefit.implicitRules","short":"A set of rules under which this content was created","definition":"A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.","comment":"Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.","min":0,"max":"1","base":{"path":"Resource.implicitRules","min":0,"max":"1"},"type":[{"code":"uri"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":true,"isModifierReason":"This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation","isSummary":true},{"id":"ExplanationOfBenefit.language","path":"ExplanationOfBenefit.language","short":"Language of the resource content","definition":"The base language in which the resource is written.","comment":"Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).","min":0,"max":"1","base":{"path":"Resource.language","min":0,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet","valueCanonical":"http://hl7.org/fhir/ValueSet/all-languages"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Language"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"preferred","description":"A human language.","valueSet":"http://hl7.org/fhir/ValueSet/languages"}},{"id":"ExplanationOfBenefit.text","path":"ExplanationOfBenefit.text","short":"Text summary of the resource, for human interpretation","definition":"A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.","comment":"Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.","alias":["narrative","html","xhtml","display"],"min":0,"max":"1","base":{"path":"DomainResource.text","min":0,"max":"1"},"type":[{"code":"Narrative"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"Act.text?"}]},{"id":"ExplanationOfBenefit.contained","path":"ExplanationOfBenefit.contained","short":"Contained, inline Resources","definition":"These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.","comment":"This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.","alias":["inline resources","anonymous resources","contained resources"],"min":0,"max":"*","base":{"path":"DomainResource.contained","min":0,"max":"*"},"type":[{"code":"Resource"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.extension","path":"ExplanationOfBenefit.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"DomainResource.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.modifierExtension","path":"ExplanationOfBenefit.modifierExtension","short":"Extensions that cannot be ignored","definition":"May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"DomainResource.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them","isSummary":false,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.identifier","path":"ExplanationOfBenefit.identifier","short":"Business Identifier for the resource","definition":"A unique identifier assigned to this explanation of benefit.","comment":"Identifier assigned by a payer for a claim received from a provider or subscriber. It is not the same identifier as that assigned by a provider. (35)","requirements":"Allows EOBs to be distinguished and referenced.","min":1,"max":"*","base":{"path":"ExplanationOfBenefit.identifier","min":0,"max":"*"},"type":[{"code":"Identifier"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"mapping":[{"identity":"workflow","map":"Event.identifier"},{"identity":"w5","map":"FiveWs.identifier"}]},{"id":"ExplanationOfBenefit.identifier.id","path":"ExplanationOfBenefit.identifier.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.identifier.extension","path":"ExplanationOfBenefit.identifier.extension","slicing":{"discriminator":[{"type":"value","path":"url"}],"description":"Extensions are always sliced by (at least) url","rules":"open"},"short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.identifier.use","path":"ExplanationOfBenefit.identifier.use","short":"usual | official | temp | secondary | old (If known)","definition":"The purpose of this identifier.","comment":"Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.","requirements":"Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.","min":0,"max":"1","base":{"path":"Identifier.use","min":0,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":true,"isModifierReason":"This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.","isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"IdentifierUse"}],"strength":"required","description":"Identifies the purpose for this identifier, if known .","valueSet":"http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"},"mapping":[{"identity":"v2","map":"N/A"},{"identity":"rim","map":"Role.code or implied by context"}]},{"id":"ExplanationOfBenefit.identifier.type","path":"ExplanationOfBenefit.identifier.type","short":"Description of identifier","definition":"A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.","comment":"Indicates that the claim identifier is that assigned by a payer for a claim received from a provider or subscriber. (183)","requirements":"Allows users to make use of identifiers when the identifier system is not known.","min":1,"max":"1","base":{"path":"Identifier.type","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"binding":{"strength":"extensible","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimIdentifierType"},"mapping":[{"identity":"v2","map":"CX.5"},{"identity":"rim","map":"Role.code or implied by context"}]},{"id":"ExplanationOfBenefit.identifier.system","path":"ExplanationOfBenefit.identifier.system","short":"The namespace for the identifier value","definition":"Establishes the namespace for the value - that is, a URL that describes a set values that are unique.","comment":"Identifier.system is always case sensitive.","requirements":"There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.","min":0,"max":"1","base":{"path":"Identifier.system","min":0,"max":"1"},"type":[{"code":"uri"}],"example":[{"label":"General","valueUri":"http://www.acme.com/identifiers/patient"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"CX.4 / EI-2-4"},{"identity":"rim","map":"II.root or Role.id.root"},{"identity":"servd","map":"./IdentifierType"}]},{"id":"ExplanationOfBenefit.identifier.value","path":"ExplanationOfBenefit.identifier.value","short":"The value that is unique","definition":"The portion of the identifier typically relevant to the user and which is unique within the context of the system.","comment":"If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.","min":0,"max":"1","base":{"path":"Identifier.value","min":0,"max":"1"},"type":[{"code":"string"}],"example":[{"label":"General","valueString":"123456"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"CX.1 / EI.1"},{"identity":"rim","map":"II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"},{"identity":"servd","map":"./Value"}]},{"id":"ExplanationOfBenefit.identifier.period","path":"ExplanationOfBenefit.identifier.period","short":"Time period when id is/was valid for use","definition":"Time period during which identifier is/was valid for use.","min":0,"max":"1","base":{"path":"Identifier.period","min":0,"max":"1"},"type":[{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"CX.7 + CX.8"},{"identity":"rim","map":"Role.effectiveTime or implied by context"},{"identity":"servd","map":"./StartDate and ./EndDate"}]},{"id":"ExplanationOfBenefit.identifier.assigner","path":"ExplanationOfBenefit.identifier.assigner","short":"Organization that issued id (may be just text)","definition":"Organization that issued/manages the identifier.","comment":"The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.","min":0,"max":"1","base":{"path":"Identifier.assigner","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Organization"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"CX.4 / (CX.4,CX.9,CX.10)"},{"identity":"rim","map":"II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"},{"identity":"servd","map":"./IdentifierIssuingAuthority"}]},{"id":"ExplanationOfBenefit.status","path":"ExplanationOfBenefit.status","short":"active | cancelled | draft | entered-in-error","definition":"The status of the resource instance.","comment":"Claim processing status code (140).  Expected values are active or cancelled.  To comply with the CMS rule, draft EOBs are not required","requirements":"Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.status","min":1,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":true,"isModifierReason":"This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid","isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ExplanationOfBenefitStatus"}],"strength":"required","description":"A code specifying the state of the resource instance.","valueSet":"http://hl7.org/fhir/ValueSet/explanationofbenefit-status|4.0.1"},"mapping":[{"identity":"workflow","map":"Event.status"},{"identity":"w5","map":"FiveWs.status"}]},{"id":"ExplanationOfBenefit.type","path":"ExplanationOfBenefit.type","short":"Category or discipline","definition":"The category of claim, e.g. oral, pharmacy, vision, institutional, professional.","comment":"Specifies the type of claim. (e.g., inpatient insitutional, outpatient institutional, physician, etc.) (16).  Defines the Claims profiles.  Values from Claim Type Codes are required; a data absent reason is not allowed","requirements":"Claim type determine the general sets of business rules applied for information requirements and adjudication.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.type","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"patternCodeableConcept":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/claim-type","code":"institutional"}]},"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/ValueSet/claim-type"},"mapping":[{"identity":"workflow","map":"Event.code"},{"identity":"w5","map":"FiveWs.class"}]},{"id":"ExplanationOfBenefit.subType","path":"ExplanationOfBenefit.subType","short":"More granular claim type","definition":"A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.","comment":"This may contain the local bill type codes such as the US UB-04 bill type code.","requirements":"Some jurisdictions need a finer grained claim type for routing and adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.subType","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ClaimSubType"}],"strength":"example","description":"A more granular claim typecode.","valueSet":"http://hl7.org/fhir/ValueSet/claim-subtype"},"mapping":[{"identity":"w5","map":"FiveWs.class"}]},{"id":"ExplanationOfBenefit.use","path":"ExplanationOfBenefit.use","short":"claim | preauthorization | predetermination","definition":"A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.","comment":"Expected value is claim. The CMS rule applies to adjudicated claims; it does not require preauthorizations or predeterminations","requirements":"This element is required to understand the nature of the request for adjudication.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.use","min":1,"max":"1"},"type":[{"code":"code"}],"patternCode":"claim","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Use"}],"strength":"required","description":"Complete, proposed, exploratory, other.","valueSet":"http://hl7.org/fhir/ValueSet/claim-use|4.0.1"},"mapping":[{"identity":"w5","map":"FiveWs.class"}]},{"id":"ExplanationOfBenefit.patient","path":"ExplanationOfBenefit.patient","short":"The recipient of the products and services","definition":"The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought.","comment":"Identifier for a member assigned by the Payer.  If members receive ID cards, that is the identifier that should be provided. (1). The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction. Additional required path:EOB.insurance.coverage(Coverage).beneficiary(Patient).identifier","requirements":"The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.patient","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Event.subject"},{"identity":"w5","map":"FiveWs.subject[x]"},{"identity":"w5","map":"FiveWs.subject"}]},{"id":"ExplanationOfBenefit.billablePeriod","path":"ExplanationOfBenefit.billablePeriod","short":"Relevant time frame for the claim","definition":"The period for which charges are being submitted.","comment":"Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and prodeterminations. Typically line item dates of service should fall within the billing period if one is specified.","requirements":"A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.billablePeriod","min":0,"max":"1"},"type":[{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"w5","map":"FiveWs.done[x]"}]},{"id":"ExplanationOfBenefit.billablePeriod.id","path":"ExplanationOfBenefit.billablePeriod.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.billablePeriod.extension","path":"ExplanationOfBenefit.billablePeriod.extension","slicing":{"discriminator":[{"type":"value","path":"url"}],"description":"Extensions are always sliced by (at least) url","rules":"open"},"short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.billablePeriod.start","path":"ExplanationOfBenefit.billablePeriod.start","short":"Starting time with inclusive boundary","definition":"The start of the period. The boundary is inclusive.","comment":"The first day on the billing statement covering services rendered to the beneficiary (i.e. 'Statement Covers From Date’). (177)","min":0,"max":"1","base":{"path":"Period.start","min":0,"max":"1"},"type":[{"code":"dateTime"}],"condition":["per-1"],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"DR.1"},{"identity":"rim","map":"./low"}]},{"id":"ExplanationOfBenefit.billablePeriod.end","path":"ExplanationOfBenefit.billablePeriod.end","short":"End time with inclusive boundary, if not ongoing","definition":"The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.","comment":"The last day on the billing statement covering services rendered to the beneficiary (i.e. 'Statement Covers Thru Date’). (178)","min":0,"max":"1","base":{"path":"Period.end","min":0,"max":"1"},"type":[{"code":"dateTime"}],"meaningWhenMissing":"If the end of the period is missing, it means that the period is ongoing","condition":["per-1"],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"DR.2"},{"identity":"rim","map":"./high"}]},{"id":"ExplanationOfBenefit.created","path":"ExplanationOfBenefit.created","short":"Response creation date","definition":"The date this resource was created.","comment":"Date the claim was adjudicated (179)","requirements":"Need to record a timestamp for use by both the recipient and the issuer.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.created","min":1,"max":"1"},"type":[{"code":"dateTime"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Event.occurrence[x]"},{"identity":"w5","map":"FiveWs.recorded"}]},{"id":"ExplanationOfBenefit.enterer","path":"ExplanationOfBenefit.enterer","short":"Author of the claim","definition":"Individual who created the claim, predetermination or preauthorization.","requirements":"Some jurisdictions require the contact information for personnel completing claims.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.enterer","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Practitioner","http://hl7.org/fhir/StructureDefinition/PractitionerRole"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"workflow","map":"Event.performer.agent"},{"identity":"w5","map":"FiveWs.author"}]},{"id":"ExplanationOfBenefit.insurer","path":"ExplanationOfBenefit.insurer","short":"Party responsible for reimbursement","definition":"The party responsible for authorization, adjudication and reimbursement.","comment":"Code of the payer responsible for the claim (2, 5).  Same as insurance.coverage.organization.  Party responsible for reimbursing the provider","requirements":"To be a valid claim, preauthorization or predetermination there must be a party who is responsible for adjudicating the contents against a policy which provides benefits for the patient.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.insurer","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Event.performer.agent"},{"identity":"w5","map":"FiveWs.author"}]},{"id":"ExplanationOfBenefit.provider","path":"ExplanationOfBenefit.provider","short":"Party responsible for the claim","definition":"The provider which is responsible for the claim, predetermination or preauthorization.","comment":"The identifier assigned to the Billing Provider. (94)","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.provider","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"w5","map":"FiveWs.source"}]},{"id":"ExplanationOfBenefit.priority","path":"ExplanationOfBenefit.priority","short":"Desired processing urgency","definition":"The provider-required urgency of processing the request. Typical values include: stat, routine deferred.","comment":"If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request.","requirements":"The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.priority","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/ValueSet/process-priority"},"mapping":[{"identity":"v2","map":"Request.priority"}]},{"id":"ExplanationOfBenefit.fundsReserveRequested","path":"ExplanationOfBenefit.fundsReserveRequested","short":"For whom to reserve funds","definition":"A code to indicate whether and for whom funds are to be reserved for future claims.","comment":"This field is only used for preauthorizations.","requirements":"In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested.","alias":["Fund pre-allocation"],"min":0,"max":"1","base":{"path":"ExplanationOfBenefit.fundsReserveRequested","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"FundsReserve"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"example","description":"For whom funds are to be reserved: (Patient, Provider, None).","valueSet":"http://hl7.org/fhir/ValueSet/fundsreserve"}},{"id":"ExplanationOfBenefit.fundsReserve","path":"ExplanationOfBenefit.fundsReserve","short":"Funds reserved status","definition":"A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.","comment":"Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none.","requirements":"Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.fundsReserve","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"FundsReserve"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"example","description":"For whom funds are to be reserved: (Patient, Provider, None).","valueSet":"http://hl7.org/fhir/ValueSet/fundsreserve"}},{"id":"ExplanationOfBenefit.related","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"RelatedClaim"}],"path":"ExplanationOfBenefit.related","short":"Prior or corollary claims","definition":"Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.","comment":"If the current claim represents a claim that has been adjusted and was given a prior claim number, this field represents the prior claim number. If the current claim has been adjusted; i.e., replaced by or merged to another claim number, this data element represents that new number.(111, 112)","requirements":"For workplace or other accidents it is common to relate separate claims arising from the same event.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.related","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.related.id","path":"ExplanationOfBenefit.related.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.related.extension","path":"ExplanationOfBenefit.related.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.related.modifierExtension","path":"ExplanationOfBenefit.related.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.related.claim","path":"ExplanationOfBenefit.related.claim","short":"Reference to the related claim","definition":"Reference to a related claim.","requirements":"For workplace or other accidents it is common to relate separate claims arising from the same event.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.related.claim","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Claim"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.related.relationship","path":"ExplanationOfBenefit.related.relationship","short":"How the reference claim is related","definition":"A code to convey how the claims are related.","comment":"For example, prior claim or umbrella.","requirements":"Some insurers need a declaration of the type of relationship.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.related.relationship","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBRelatedClaimRelationshipCodes"}},{"id":"ExplanationOfBenefit.related.reference","path":"ExplanationOfBenefit.related.reference","short":"File or case reference","definition":"An alternate organizational reference to the case or file to which this particular claim pertains.","comment":"For example, Property/Casualty insurer claim number or Workers Compensation case number.","requirements":"In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.related.reference","min":0,"max":"1"},"type":[{"code":"Identifier"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.prescription","path":"ExplanationOfBenefit.prescription","short":"Prescription authorizing services or products","definition":"Prescription to support the dispensing of pharmacy, device or vision products.","requirements":"Required to authorize the dispensing of controlled substances and devices.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.prescription","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/MedicationRequest","http://hl7.org/fhir/StructureDefinition/VisionPrescription"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.originalPrescription","path":"ExplanationOfBenefit.originalPrescription","short":"Original prescription if superceded by fulfiller","definition":"Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.","comment":"For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.","requirements":"Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.originalPrescription","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/MedicationRequest"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payee","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Payee"}],"path":"ExplanationOfBenefit.payee","short":"Recipient of benefits payable","definition":"The party to be reimbursed for cost of the products and services according to the terms of the policy.","comment":"Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and may choose to pay the subscriber instead.","requirements":"The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payee","min":0,"max":"1"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payee.id","path":"ExplanationOfBenefit.payee.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.payee.extension","path":"ExplanationOfBenefit.payee.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.payee.modifierExtension","path":"ExplanationOfBenefit.payee.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.payee.type","path":"ExplanationOfBenefit.payee.type","short":"Category of recipient","definition":"Type of Party to be reimbursed: Subscriber, provider, other.","comment":"Identifies the type of recipient of the adjudication amount; i.e., provider, subscriber, beneficiary or another recipient. (120)","requirements":"Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.payee.type","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayeeType"}},{"id":"ExplanationOfBenefit.payee.party","path":"ExplanationOfBenefit.payee.party","short":"Recipient reference","definition":"Reference to the individual or organization to whom any payment will be made.","comment":"Recipient reference (121)","requirements":"Need to provide demographics if the payee is not 'subscriber' nor 'provider'.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.payee.party","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization","http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient","http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.referral","path":"ExplanationOfBenefit.referral","short":"Treatment Referral","definition":"A reference to a referral resource.","comment":"The referral resource which lists the date, practitioner, reason and other supporting information.","requirements":"Some insurers require proof of referral to pay for services or to pay specialist rates for services.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.referral","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/ServiceRequest"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.cause"}]},{"id":"ExplanationOfBenefit.facility","path":"ExplanationOfBenefit.facility","short":"Servicing Facility","definition":"Facility where the services were provided.","requirements":"Insurance adjudication can be dependant on where services were delivered.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.facility","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Location"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"workflow","map":"Event.performer.location"},{"identity":"w5","map":"FiveWs.where[x]"}]},{"id":"ExplanationOfBenefit.claim","path":"ExplanationOfBenefit.claim","short":"Claim reference","definition":"The business identifier for the instance of the adjudication request: claim predetermination or preauthorization.","requirements":"To provide a link to the original adjudication request.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.claim","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Claim"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.why[x]"}]},{"id":"ExplanationOfBenefit.claimResponse","path":"ExplanationOfBenefit.claimResponse","short":"Claim response reference","definition":"The business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response.","requirements":"To provide a link to the original adjudication response.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.claimResponse","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/ClaimResponse"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.outcome","path":"ExplanationOfBenefit.outcome","short":"queued | complete | error | partial","definition":"The outcome of the claim, predetermination, or preauthorization processing.","comment":"Expected value is complete","requirements":"To advise the requestor of an overall processing outcome.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.outcome","min":1,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"RemittanceOutcome"}],"strength":"required","description":"The result of the claim processing.","valueSet":"http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1"}},{"id":"ExplanationOfBenefit.disposition","path":"ExplanationOfBenefit.disposition","short":"Disposition Message","definition":"A human readable description of the status of the adjudication.","requirements":"Provided for user display.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.disposition","min":0,"max":"1"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.preAuthRef","path":"ExplanationOfBenefit.preAuthRef","short":"Preauthorization reference","definition":"Reference from the Insurer which is used in later communications which refers to this adjudication.","comment":"This value is only present on preauthorization adjudications.","requirements":"On subsequent claims, the insurer may require the provider to quote this value.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.preAuthRef","min":0,"max":"*"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.preAuthRefPeriod","path":"ExplanationOfBenefit.preAuthRefPeriod","short":"Preauthorization in-effect period","definition":"The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.","comment":"This value is only present on preauthorization adjudications.","requirements":"On subsequent claims, the insurer may require the provider to quote this value.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.preAuthRefPeriod","min":0,"max":"*"},"type":[{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.careTeam","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"CareTeam"}],"path":"ExplanationOfBenefit.careTeam","short":"Care Team members","definition":"The members of the team who provided the products and services.","requirements":"Common to identify the responsible and supporting practitioners.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.careTeam","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"EOB-inst-careTeam-practitioner","severity":"error","human":"Institutional EOB: Careteam roles refer to a practitioner","expression":"(\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists() implies\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists().provider.all(resolve() is Practitioner)\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"},{"key":"EOB-inst-careTeam-organization","severity":"error","human":"Institutional EOB:  Careteam roles refer to an organization","expression":"(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().provider.all(resolve() is Organization)\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.careTeam.id","path":"ExplanationOfBenefit.careTeam.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.careTeam.extension","path":"ExplanationOfBenefit.careTeam.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.careTeam.modifierExtension","path":"ExplanationOfBenefit.careTeam.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.careTeam.sequence","path":"ExplanationOfBenefit.careTeam.sequence","short":"Order of care team","definition":"A number to uniquely identify care team entries.","comment":"careTeam.sequence values uniquely identify careTeam members.  They do not necessarily indiate any order in which the patient was seen by the careTeam or identify any level of significance of the careTeam to the patient, etc.  Client app implementations should not assign any significance to the sequence values","requirements":"Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.careTeam.provider","path":"ExplanationOfBenefit.careTeam.provider","short":"Practitioner or organization","definition":"Member of the team who provided the product or service.","comment":"The identifier assigned to the care team. (varies depending on the profile)","requirements":"Often a regulatory requirement to specify the responsible provider.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.provider","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization","http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.actor"}]},{"id":"ExplanationOfBenefit.careTeam.responsible","path":"ExplanationOfBenefit.careTeam.responsible","short":"Indicator of the lead practitioner","definition":"The party who is billing and/or responsible for the claimed products or services.","comment":"Responsible might not be required when there is only a single provider listed.","requirements":"When multiple parties are present it is required to distinguish the lead or responsible individual.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.responsible","min":0,"max":"1"},"type":[{"code":"boolean"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.careTeam.role","path":"ExplanationOfBenefit.careTeam.role","short":"Function within the team","definition":"The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.","comment":"The functional role of a provider on a claim. (165)","requirements":"When multiple parties are present it is required to distinguish the roles performed by each member.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.role","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInstitutionalCareTeamRole"}},{"id":"ExplanationOfBenefit.careTeam.qualification","path":"ExplanationOfBenefit.careTeam.qualification","short":"Practitioner credential or specialization","definition":"The qualification of the practitioner which is applicable for this service.","requirements":"Need to specify which qualification a provider is delivering the product or service under.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.qualification","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ProviderQualification"}],"strength":"example","description":"Provider professional qualifications.","valueSet":"http://hl7.org/fhir/ValueSet/provider-qualification"}},{"id":"ExplanationOfBenefit.supportingInfo","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"SupportingInformation"}],"path":"ExplanationOfBenefit.supportingInfo","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on $this pattern","ordered":false,"rules":"open"},"short":"Supporting information","definition":"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.","comment":"Defines data elements not available in the base EOB resource","requirements":"Typically these information codes are required to support the services rendered or the adjudication of the services rendered.","min":1,"max":"*","base":{"path":"ExplanationOfBenefit.supportingInfo","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo.id","path":"ExplanationOfBenefit.supportingInfo.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo.extension","path":"ExplanationOfBenefit.supportingInfo.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo.modifierExtension","path":"ExplanationOfBenefit.supportingInfo.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.supportingInfo.sequence","path":"ExplanationOfBenefit.supportingInfo.sequence","short":"Information instance identifier","definition":"A number to uniquely identify supporting information entries.","comment":"Client app implementations should look-up supportingInfo elements based on category values instead of sequence values","requirements":"Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo.category","path":"ExplanationOfBenefit.supportingInfo.category","short":"Classification of the supplied information","definition":"The general class of the information supplied: information; exception; accident, employment; onset, etc.","comment":"This may contain a category for the local bill type codes.","requirements":"Required to group or associate information items with common characteristics. 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For example, could contain a PDF in an Attachment of the Police Report for an Accident.","requirements":"To convey the data content to be provided when the information is more than a simple code or period.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.value[x]","min":0,"max":"1"},"type":[{"code":"boolean"},{"code":"string"},{"code":"Quantity"},{"code":"Attachment"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Resource"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo.reason","path":"ExplanationOfBenefit.supportingInfo.reason","short":"Explanation for the information","definition":"Provides the reason in the situation where a reason code is required in addition to the content.","comment":"For example: the reason for the additional stay, or why a tooth is  missing.","requirements":"Needed when the supporting information has both a date and amount/value and requires explanation.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.reason","min":0,"max":"1"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"MissingReason"}],"strength":"example","description":"Reason codes for the missing teeth.","valueSet":"http://hl7.org/fhir/ValueSet/missing-tooth-reason"}},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"SupportingInformation"}],"path":"ExplanationOfBenefit.supportingInfo","sliceName":"billingnetworkcontractingstatus","short":"Supporting information","definition":"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.","comment":"Indicates that the Billing Provider has a contract with the Plan (regardless of the network) as of the effective date of service or admission. 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Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  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This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15). (13)","requirements":"Typically these information codes are required to support the services rendered or the adjudication of the services rendered.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:pointoforigin.id","path":"ExplanationOfBenefit.supportingInfo.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). 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Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  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For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.supportingInfo:pointoforigin.sequence","path":"ExplanationOfBenefit.supportingInfo.sequence","short":"Information instance identifier","definition":"A number to uniquely identify supporting information entries.","comment":"Client app implementations should look-up supportingInfo elements based on category values instead of sequence values","requirements":"Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:pointoforigin.category","path":"ExplanationOfBenefit.supportingInfo.category","short":"Classification of the supplied information","definition":"The general class of the information supplied: information; exception; accident, employment; onset, etc.","comment":"This may contain a category for the local bill type codes.","requirements":"Required to group or associate information items with common characteristics. 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For example, could contain a PDF in an Attachment of the Police Report for an Accident.","requirements":"To convey the data content to be provided when the information is more than a simple code or period.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.value[x]","min":0,"max":"1"},"type":[{"code":"boolean"},{"code":"string"},{"code":"Quantity"},{"code":"Attachment"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Resource"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:admtype.reason","path":"ExplanationOfBenefit.supportingInfo.reason","short":"Explanation for the information","definition":"Provides the reason in the situation where a reason code is required in addition to the content.","comment":"For example: the reason for the additional stay, or why a tooth is  missing.","requirements":"Needed when the supporting information has both a date and amount/value and requires explanation.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.reason","min":0,"max":"1"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"MissingReason"}],"strength":"example","description":"Reason codes for the missing teeth.","valueSet":"http://hl7.org/fhir/ValueSet/missing-tooth-reason"}},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"SupportingInformation"}],"path":"ExplanationOfBenefit.supportingInfo","sliceName":"discharge-status","short":"Supporting information","definition":"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.","comment":"Patient’s status as of the discharge date for a facility stay. Information located on UB04. (Form Locator 17). (117)","requirements":"Typically these information codes are required to support the services rendered or the adjudication of the services rendered.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.id","path":"ExplanationOfBenefit.supportingInfo.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). 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Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  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The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.sequence","path":"ExplanationOfBenefit.supportingInfo.sequence","short":"Information instance identifier","definition":"A number to uniquely identify supporting information entries.","comment":"Client app implementations should look-up supportingInfo elements based on category values instead of sequence values","requirements":"Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.category","path":"ExplanationOfBenefit.supportingInfo.category","short":"Classification of the supplied information","definition":"The general class of the information supplied: information; exception; accident, employment; onset, etc.","comment":"This may contain a category for the local bill type codes.","requirements":"Required to group or associate information items with common characteristics. 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For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.supportingInfo:drg.sequence","path":"ExplanationOfBenefit.supportingInfo.sequence","short":"Information instance identifier","definition":"A number to uniquely identify supporting information entries.","comment":"Client app implementations should look-up supportingInfo elements based on category values instead of sequence values","requirements":"Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:drg.category","path":"ExplanationOfBenefit.supportingInfo.category","short":"Classification of the supplied information","definition":"The general class of the information supplied: information; exception; accident, employment; onset, etc.","comment":"This may contain a category for the local bill type codes.","requirements":"Required to group or associate information items with common characteristics. For example: admission information or prior treatments.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.category","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"drg"}]},"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"extensible","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"}},{"id":"ExplanationOfBenefit.supportingInfo:drg.code","path":"ExplanationOfBenefit.supportingInfo.code","short":"Type of information","definition":"System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.","comment":"This may contain the local bill type codes such as the US UB-04 bill type code.","requirements":"Required to identify the kind of additional information.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.code","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/CMSMS3MAPAPRDRG"}},{"id":"ExplanationOfBenefit.supportingInfo:drg.timing[x]","path":"ExplanationOfBenefit.supportingInfo.timing[x]","short":"When it occurred","definition":"The date when or period to which this information refers.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.timing[x]","min":0,"max":"1"},"type":[{"code":"date"},{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:drg.value[x]","path":"ExplanationOfBenefit.supportingInfo.value[x]","short":"Data to be provided","definition":"Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.","comment":"Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.","requirements":"To convey the data content to be provided when the information is more than a simple code or period.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.value[x]","min":0,"max":"1"},"type":[{"code":"boolean"},{"code":"string"},{"code":"Quantity"},{"code":"Attachment"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Resource"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:drg.reason","path":"ExplanationOfBenefit.supportingInfo.reason","short":"Explanation for the information","definition":"Provides the reason in the situation where a reason code is required in addition to the content.","comment":"For example: the reason for the additional stay, or why a tooth is  missing.","requirements":"Needed when the supporting information has both a date and amount/value and requires explanation.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.reason","min":0,"max":"1"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"MissingReason"}],"strength":"example","description":"Reason codes for the missing teeth.","valueSet":"http://hl7.org/fhir/ValueSet/missing-tooth-reason"}},{"id":"ExplanationOfBenefit.diagnosis","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Diagnosis"}],"path":"ExplanationOfBenefit.diagnosis","short":"Pertinent diagnosis information","definition":"Information about diagnoses relevant to the claim items.","comment":"Diagnosis codes describe an individual's disease or medical condition. (6, 7, 8, 21, 22, 23, 30)","requirements":"Required for the adjudication by provided context for the services and product listed.","min":1,"max":"*","base":{"path":"ExplanationOfBenefit.diagnosis","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.diagnosis.id","path":"ExplanationOfBenefit.diagnosis.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.diagnosis.extension","path":"ExplanationOfBenefit.diagnosis.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.diagnosis.modifierExtension","path":"ExplanationOfBenefit.diagnosis.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.diagnosis.sequence","path":"ExplanationOfBenefit.diagnosis.sequence","short":"Diagnosis instance identifier","definition":"A number to uniquely identify diagnosis entries.","comment":"Diagnosis.sequence values do not necessarily indiate any order in which the diagnosis was reported or identified.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of diagnosis.type to identify primary, secondary, etc.","requirements":"Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.diagnosis.diagnosis[x]","path":"ExplanationOfBenefit.diagnosis.diagnosis[x]","short":"Nature of illness or problem","definition":"The nature of illness or problem in a coded form or as a reference to an external defined Condition.","requirements":"Provides health context for the evaluation of the products and/or services.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.diagnosis[x]","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/CDCICD910CMDiagnosisCodes"}},{"id":"ExplanationOfBenefit.diagnosis.type","path":"ExplanationOfBenefit.diagnosis.type","short":"Timing or nature of the diagnosis","definition":"When the condition was observed or the relative ranking.","comment":"Indicates if the inpatient institutional diagnosis is admitting, principal, other or an external cause of injury. (21, 22, 23)","requirements":"Often required to capture a particular diagnosis, for example: primary or discharge.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.type","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInpatientInstitutionalDiagnosisType"}},{"id":"ExplanationOfBenefit.diagnosis.onAdmission","path":"ExplanationOfBenefit.diagnosis.onAdmission","short":"Present on admission","definition":"Indication of whether the diagnosis was present on admission to a facility.","comment":"Used to capture whether a diagnosis was present at time of a patient's admission. (28)","requirements":"Many systems need to understand for adjudication if the diagnosis was present a time of admission.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.onAdmission","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPresentOnAdmission"}},{"id":"ExplanationOfBenefit.diagnosis.packageCode","path":"ExplanationOfBenefit.diagnosis.packageCode","short":"Package billing code","definition":"A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.","comment":"For example, DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardio-infarction and a DRG for HeartAttack would assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.","requirements":"Required to relate the current  diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.packageCode","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"DiagnosisRelatedGroup"}],"strength":"example","description":"The DRG codes associated with the diagnosis.","valueSet":"http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup"}},{"id":"ExplanationOfBenefit.procedure","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Procedure"}],"path":"ExplanationOfBenefit.procedure","short":"Clinical procedures performed","definition":"Procedures performed on the patient relevant to the billing items with the claim.","comment":"Medical procedure a patient received during inpatient stay. Current coding methods include: International Classification of Diseases Surgical Procedures (ICD-9). Information located on UB04 (Form Locator 74). (25, 27, 10, 12)","requirements":"The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.procedure","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.procedure.id","path":"ExplanationOfBenefit.procedure.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.procedure.extension","path":"ExplanationOfBenefit.procedure.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.procedure.modifierExtension","path":"ExplanationOfBenefit.procedure.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.procedure.sequence","path":"ExplanationOfBenefit.procedure.sequence","short":"Procedure instance identifier","definition":"A number to uniquely identify procedure entries.","comment":" procedure.sequence values do not necessarily indiate any order in which the procedure occurred.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of procedure.type to identify primary and secondary procedures","requirements":"Necessary to provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.procedure.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.procedure.type","path":"ExplanationOfBenefit.procedure.type","short":"Category of Procedure","definition":"When the condition was observed or the relative ranking.","comment":"Indicates if the inpatient institutional procedure (ICD-PCS) is the principal procedure or another procedure. (186)","requirements":"Often required to capture a particular diagnosis, for example: primary or discharge.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.procedure.type","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimProcedureType"}},{"id":"ExplanationOfBenefit.procedure.date","path":"ExplanationOfBenefit.procedure.date","short":"When the procedure was performed","definition":"Date and optionally time the procedure was performed.","requirements":"Required for auditing purposes.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.procedure.date","min":0,"max":"1"},"type":[{"code":"dateTime"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.procedure.procedure[x]","path":"ExplanationOfBenefit.procedure.procedure[x]","short":"Specific clinical procedure","definition":"The code or reference to a Procedure resource which identifies the clinical intervention performed.","requirements":"This identifies the actual clinical procedure.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.procedure.procedure[x]","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/CMSICD910PCSProcedureCodes"}},{"id":"ExplanationOfBenefit.procedure.udi","path":"ExplanationOfBenefit.procedure.udi","short":"Unique device identifier","definition":"Unique Device Identifiers associated with this line item.","requirements":"The UDI code allows the insurer to obtain device level information on the product supplied.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.procedure.udi","min":0,"max":"*"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Device"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.precedence","path":"ExplanationOfBenefit.precedence","short":"Precedence (primary, secondary, etc.)","definition":"This indicates the relative order of a series of EOBs related to different coverages for the same suite of services.","requirements":"Needed to coordinate between multiple EOBs for the same suite of services.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.precedence","min":0,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.insurance","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Insurance"}],"path":"ExplanationOfBenefit.insurance","short":"Patient insurance information","definition":"Financial instruments for reimbursement for the health care products and services specified on the claim.","comment":"Identity of the payers responsible for the claim. (2, 141).  All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. An invariant is defined to enforce the following rule:  Will have multiple occurrences on secondary / tertiary, etc. claims.  Up to one occurrence, that of the ExplanationOfBenefit.insurer, will have a boolean value = 'True'","requirements":"At least one insurer is required for a claim to be a claim.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.insurance","min":1,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"EOB-insurance-focal","severity":"error","human":"EOB.insurance:  at most one with focal = true","expression":"insurance.select (focal = true).count() < 2","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"Coverage"}]},{"id":"ExplanationOfBenefit.insurance.id","path":"ExplanationOfBenefit.insurance.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.insurance.extension","path":"ExplanationOfBenefit.insurance.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.insurance.modifierExtension","path":"ExplanationOfBenefit.insurance.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.insurance.focal","path":"ExplanationOfBenefit.insurance.focal","short":"Coverage to be used for adjudication","definition":"A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.","comment":"A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example, a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies. An invariant is defined to enforce the following rule:  Will have multiple occurrences on secondary / tertiary, etc. claims.  Up to one occurrence, that of the ExplanationOfBenefit.insurer, will have a boolean value = 'True'","requirements":"To identify which coverage in the list is being used to adjudicate this claim.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.insurance.focal","min":1,"max":"1"},"type":[{"code":"boolean"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.insurance.coverage","path":"ExplanationOfBenefit.insurance.coverage","short":"Insurance information","definition":"Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.","comment":"Same as insurance.coverage.organization.  Party responsible for reimbursing the provider. When focal = true, Coverage.payer--> Organization.identifier.  When focal = false, EOB.insurance.coverage.display = [name of other carrier]","requirements":"Required to allow the adjudicator to locate the correct policy and history within their information system.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.insurance.coverage","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.insurance.preAuthRef","path":"ExplanationOfBenefit.insurance.preAuthRef","short":"Prior authorization reference number","definition":"Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.","comment":"This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.","requirements":"Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.insurance.preAuthRef","min":0,"max":"*"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.accident","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Accident"}],"path":"ExplanationOfBenefit.accident","short":"Details of the event","definition":"Details of a accident which resulted in injuries which required the products and services listed in the claim.","requirements":"When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.accident","min":0,"max":"1"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.accident.id","path":"ExplanationOfBenefit.accident.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.accident.extension","path":"ExplanationOfBenefit.accident.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.accident.modifierExtension","path":"ExplanationOfBenefit.accident.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.accident.date","path":"ExplanationOfBenefit.accident.date","short":"When the incident occurred","definition":"Date of an accident event  related to the products and services contained in the claim.","comment":"The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.","requirements":"Required for audit purposes and adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.accident.date","min":0,"max":"1"},"type":[{"code":"date"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.accident.type","path":"ExplanationOfBenefit.accident.type","short":"The nature of the accident","definition":"The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.","requirements":"Coverage may be dependant on the type of accident.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.accident.type","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"AccidentType"}],"strength":"extensible","description":"Type of accident: work place, auto, etc.","valueSet":"http://terminology.hl7.org/ValueSet/v3-ActIncidentCode"}},{"id":"ExplanationOfBenefit.accident.location[x]","path":"ExplanationOfBenefit.accident.location[x]","short":"Where the event occurred","definition":"The physical location of the accident event.","requirements":"Required for audit purposes and determination of applicable insurance liability.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.accident.location[x]","min":0,"max":"1"},"type":[{"code":"Address"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Location"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Item"}],"path":"ExplanationOfBenefit.item","short":"Product or service provided","definition":"A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.","requirements":"The items to be processed for adjudication.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.id","path":"ExplanationOfBenefit.item.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.extension","path":"ExplanationOfBenefit.item.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.modifierExtension","path":"ExplanationOfBenefit.item.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.item.sequence","path":"ExplanationOfBenefit.item.sequence","short":"Item instance identifier","definition":"A number to uniquely identify item entries.","comment":"Line identification number that represents the number assigned in a source system for identification and processing. (36)","requirements":"Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.careTeamSequence","path":"ExplanationOfBenefit.item.careTeamSequence","short":"Applicable care team members","definition":"Care team members related to this service or product.","requirements":"Need to identify the individuals and their roles in the provision of the product or service.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.careTeamSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.diagnosisSequence","path":"ExplanationOfBenefit.item.diagnosisSequence","short":"Applicable diagnoses","definition":"Diagnoses applicable for this service or product.","requirements":"Need to related the product or service to the associated diagnoses.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.diagnosisSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.procedureSequence","path":"ExplanationOfBenefit.item.procedureSequence","short":"Applicable procedures","definition":"Procedures applicable for this service or product.","requirements":"Need to provide any listed specific procedures to support the product or service being claimed.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.procedureSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > 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procedures.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.subSite","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Surface"}],"strength":"example","description":"The code for the tooth surface and surface combinations.","valueSet":"http://hl7.org/fhir/ValueSet/surface"}},{"id":"ExplanationOfBenefit.item.encounter","path":"ExplanationOfBenefit.item.encounter","short":"Encounters related to this billed item","definition":"A billed item may include goods or services provided in multiple encounters.","requirements":"Used in some jurisdictions to link clinical events to claim items.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.encounter","min":0,"max":"*"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Encounter"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.noteNumber","path":"ExplanationOfBenefit.item.noteNumber","short":"Applicable note numbers","definition":"The numbers associated with notes below which apply to the adjudication of this item.","comment":"References number of the associated processNote entered","requirements":"Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line 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The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. 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Mutually exclusive to the amount element above.","comment":"For example: eligible percentage or co-payment percentage.","requirements":"Some adjudication categories convey a percentage or a fixed value.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.adjudication.value","min":0,"max":"1"},"type":[{"code":"decimal"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Detail"}],"path":"ExplanationOfBenefit.item.detail","short":"Additional items","definition":"Second-tier of goods and services.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.id","path":"ExplanationOfBenefit.item.detail.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.detail.extension","path":"ExplanationOfBenefit.item.detail.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.detail.modifierExtension","path":"ExplanationOfBenefit.item.detail.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.item.detail.sequence","path":"ExplanationOfBenefit.item.detail.sequence","short":"Product or service provided","definition":"A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.","requirements":"The items to be processed for adjudication.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.revenue","path":"ExplanationOfBenefit.item.detail.revenue","short":"Revenue or cost center code","definition":"The type of revenue or cost center providing the product and/or service.","requirements":"Needed in the processing of institutional claims.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.revenue","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"RevenueCenter"}],"strength":"example","description":"Codes for the revenue or cost centers supplying the service and/or products.","valueSet":"http://hl7.org/fhir/ValueSet/ex-revenue-center"}},{"id":"ExplanationOfBenefit.item.detail.category","path":"ExplanationOfBenefit.item.detail.category","short":"Benefit classification","definition":"Code to identify the general type of benefits under which products and services are provided.","comment":"Examples include: Medical Care, Periodontics, Renal Dialysis, Vision Coverage.","requirements":"Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.category","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitCategory"}],"strength":"example","description":"Benefit categories such as: oral, medical, vision, oral-basic etc.","valueSet":"http://hl7.org/fhir/ValueSet/ex-benefitcategory"}},{"id":"ExplanationOfBenefit.item.detail.productOrService","path":"ExplanationOfBenefit.item.detail.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product 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id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Modifiers"}],"strength":"example","description":"Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.","valueSet":"http://hl7.org/fhir/ValueSet/claim-modifiers"}},{"id":"ExplanationOfBenefit.item.detail.programCode","path":"ExplanationOfBenefit.item.detail.programCode","short":"Program the product or service is provided under","definition":"Identifies the program under which this may be recovered.","comment":"For example: Neonatal program, child dental program or drug users recovery program.","requirements":"Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.programCode","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ProgramCode"}],"strength":"example","description":"Program specific reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/ex-program-code"}},{"id":"ExplanationOfBenefit.item.detail.quantity","path":"ExplanationOfBenefit.item.detail.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","requirements":"Required when the product or service code does not convey the quantity provided.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.quantity","min":0,"max":"1"},"type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.unitPrice","path":"ExplanationOfBenefit.item.detail.unitPrice","short":"Fee, charge or cost per item","definition":"If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.","requirements":"The amount charged to the patient by the provider for a single unit.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.unitPrice","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.factor","path":"ExplanationOfBenefit.item.detail.factor","short":"Price scaling factor","definition":"A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.","comment":"To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).","requirements":"When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.factor","min":0,"max":"1"},"type":[{"code":"decimal"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.net","path":"ExplanationOfBenefit.item.detail.net","short":"Total item cost","definition":"The quantity times the unit price for an additional service or product or charge.","comment":"For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.","requirements":"Provides the total amount claimed  for the group (if a grouper) or the line item.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.net","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.udi","path":"ExplanationOfBenefit.item.detail.udi","short":"Unique device identifier","definition":"Unique Device Identifiers associated with this line item.","requirements":"The UDI code allows the insurer to obtain device level information on the product supplied.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.udi","min":0,"max":"*"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Device"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.noteNumber","path":"ExplanationOfBenefit.item.detail.noteNumber","short":"Applicable note numbers","definition":"The numbers associated with notes below which apply to the adjudication of this item.","requirements":"Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.noteNumber","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.adjudication","path":"ExplanationOfBenefit.item.detail.adjudication","short":"Detail level adjudication details","definition":"The adjudication results.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.adjudication","min":0,"max":"*"},"contentReference":"http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"SubDetail"}],"path":"ExplanationOfBenefit.item.detail.subDetail","short":"Additional items","definition":"Third-tier of goods and services.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.id","path":"ExplanationOfBenefit.item.detail.subDetail.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.detail.subDetail.extension","path":"ExplanationOfBenefit.item.detail.subDetail.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.detail.subDetail.modifierExtension","path":"ExplanationOfBenefit.item.detail.subDetail.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.item.detail.subDetail.sequence","path":"ExplanationOfBenefit.item.detail.subDetail.sequence","short":"Product or service provided","definition":"A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.","requirements":"The items to be processed for adjudication.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.revenue","path":"ExplanationOfBenefit.item.detail.subDetail.revenue","short":"Revenue or cost center code","definition":"The type of revenue or cost center providing the product and/or service.","requirements":"Needed in the processing of institutional claims.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.revenue","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"RevenueCenter"}],"strength":"example","description":"Codes for the revenue or cost centers supplying the service and/or products.","valueSet":"http://hl7.org/fhir/ValueSet/ex-revenue-center"}},{"id":"ExplanationOfBenefit.item.detail.subDetail.category","path":"ExplanationOfBenefit.item.detail.subDetail.category","short":"Benefit classification","definition":"Code to identify the general type of benefits under which products and services are provided.","comment":"Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.","requirements":"Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.category","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitCategory"}],"strength":"example","description":"Benefit categories such as: oral, medical, vision, oral-basic etc.","valueSet":"http://hl7.org/fhir/ValueSet/ex-benefitcategory"}},{"id":"ExplanationOfBenefit.item.detail.subDetail.productOrService","path":"ExplanationOfBenefit.item.detail.subDetail.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product 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id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Modifiers"}],"strength":"example","description":"Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.","valueSet":"http://hl7.org/fhir/ValueSet/claim-modifiers"}},{"id":"ExplanationOfBenefit.item.detail.subDetail.programCode","path":"ExplanationOfBenefit.item.detail.subDetail.programCode","short":"Program the product or service is provided under","definition":"Identifies the program under which this may be recovered.","comment":"For example: Neonatal program, child dental program or drug users recovery program.","requirements":"Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.programCode","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ProgramCode"}],"strength":"example","description":"Program specific reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/ex-program-code"}},{"id":"ExplanationOfBenefit.item.detail.subDetail.quantity","path":"ExplanationOfBenefit.item.detail.subDetail.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","requirements":"Required when the product or service code does not convey the quantity provided.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.quantity","min":0,"max":"1"},"type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.unitPrice","path":"ExplanationOfBenefit.item.detail.subDetail.unitPrice","short":"Fee, charge or cost per item","definition":"If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.","requirements":"The amount charged to the patient by the provider for a single unit.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.unitPrice","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.factor","path":"ExplanationOfBenefit.item.detail.subDetail.factor","short":"Price scaling factor","definition":"A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.","comment":"To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).","requirements":"When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.factor","min":0,"max":"1"},"type":[{"code":"decimal"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.net","path":"ExplanationOfBenefit.item.detail.subDetail.net","short":"Total item cost","definition":"The quantity times the unit price for an additional service or product or charge.","comment":"For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.","requirements":"Provides the total amount claimed  for the group (if a grouper) or the line item.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.net","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.udi","path":"ExplanationOfBenefit.item.detail.subDetail.udi","short":"Unique device identifier","definition":"Unique Device Identifiers associated with this line item.","requirements":"The UDI code allows the insurer to obtain device level information on the product supplied.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.udi","min":0,"max":"*"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Device"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.noteNumber","path":"ExplanationOfBenefit.item.detail.subDetail.noteNumber","short":"Applicable note numbers","definition":"The numbers associated with notes below which apply to the adjudication of this item.","requirements":"Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.noteNumber","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.adjudication","path":"ExplanationOfBenefit.item.detail.subDetail.adjudication","short":"Subdetail level adjudication details","definition":"The adjudication results.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.adjudication","min":0,"max":"*"},"contentReference":"http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint","valueString":"740;600"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"AddedItem"}],"path":"ExplanationOfBenefit.addItem","short":"Insurer added line items","definition":"The first-tier service adjudications for payor added product or service lines.","requirements":"Insurers may redefine the provided product or service or may package and/or decompose groups of products and services. The addItems allows the insurer to provide their line item list with linkage to the submitted items/details/sub-details. In a preauthorization the insurer may use the addItem structure to provide additional information on authorized products and services.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.id","path":"ExplanationOfBenefit.addItem.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.extension","path":"ExplanationOfBenefit.addItem.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.modifierExtension","path":"ExplanationOfBenefit.addItem.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.addItem.itemSequence","path":"ExplanationOfBenefit.addItem.itemSequence","short":"Item sequence number","definition":"Claim items which this service line is intended to replace.","requirements":"Provides references to the claim items.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.itemSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detailSequence","path":"ExplanationOfBenefit.addItem.detailSequence","short":"Detail sequence number","definition":"The sequence number of the details within the claim item which this line is intended to replace.","requirements":"Provides references to the claim details within the claim item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detailSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.subDetailSequence","path":"ExplanationOfBenefit.addItem.subDetailSequence","short":"Subdetail sequence number","definition":"The sequence number of the sub-details woithin the details within the claim item which this line is intended to replace.","requirements":"Provides references to the claim sub-details within the claim detail.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.subDetailSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.provider","path":"ExplanationOfBenefit.addItem.provider","short":"Authorized providers","definition":"The providers who are authorized for the services rendered to the patient.","requirements":"Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.provider","min":0,"max":"*"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Practitioner","http://hl7.org/fhir/StructureDefinition/PractitionerRole","http://hl7.org/fhir/StructureDefinition/Organization"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.source"}]},{"id":"ExplanationOfBenefit.addItem.productOrService","path":"ExplanationOfBenefit.addItem.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product 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classifications.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.programCode","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ProgramCode"}],"strength":"example","description":"Program specific reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/ex-program-code"}},{"id":"ExplanationOfBenefit.addItem.serviced[x]","path":"ExplanationOfBenefit.addItem.serviced[x]","short":"Date or dates of service or product delivery","definition":"The date or dates when the service or product was supplied, performed or completed.","requirements":"Needed to determine whether the  service or product was provided during the term of the insurance coverage.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.serviced[x]","min":0,"max":"1"},"type":[{"code":"date"},{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.done[x]"}]},{"id":"ExplanationOfBenefit.addItem.location[x]","path":"ExplanationOfBenefit.addItem.location[x]","short":"Place of service or where product was supplied","definition":"Where the product or service was provided.","requirements":"The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.location[x]","min":0,"max":"1"},"type":[{"code":"CodeableConcept"},{"code":"Address"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Location"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServicePlace"}],"strength":"example","description":"Place where the service is rendered.","valueSet":"http://hl7.org/fhir/ValueSet/service-place"},"mapping":[{"identity":"w5","map":"FiveWs.where[x]"}]},{"id":"ExplanationOfBenefit.addItem.quantity","path":"ExplanationOfBenefit.addItem.quantity","short":"Count of products or 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procedures.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.subSite","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Surface"}],"strength":"example","description":"The code for the tooth surface and surface combinations.","valueSet":"http://hl7.org/fhir/ValueSet/surface"}},{"id":"ExplanationOfBenefit.addItem.noteNumber","path":"ExplanationOfBenefit.addItem.noteNumber","short":"Applicable note numbers","definition":"The numbers associated with notes below which apply to the adjudication of this item.","requirements":"Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.noteNumber","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.adjudication","path":"ExplanationOfBenefit.addItem.adjudication","short":"Added items adjudication","definition":"The adjudication results.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.adjudication","min":0,"max":"*"},"contentReference":"http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value 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This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.detail.extension","path":"ExplanationOfBenefit.addItem.detail.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.detail.modifierExtension","path":"ExplanationOfBenefit.addItem.detail.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.addItem.detail.productOrService","path":"ExplanationOfBenefit.addItem.detail.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product codes.","valueSet":"http://hl7.org/fhir/ValueSet/service-uscls"}},{"id":"ExplanationOfBenefit.addItem.detail.modifier","path":"ExplanationOfBenefit.addItem.detail.modifier","short":"Service/Product billing modifiers","definition":"Item typification or modifiers codes to convey additional context for the product or service.","comment":"For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.","requirements":"To support inclusion of the item for adjudication or to charge an elevated fee.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detail.modifier","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Modifiers"}],"strength":"example","description":"Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.","valueSet":"http://hl7.org/fhir/ValueSet/claim-modifiers"}},{"id":"ExplanationOfBenefit.addItem.detail.quantity","path":"ExplanationOfBenefit.addItem.detail.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","requirements":"Required when the product or service code does not convey the quantity provided.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.quantity","min":0,"max":"1"},"type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.unitPrice","path":"ExplanationOfBenefit.addItem.detail.unitPrice","short":"Fee, charge or cost per item","definition":"If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.","requirements":"The amount charged to the patient by the provider for a single unit.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.unitPrice","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.factor","path":"ExplanationOfBenefit.addItem.detail.factor","short":"Price scaling factor","definition":"A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. 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Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension","path":"ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. 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The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.productOrService","path":"ExplanationOfBenefit.addItem.detail.subDetail.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product codes.","valueSet":"http://hl7.org/fhir/ValueSet/service-uscls"}},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.modifier","path":"ExplanationOfBenefit.addItem.detail.subDetail.modifier","short":"Service/Product billing modifiers","definition":"Item typification or modifiers codes to convey additional context for the product or service.","comment":"For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.","requirements":"To support inclusion of the item for adjudication or to charge an elevated fee.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.modifier","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Modifiers"}],"strength":"example","description":"Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.","valueSet":"http://hl7.org/fhir/ValueSet/claim-modifiers"}},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.quantity","path":"ExplanationOfBenefit.addItem.detail.subDetail.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","requirements":"Required when the product or service code does not convey the quantity provided.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.quantity","min":0,"max":"1"},"type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.unitPrice","path":"ExplanationOfBenefit.addItem.detail.subDetail.unitPrice","short":"Fee, charge or cost per item","definition":"If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.","requirements":"The amount charged to the patient by the provider for a single unit.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.unitPrice","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.factor","path":"ExplanationOfBenefit.addItem.detail.subDetail.factor","short":"Price scaling factor","definition":"A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.","comment":"To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).","requirements":"When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.factor","min":0,"max":"1"},"type":[{"code":"decimal"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.net","path":"ExplanationOfBenefit.addItem.detail.subDetail.net","short":"Total item cost","definition":"The quantity times the unit price for an additional service or product or charge.","comment":"For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.","requirements":"Provides the total amount claimed  for the group (if a grouper) or the line item.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.net","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.noteNumber","path":"ExplanationOfBenefit.addItem.detail.subDetail.noteNumber","short":"Applicable note numbers","definition":"The numbers associated with notes below which apply to the adjudication of this item.","requirements":"Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.noteNumber","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.adjudication","path":"ExplanationOfBenefit.addItem.detail.subDetail.adjudication","short":"Added items adjudication","definition":"The adjudication results.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.adjudication","min":0,"max":"*"},"contentReference":"http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.adjudication","path":"ExplanationOfBenefit.adjudication","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on value pattern","ordered":false,"rules":"closed"},"short":"Header-level adjudication","definition":"The adjudication results which are presented at the header level rather than at the line-item or add-item levels.","requirements":"Some insurers will receive line-items but provide the adjudication only at a summary or header-level.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.adjudication","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"adjudication-has-amount-type-slice","severity":"error","human":"If Adjudication is present, it must have at least one adjudicationamounttype slice","expression":"(exists() implies where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.adjudication.id","path":"ExplanationOfBenefit.adjudication.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). 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Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.adjudication.modifierExtension","path":"ExplanationOfBenefit.adjudication.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. 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For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.adjudication.category","path":"ExplanationOfBenefit.adjudication.category","short":"Type of adjudication information","definition":"A code to indicate the information type of this adjudication record. 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For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.adjudication:adjudicationamounttype.category","path":"ExplanationOfBenefit.adjudication.category","short":"Type of adjudication information","definition":"A code to indicate the information type of this adjudication record. 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Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.total:inoutnetwork.category","path":"ExplanationOfBenefit.total.category","short":"Type of adjudication information","definition":"A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.","comment":"For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.","requirements":"Needed to convey the type of total provided.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.total.category","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus"}},{"id":"ExplanationOfBenefit.total:inoutnetwork.amount","path":"ExplanationOfBenefit.total.amount","short":"Financial total for the category","definition":"Monetary total amount associated with the category.","requirements":"Needed to convey the total monetary amount.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.total.amount","min":1,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.payment","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint","valueString":"360;650"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Payment"}],"path":"ExplanationOfBenefit.payment","short":"Payment Details","definition":"Payment details for the adjudication of the claim.","requirements":"Needed to convey references to the financial instrument that has been used if payment has been made.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment","min":0,"max":"1"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payment.id","path":"ExplanationOfBenefit.payment.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.payment.extension","path":"ExplanationOfBenefit.payment.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.payment.modifierExtension","path":"ExplanationOfBenefit.payment.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.payment.type","path":"ExplanationOfBenefit.payment.type","short":"Partial or complete payment","definition":"Whether this represents partial or complete payment of the benefits payable.","comment":"Indicates whether the claim was paid or denied. (91)","requirements":"To advise the requestor when the insurer believes all payments to have been completed.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.type","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerClaimPaymentStatusCode"}},{"id":"ExplanationOfBenefit.payment.adjustment","path":"ExplanationOfBenefit.payment.adjustment","short":"Payment adjustment for non-claim issues","definition":"Total amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication.","comment":"Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider.","requirements":"To advise the requestor of adjustments applied to the payment.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.adjustment","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payment.adjustmentReason","path":"ExplanationOfBenefit.payment.adjustmentReason","short":"Explanation for the variance","definition":"Reason for the payment adjustment.","requirements":"Needed to clarify the monetary adjustment.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.adjustmentReason","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"PaymentAdjustmentReason"}],"strength":"example","description":"Payment Adjustment reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/payment-adjustment-reason"}},{"id":"ExplanationOfBenefit.payment.date","path":"ExplanationOfBenefit.payment.date","short":"Expected date of payment","definition":"Estimated date the payment will be issued or the actual issue date of payment.","comment":"The date the claim was paid. (107)","requirements":"To advise the payee when payment can be expected.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.date","min":0,"max":"1"},"type":[{"code":"date"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payment.amount","path":"ExplanationOfBenefit.payment.amount","short":"Payable amount after adjustment","definition":"Benefits payable less any payment adjustment.","requirements":"Needed to provide the actual payment amount.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.amount","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payment.identifier","path":"ExplanationOfBenefit.payment.identifier","short":"Business identifier for the payment","definition":"Issuer's unique identifier for the payment instrument.","comment":"For example: EFT number or check number.","requirements":"Enable the receiver to reconcile when payment received.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.identifier","min":0,"max":"1"},"type":[{"code":"Identifier"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.formCode","path":"ExplanationOfBenefit.formCode","short":"Printed form identifier","definition":"A code for the form to be used for printing the content.","comment":"May be needed to identify specific jurisdictional forms.","requirements":"Needed to specify the specific form used for producing output for this response.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.formCode","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Forms"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"example","description":"The forms codes.","valueSet":"http://hl7.org/fhir/ValueSet/forms"}},{"id":"ExplanationOfBenefit.form","path":"ExplanationOfBenefit.form","short":"Printed reference or actual form","definition":"The actual form, by reference or inclusion, for printing the content or an EOB.","comment":"Needed to permit insurers to include the actual form.","requirements":"Needed to include the specific form used for producing output for this response.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.form","min":0,"max":"1"},"type":[{"code":"Attachment"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.processNote","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Note"}],"path":"ExplanationOfBenefit.processNote","short":"Note concerning adjudication","definition":"A note that describes or explains adjudication results in a human readable form.","requirements":"Provides the insurer specific textual explanations associated with the processing.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.processNote","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.processNote.id","path":"ExplanationOfBenefit.processNote.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.processNote.extension","path":"ExplanationOfBenefit.processNote.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.processNote.modifierExtension","path":"ExplanationOfBenefit.processNote.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.processNote.number","path":"ExplanationOfBenefit.processNote.number","short":"Note instance identifier","definition":"A number to uniquely identify a note entry.","requirements":"Necessary to provide a mechanism to link from adjudications.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.processNote.number","min":0,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.processNote.type","path":"ExplanationOfBenefit.processNote.type","short":"display | print | printoper","definition":"The business purpose of the note text.","requirements":"To convey the expectation for when the text is used.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.processNote.type","min":0,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"NoteType"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"required","description":"The presentation types of notes.","valueSet":"http://hl7.org/fhir/ValueSet/note-type|4.0.1"}},{"id":"ExplanationOfBenefit.processNote.text","path":"ExplanationOfBenefit.processNote.text","short":"Note explanatory text","definition":"The explanation or description associated with the processing.","comment":"Payment denial explanation to a member, typically goes on the EOB when the payment is denied or disallowed (181)","requirements":"Required to provide human readable explanation.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.processNote.text","min":0,"max":"1"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.processNote.language","path":"ExplanationOfBenefit.processNote.language","short":"Language of the text","definition":"A code to define the language used in the text of the note.","comment":"Only required if the language is different from the resource language.","requirements":"Note text may vary from the resource defined language.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.processNote.language","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet","valueCanonical":"http://hl7.org/fhir/ValueSet/all-languages"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Language"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"preferred","description":"A human language.","valueSet":"http://hl7.org/fhir/ValueSet/languages"}},{"id":"ExplanationOfBenefit.benefitPeriod","path":"ExplanationOfBenefit.benefitPeriod","short":"When the benefits are applicable","definition":"The term of the benefits documented in this response.","comment":"Not applicable when use=claim.","requirements":"Needed as coverages may be multi-year while benefits tend to be annual therefore a separate expression of the benefit period is needed.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitPeriod","min":0,"max":"1"},"type":[{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"BenefitBalance"}],"path":"ExplanationOfBenefit.benefitBalance","short":"Balance by Benefit Category","definition":"Balance by Benefit Category.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.benefitBalance","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance.id","path":"ExplanationOfBenefit.benefitBalance.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.benefitBalance.extension","path":"ExplanationOfBenefit.benefitBalance.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.benefitBalance.modifierExtension","path":"ExplanationOfBenefit.benefitBalance.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.benefitBalance.category","path":"ExplanationOfBenefit.benefitBalance.category","short":"Benefit classification","definition":"Code to identify the general type of benefits under which products and services are provided.","comment":"Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.","requirements":"Needed to convey the category of service or product for which eligibility is sought.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.category","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitCategory"}],"strength":"example","description":"Benefit categories such as: oral, medical, vision, oral-basic etc.","valueSet":"http://hl7.org/fhir/ValueSet/ex-benefitcategory"}},{"id":"ExplanationOfBenefit.benefitBalance.excluded","path":"ExplanationOfBenefit.benefitBalance.excluded","short":"Excluded from the plan","definition":"True if the indicated class of service is excluded from the plan, missing or False indicates the product or service is included in the coverage.","requirements":"Needed to identify items that are specifically excluded from the coverage.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.excluded","min":0,"max":"1"},"type":[{"code":"boolean"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance.name","path":"ExplanationOfBenefit.benefitBalance.name","short":"Short name for the benefit","definition":"A short name or tag for the benefit.","comment":"For example: MED01, or DENT2.","requirements":"Required to align with other plan names.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.name","min":0,"max":"1"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance.description","path":"ExplanationOfBenefit.benefitBalance.description","short":"Description of the benefit or services covered","definition":"A richer description of the benefit or services covered.","comment":"For example, 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'.","requirements":"Needed for human readable reference.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.description","min":0,"max":"1"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance.network","path":"ExplanationOfBenefit.benefitBalance.network","short":"In or out of network","definition":"Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers.","requirements":"Needed as in or out of network providers are treated differently under the coverage.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.network","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitNetwork"}],"strength":"example","description":"Code to classify in or out of network services.","valueSet":"http://hl7.org/fhir/ValueSet/benefit-network"}},{"id":"ExplanationOfBenefit.benefitBalance.unit","path":"ExplanationOfBenefit.benefitBalance.unit","short":"Individual or family","definition":"Indicates if the benefits apply to an individual or to the family.","requirements":"Needed for the understanding of the benefits.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.unit","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitUnit"}],"strength":"example","description":"Unit covered/serviced - individual or family.","valueSet":"http://hl7.org/fhir/ValueSet/benefit-unit"}},{"id":"ExplanationOfBenefit.benefitBalance.term","path":"ExplanationOfBenefit.benefitBalance.term","short":"Annual or lifetime","definition":"The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.","requirements":"Needed for the understanding of the benefits.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.term","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitTerm"}],"strength":"example","description":"Coverage unit - annual, lifetime.","valueSet":"http://hl7.org/fhir/ValueSet/benefit-term"}},{"id":"ExplanationOfBenefit.benefitBalance.financial","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Benefit"}],"path":"ExplanationOfBenefit.benefitBalance.financial","short":"Benefit Summary","definition":"Benefits Used to date.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.benefitBalance.financial","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance.financial.id","path":"ExplanationOfBenefit.benefitBalance.financial.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.benefitBalance.financial.extension","path":"ExplanationOfBenefit.benefitBalance.financial.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.benefitBalance.financial.modifierExtension","path":"ExplanationOfBenefit.benefitBalance.financial.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.benefitBalance.financial.type","path":"ExplanationOfBenefit.benefitBalance.financial.type","short":"Benefit classification","definition":"Classification of benefit being provided.","comment":"For example: deductible, visits, benefit amount.","requirements":"Needed to convey the nature of the benefit.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.financial.type","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitType"}],"strength":"example","description":"Deductable, visits, co-pay, etc.","valueSet":"http://hl7.org/fhir/ValueSet/benefit-type"}},{"id":"ExplanationOfBenefit.benefitBalance.financial.allowed[x]","path":"ExplanationOfBenefit.benefitBalance.financial.allowed[x]","short":"Benefits allowed","definition":"The quantity of the benefit which is permitted under the coverage.","requirements":"Needed to convey the benefits offered under the coverage.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.financial.allowed[x]","min":0,"max":"1"},"type":[{"code":"unsignedInt"},{"code":"string"},{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance.financial.used[x]","path":"ExplanationOfBenefit.benefitBalance.financial.used[x]","short":"Benefits used","definition":"The quantity of the benefit which have been consumed to date.","requirements":"Needed to convey the benefits consumed to date.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.financial.used[x]","min":0,"max":"1"},"type":[{"code":"unsignedInt"},{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false}]},"differential":{"element":[{"id":"ExplanationOfBenefit","path":"ExplanationOfBenefit","constraint":[{"key":"dom-2","severity":"error","human":"If the resource is contained in another resource, it SHALL NOT contain nested Resources","expression":"contained.contained.empty()","xpath":"not(parent::f:contained and f:contained)","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-3","severity":"error","human":"If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource","expression":"contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()","xpath":"not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-4","severity":"error","human":"If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated","expression":"contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()","xpath":"not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-5","severity":"error","human":"If a resource is contained in another resource, it SHALL NOT have a security label","expression":"contained.meta.security.empty()","xpath":"not(exists(f:contained/*/f:meta/f:security))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice","valueBoolean":true},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation","valueMarkdown":"When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."}],"key":"dom-6","severity":"warning","human":"A resource should have narrative for robust management","expression":"text.`div`.exists()","xpath":"exists(f:text/h:div)","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"EOB-institutional-item-or-header-adjudication","severity":"error","human":"Institutional EOB:  Should have adjudication at the item or header level, but not both","expression":"(adjudication.exists() != item.adjudication.exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"}]},{"id":"ExplanationOfBenefit.type","path":"ExplanationOfBenefit.type","patternCodeableConcept":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/claim-type","code":"institutional"}]}},{"id":"ExplanationOfBenefit.billablePeriod","path":"ExplanationOfBenefit.billablePeriod","min":1},{"id":"ExplanationOfBenefit.billablePeriod.start","path":"ExplanationOfBenefit.billablePeriod.start","mustSupport":true},{"id":"ExplanationOfBenefit.billablePeriod.end","path":"ExplanationOfBenefit.billablePeriod.end","mustSupport":true},{"id":"ExplanationOfBenefit.created","path":"ExplanationOfBenefit.created","mustSupport":true},{"id":"ExplanationOfBenefit.provider","path":"ExplanationOfBenefit.provider","type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"]}]},{"id":"ExplanationOfBenefit.careTeam","path":"ExplanationOfBenefit.careTeam","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"EOB-inst-careTeam-practitioner","severity":"error","human":"Institutional EOB: Careteam roles refer to a practitioner","expression":"(\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists() implies\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists().provider.all(resolve() is Practitioner)\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"},{"key":"EOB-inst-careTeam-organization","severity":"error","human":"Institutional EOB:  Careteam roles refer to an organization","expression":"(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().provider.all(resolve() is Organization)\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"}]},{"id":"ExplanationOfBenefit.careTeam.role","path":"ExplanationOfBenefit.careTeam.role","min":1,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInstitutionalCareTeamRole"}},{"id":"ExplanationOfBenefit.supportingInfo","path":"ExplanationOfBenefit.supportingInfo","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on $this pattern","ordered":false,"rules":"open"},"min":1},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus","path":"ExplanationOfBenefit.supportingInfo","sliceName":"billingnetworkcontractingstatus","comment":"Indicates that the Billing Provider has a contract with the Plan (regardless of the network) as of the effective date of service or admission. (101)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"billingnetworkcontractingstatus"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderContractingStatus"}},{"id":"ExplanationOfBenefit.supportingInfo:admissionperiod","path":"ExplanationOfBenefit.supportingInfo","sliceName":"admissionperiod","comment":"The Period.start date corresponds with the date the beneficiary was admitted to a facility and the onset of services. May precede the Statement From Date if this claim is for a beneficiary who has been continuously under care. The Period.end date corresponds with the date beneficiary was discharged from the facility, or died. Matches the final Statement Thru Date. When there is a discharge date, the Patient Discharge Status Code indicates the final disposition of the patient after discharge. (18, 19)","min":1,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:admissionperiod.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"admissionperiod"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:admissionperiod.timing[x]","path":"ExplanationOfBenefit.supportingInfo.timing[x]","slicing":{"discriminator":[{"type":"type","path":"$this"}],"ordered":false,"rules":"open"},"min":1},{"id":"ExplanationOfBenefit.supportingInfo:admissionperiod.timingPeriod","path":"ExplanationOfBenefit.supportingInfo.timingPeriod","min":1,"max":"1","type":[{"code":"Period"}],"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:clmrecvddate","path":"ExplanationOfBenefit.supportingInfo","sliceName":"clmrecvddate","comment":"The date the claim was received by the payer (88)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:clmrecvddate.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"clmrecvddate"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]","path":"ExplanationOfBenefit.supportingInfo.timing[x]","min":1,"type":[{"code":"date"}],"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:typeofbill","path":"ExplanationOfBenefit.supportingInfo","sliceName":"typeofbill","comment":"UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of institution, the second digit classifies the type of care being billed, and the third digit  identifies the frequency of the bill for a specific course of treatment or inpatient confinement. (17)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:typeofbill.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"typeofbill"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:typeofbill.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCTypeOfBill"}},{"id":"ExplanationOfBenefit.supportingInfo:pointoforigin","path":"ExplanationOfBenefit.supportingInfo","sliceName":"pointoforigin","comment":"Identifies the place where the patient was identified as needing admission to an institution. This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15). (13)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:pointoforigin.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"pointoforigin"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:pointoforigin.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPointOfOriginForAdmissionOrVisit"}},{"id":"ExplanationOfBenefit.supportingInfo:admtype","path":"ExplanationOfBenefit.supportingInfo","sliceName":"admtype","comment":"Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled. (14)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:admtype.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"admtype"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:admtype.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPriorityTypeOfAdmissionOrVisit"}},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status","path":"ExplanationOfBenefit.supportingInfo","sliceName":"discharge-status","comment":"Patient’s status as of the discharge date for a facility stay. Information located on UB04. (Form Locator 17). (117)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"discharge-status"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPatientDischargeStatus"}},{"id":"ExplanationOfBenefit.supportingInfo:drg","path":"ExplanationOfBenefit.supportingInfo","sliceName":"drg","comment":"Claim diagnosis related group (DRG). DRGs require the DRG system; i.e., MS-DRG / AP-DRG / APR-DRG, the DRG version and the code value (32, 33. 113)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:drg.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"drg"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:drg.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/CMSMS3MAPAPRDRG"}},{"id":"ExplanationOfBenefit.diagnosis","path":"ExplanationOfBenefit.diagnosis","comment":"Diagnosis codes describe an individual's disease or medical condition. (6, 7, 8, 21, 22, 23, 30)","min":1,"mustSupport":true},{"id":"ExplanationOfBenefit.diagnosis.sequence","path":"ExplanationOfBenefit.diagnosis.sequence","comment":"Diagnosis.sequence values do not necessarily indiate any order in which the diagnosis was reported or identified.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of diagnosis.type to identify primary, secondary, etc."},{"id":"ExplanationOfBenefit.diagnosis.diagnosis[x]","path":"ExplanationOfBenefit.diagnosis.diagnosis[x]","type":[{"code":"CodeableConcept"}],"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/CDCICD910CMDiagnosisCodes"}},{"id":"ExplanationOfBenefit.diagnosis.type","path":"ExplanationOfBenefit.diagnosis.type","comment":"Indicates if the inpatient institutional diagnosis is admitting, principal, other or an external cause of injury. (21, 22, 23)","min":1,"max":"1","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInpatientInstitutionalDiagnosisType"}},{"id":"ExplanationOfBenefit.diagnosis.onAdmission","path":"ExplanationOfBenefit.diagnosis.onAdmission","comment":"Used to capture whether a diagnosis was present at time of a patient's admission. (28)","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPresentOnAdmission"}},{"id":"ExplanationOfBenefit.procedure","path":"ExplanationOfBenefit.procedure","comment":"Medical procedure a patient received during inpatient stay. Current coding methods include: International Classification of Diseases Surgical Procedures (ICD-9). Information located on UB04 (Form Locator 74). (25, 27, 10, 12)","mustSupport":true},{"id":"ExplanationOfBenefit.procedure.sequence","path":"ExplanationOfBenefit.procedure.sequence","comment":" procedure.sequence values do not necessarily indiate any order in which the procedure occurred.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of procedure.type to identify primary and secondary procedures"},{"id":"ExplanationOfBenefit.procedure.type","path":"ExplanationOfBenefit.procedure.type","comment":"Indicates if the inpatient institutional procedure (ICD-PCS) is the principal procedure or another procedure. (186)","min":1,"max":"1","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimProcedureType"}},{"id":"ExplanationOfBenefit.procedure.date","path":"ExplanationOfBenefit.procedure.date","mustSupport":true},{"id":"ExplanationOfBenefit.procedure.procedure[x]","path":"ExplanationOfBenefit.procedure.procedure[x]","type":[{"code":"CodeableConcept"}],"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/CMSICD910PCSProcedureCodes"}},{"id":"ExplanationOfBenefit.insurance","path":"ExplanationOfBenefit.insurance","max":"1"},{"id":"ExplanationOfBenefit.item.revenue","path":"ExplanationOfBenefit.item.revenue","comment":"Code used on the UB-04 (Form Locator 42) to identify a specific accommodation, ancillary service, or billing calculation related to the service being billed (86)","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCRevenueCodes"}},{"id":"ExplanationOfBenefit.item.productOrService","path":"ExplanationOfBenefit.item.productOrService","comment":"Medical procedure a patient received from a health care provider. Current coding methods include: CPT-4 and HCFA Common Procedure Coding System Level II - (HCPCSII). (40)","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSProcedureCodes"}},{"id":"ExplanationOfBenefit.item.modifier","path":"ExplanationOfBenefit.item.modifier","comment":"Modifier(s) for the procedure represented on this line. Identifies special circumstances related to the performance of the service. (41)","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers"}},{"id":"ExplanationOfBenefit.item.quantity","path":"ExplanationOfBenefit.item.quantity","comment":"The quantity of units, times, days, visits, services, or treatments for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (42)","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication","path":"ExplanationOfBenefit.item.adjudication","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on value pattern","ordered":false,"rules":"closed"},"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"adjudication-has-amount-type-slice","severity":"error","human":"If Adjudication is present, it must have at least one adjudicationamounttype slice","expression":"(exists() implies where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"}],"mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication.category","path":"ExplanationOfBenefit.item.adjudication.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"}},{"id":"ExplanationOfBenefit.item.adjudication:adjudicationamounttype","path":"ExplanationOfBenefit.item.adjudication","sliceName":"adjudicationamounttype","comment":"Describes the various amount fields used when payers receive and adjudicate a claim. (187)","min":0,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category","path":"ExplanationOfBenefit.item.adjudication.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"}},{"id":"ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount","path":"ExplanationOfBenefit.item.adjudication.amount","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication:denialreason","path":"ExplanationOfBenefit.item.adjudication","sliceName":"denialreason","comment":"Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)","min":0,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication:denialreason.category","path":"ExplanationOfBenefit.item.adjudication.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator","code":"denialreason"}]}},{"id":"ExplanationOfBenefit.item.adjudication:denialreason.reason","path":"ExplanationOfBenefit.item.adjudication.reason","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"}},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits","path":"ExplanationOfBenefit.item.adjudication","sliceName":"allowedunits","comment":"The quantity of units, times, days, visits, services, or treatments allowed for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (149)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.category","path":"ExplanationOfBenefit.item.adjudication.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator","code":"allowedunits"}]}},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.value","path":"ExplanationOfBenefit.item.adjudication.value","mustSupport":true},{"id":"ExplanationOfBenefit.adjudication","path":"ExplanationOfBenefit.adjudication","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on value pattern","ordered":false,"rules":"closed"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"adjudication-has-amount-type-slice","severity":"error","human":"If Adjudication is present, it must have at least one adjudicationamounttype slice","expression":"(exists() implies where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"}],"mustSupport":true},{"id":"ExplanationOfBenefit.adjudication.category","path":"ExplanationOfBenefit.adjudication.category","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"}},{"id":"ExplanationOfBenefit.adjudication:adjudicationamounttype","path":"ExplanationOfBenefit.adjudication","sliceName":"adjudicationamounttype","comment":"Describes the various amount fields used when payers receive and adjudicate a claim. (187)","min":0,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.adjudication:adjudicationamounttype.category","path":"ExplanationOfBenefit.adjudication.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"}},{"id":"ExplanationOfBenefit.adjudication:adjudicationamounttype.amount","path":"ExplanationOfBenefit.adjudication.amount","min":1},{"id":"ExplanationOfBenefit.adjudication:denialreason","path":"ExplanationOfBenefit.adjudication","sliceName":"denialreason","comment":"Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)","min":0,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.adjudication:denialreason.category","path":"ExplanationOfBenefit.adjudication.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator","code":"denialreason"}]}},{"id":"ExplanationOfBenefit.adjudication:denialreason.reason","path":"ExplanationOfBenefit.adjudication.reason","comment":"Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"}},{"id":"ExplanationOfBenefit.total","path":"ExplanationOfBenefit.total","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on value pattern","ordered":false,"rules":"open"}},{"id":"ExplanationOfBenefit.total.category","path":"ExplanationOfBenefit.total.category","mustSupport":true,"binding":{"strength":"extensible","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBTotalCategoryDiscriminator"}},{"id":"ExplanationOfBenefit.total.amount","path":"ExplanationOfBenefit.total.amount","comment":"Total amount for each category (i.e., submitted, allowed, etc.) (148)"},{"id":"ExplanationOfBenefit.total:adjudicationamounttype","path":"ExplanationOfBenefit.total","sliceName":"adjudicationamounttype","comment":"Describes the various amount fields used when payers receive and adjudicate a claim. (187)","min":1,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.total:adjudicationamounttype.category","path":"ExplanationOfBenefit.total.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"}},{"id":"ExplanationOfBenefit.total:adjudicationamounttype.amount","path":"ExplanationOfBenefit.total.amount","mustSupport":true},{"id":"ExplanationOfBenefit.total:inoutnetwork","path":"ExplanationOfBenefit.total","sliceName":"inoutnetwork","comment":"Indicates the in network or out of network payment status of the claim. (142)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.total:inoutnetwork.category","path":"ExplanationOfBenefit.total.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus"}},{"id":"ExplanationOfBenefit.payment.date","path":"ExplanationOfBenefit.payment.date","mustSupport":true},{"id":"ExplanationOfBenefit.processNote.text","path":"ExplanationOfBenefit.processNote.text","mustSupport":true}]}}
\ No newline at end of file
+{
+    "resourceType": "StructureDefinition",
+    "id": "C4BB-ExplanationOfBenefit-Inpatient-Institutional",
+    "text": {
+        "status": "extensions",
+        "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the element can appear in the instance\">Card.</a></th><th style=\"width: 100px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the element\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_resource.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit\">ExplanationOfBenefit</a><a name=\"ExplanationOfBenefit\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: black; null\" title=\"This element has or is affected by some invariants (EOB-institutional-item-or-header-adjudication)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"StructureDefinition-C4BB-ExplanationOfBenefit.html\">C4BBExplanationOfBenefit</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of Benefit resource</span><br/><span style=\"font-weight:bold\">EOB-institutional-item-or-header-adjudication: </span>Institutional EOB:  Should have adjudication at the item or header level, but not both</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.type\">type</a><a name=\"ExplanationOfBenefit.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Category or discipline</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck101.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"http://terminology.hl7.org/2.0.0/CodeSystem-claim-type.html\">http://terminology.hl7.org/CodeSystem/claim-type</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">institutional</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.billablePeriod\">billablePeriod</a><a name=\"ExplanationOfBenefit.billablePeriod\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Period\">Period</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Relevant time frame for the claim</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.billablePeriod.start\">start</a><a name=\"ExplanationOfBenefit.billablePeriod.start\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Starting time with inclusive boundary</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.billablePeriod.end\">end</a><a name=\"ExplanationOfBenefit.billablePeriod.end\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">End time with inclusive boundary, if not ongoing</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.created\">created</a><a name=\"ExplanationOfBenefit.created\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Response creation date</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.provider\">provider</a><a name=\"ExplanationOfBenefit.provider\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-C4BB-Organization.html\">C4BB Organization</a>)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Party responsible for the claim</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam\">careTeam</a><a name=\"ExplanationOfBenefit.careTeam\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: black; null\" title=\"This element has or is affected by some invariants (EOB-inst-careTeam-practitioner, EOB-inst-careTeam-organization)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Care Team members</span><br/><span style=\"font-weight:bold\">EOB-inst-careTeam-practitioner: </span>Institutional EOB: Careteam roles refer to a practitioner<br/><span style=\"font-weight:bold\">EOB-inst-careTeam-organization: </span>Institutional EOB:  Careteam roles refer to an organization</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam.role\">role</a><a name=\"ExplanationOfBenefit.careTeam.role\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Function within the team</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimInstitutionalCareTeamRole.html\">C4BB Claim Institutional Care Team Role</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo\">supportingInfo</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"font-style: italic\">1</span><span style=\"font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Supporting information</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by pattern:category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus\" title=\"Slice billingnetworkcontractingstatus\">supportingInfo:billingnetworkcontractingstatus</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">billingnetworkcontractingstatus</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBPayerProviderContractingStatus.html\">C4BB Payer Provider Contracting Status</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admissionperiod\" title=\"Slice admissionperiod\">supportingInfo:admissionperiod</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admissionperiod.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">admissionperiod</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1352.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admissionperiod.timing[x]\">timing[x]</a><a name=\"ExplanationOfBenefit.supportingInfo.timing_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"font-style: italic\">1</span><span style=\"font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">When it occurred</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by type:$this</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admissionperiod.timingPeriod\">timingPeriod</a><a name=\"ExplanationOfBenefit.supportingInfo.timingPeriod\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Period\">Period</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">When it occurred</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate\" title=\"Slice clmrecvddate\">supportingInfo:clmrecvddate</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">clmrecvddate</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]\">timing[x]</a><a name=\"ExplanationOfBenefit.supportingInfo.timing_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">When it occurred</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill\" title=\"Slice typeofbill\">supportingInfo:typeofbill</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">typeofbill</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCTypeOfBill.html\">NUBC Type of Bill Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin\" title=\"Slice pointoforigin\">supportingInfo:pointoforigin</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">pointoforigin</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPointOfOriginForAdmissionOrVisit.html\">NUBC Point Of Origin</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype\" title=\"Slice admtype\">supportingInfo:admtype</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">admtype</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPriorityTypeOfAdmissionOrVisit.html\">NUBC Priority (Type) of Admission or Visit</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status\" title=\"Slice discharge-status\">supportingInfo:discharge-status</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">discharge-status</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPatientDischargeStatus.html\">NUBC Patient Discharge Status Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:drg\" title=\"Slice drg\">supportingInfo:drg</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:drg.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">drg</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:drg.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-CMSMS3MAPAPRDRG.html\">MS-DRGs - AP-DRGs - APR-DRGs</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis\">diagnosis</a><a name=\"ExplanationOfBenefit.diagnosis\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Pertinent diagnosis information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.sequence\">sequence</a><a name=\"ExplanationOfBenefit.diagnosis.sequence\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#positiveInt\">positiveInt</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Diagnosis instance identifier</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.diagnosis[x]\">diagnosis[x]</a><a name=\"ExplanationOfBenefit.diagnosis.diagnosis_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Nature of illness or problem</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-CDCICD910CMDiagnosisCodes.html\">Diagnosis Codes - International Classification of Diseases, Clinical Modification (ICD-9-CM, ICD-10-CM)</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.type\">type</a><a name=\"ExplanationOfBenefit.diagnosis.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Timing or nature of the diagnosis</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimInpatientInstitutionalDiagnosisType.html\">C4BB Claim Inpatient Institutional Diagnosis Type</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.onAdmission\">onAdmission</a><a name=\"ExplanationOfBenefit.diagnosis.onAdmission\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Present on admission</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPresentOnAdmission.html\">NUBC Present On Admission Indicator Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure\">procedure</a><a name=\"ExplanationOfBenefit.procedure\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Clinical procedures performed</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure.sequence\">sequence</a><a name=\"ExplanationOfBenefit.procedure.sequence\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#positiveInt\">positiveInt</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Procedure instance identifier</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure.type\">type</a><a name=\"ExplanationOfBenefit.procedure.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Category of Procedure</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimProcedureType.html\">C4BB Claim Procedure Type</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure.date\">date</a><a name=\"ExplanationOfBenefit.procedure.date\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">When the procedure was performed</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.procedure.procedure[x]\">procedure[x]</a><a name=\"ExplanationOfBenefit.procedure.procedure_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Specific clinical procedure</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-CMSICD910PCSProcedureCodes.html\">Procedure Codes - International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - ICD-10 Procedure Coding System</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.insurance\">insurance</a><a name=\"ExplanationOfBenefit.insurance\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span>..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Patient insurance information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item\">item</a><a name=\"ExplanationOfBenefit.item\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.revenue\">revenue</a><a name=\"ExplanationOfBenefit.item.revenue\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Revenue or cost center code</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCRevenueCodes.html\">NUBC Revenue Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.productOrService\">productOrService</a><a name=\"ExplanationOfBenefit.item.productOrService\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Billing, service, product, or drug code</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AMACPTCMSHCPCSProcedureCodes.html\">Current Procedural Terminology (CPT) -  Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes - Procedure Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.modifier\">modifier</a><a name=\"ExplanationOfBenefit.item.modifier\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Product or service billing modifiers</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AMACPTCMSHCPCSModifiers.html\">Current Procedural Terminology (CPT) -  Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes - Procedure Modifier Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.quantity\">quantity</a><a name=\"ExplanationOfBenefit.item.quantity\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#SimpleQuantity\" title=\"Quantity\">SimpleQuantity</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Count of products or services</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication\">adjudication</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic\" title=\"This element must be supported\">S</span><span style=\"padding-left: 3px; padding-right: 3px; color: black; null; font-style: italic\" title=\"This element has or is affected by some invariants (adjudication-has-amount-type-slice)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Adjudication details</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Closed by pattern:category</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">adjudication-has-amount-type-slice: </span><span style=\"font-style: italic\">If Adjudication is present, it must have at least one adjudicationamounttype slice</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1033.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> adjudication:All Slices<a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudicationCategoryDiscriminator.html\">C4BB Adjudication Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">adjudication:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.item.adjudication.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Monetary amount</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason\" title=\"Slice denialreason\">adjudication:denialreason</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">denialreason</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason.reason\">reason</a><a name=\"ExplanationOfBenefit.item.adjudication.reason\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of adjudication outcome</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes.html\">X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits\" title=\"Slice allowedunits\">adjudication:allowedunits</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck102501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">allowedunits</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits.value\">value</a><a name=\"ExplanationOfBenefit.item.adjudication.value\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#decimal\">decimal</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Non-monitary value</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication\">adjudication</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic\" title=\"This element must be supported\">S</span><span style=\"padding-left: 3px; padding-right: 3px; color: black; null; font-style: italic\" title=\"This element has or is affected by some invariants (adjudication-has-amount-type-slice)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Header-level adjudication</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Closed by pattern:category</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">adjudication-has-amount-type-slice: </span><span style=\"font-style: italic\">If Adjudication is present, it must have at least one adjudicationamounttype slice</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck133.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> adjudication:All Slices<a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudicationCategoryDiscriminator.html\">C4BB Adjudication Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">adjudication:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Header-level adjudication</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.adjudication.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Monetary amount</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason\" title=\"Slice denialreason\">adjudication:denialreason</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Header-level adjudication</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">denialreason</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason.reason\">reason</a><a name=\"ExplanationOfBenefit.adjudication.reason\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of adjudication outcome</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes.html\">X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total\">total</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">1</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Adjudication totals</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by pattern:category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck133.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> total:All Slices<a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1330.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBTotalCategoryDiscriminator.html\">C4BB Total Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#extensible\" title=\"To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.\">extensible</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total.amount\">amount</a><a name=\"ExplanationOfBenefit.total.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Financial total for the category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">total:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication totals</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.total.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Financial total for the category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:inoutnetwork\" title=\"Slice inoutnetwork\">total:inoutnetwork</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication totals</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.total:inoutnetwork.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBPayerBenefitPaymentStatus.html\">C4BB Payer Benefit Payment Status</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.payment\">payment</a><a name=\"ExplanationOfBenefit.payment\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.payment.date\">date</a><a name=\"ExplanationOfBenefit.payment.date\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Expected date of payment</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.processNote\">processNote</a><a name=\"ExplanationOfBenefit.processNote\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-definitions.html#ExplanationOfBenefit.processNote.text\">text</a><a name=\"ExplanationOfBenefit.processNote.text\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Note explanatory text</span></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
+    },
+    "extension": [
+        {
+            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-category",
+            "valueString": "Financial.General"
+        },
+        {
+            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category",
+            "valueCode": "patient"
+        }
+    ],
+    "url": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional",
+    "version": "1.0.0",
+    "name": "C4BBExplanationOfBenefitInpatientInstitutional",
+    "title": "C4BB ExplanationOfBenefit Inpatient Institutional",
+    "status": "active",
+    "date": "2020-11-23T16:49:10+00:00",
+    "publisher": "HL7 Financial Management Working Group",
+    "contact": [
+        {
+            "name": "HL7 Financial Management Working Group",
+            "telecom": [
+                {
+                    "system": "url",
+                    "value": "http://www.hl7.org/Special/committees/fm/index.cfm"
+                },
+                {
+                    "system": "email",
+                    "value": "fm@lists.HL7.org"
+                }
+            ]
+        }
+    ],
+    "description": "The profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for inpatient services, which may include the use of equipment and supplies, laboratory services, radiology services and other charges. Inpatient claims are submitted for services rendered at an institution as part of an overnight stay. \nThe claims data is based on the institutional claim format UB-04, submission standards adopted by the Department of Health and Human \nServices.",
+    "jurisdiction": [
+        {
+            "coding": [
+                {
+                    "system": "urn:iso:std:iso:3166",
+                    "code": "US"
+                }
+            ]
+        }
+    ],
+    "fhirVersion": "4.0.1",
+    "mapping": [
+        {
+            "identity": "workflow",
+            "uri": "http://hl7.org/fhir/workflow",
+            "name": "Workflow Pattern"
+        },
+        {
+            "identity": "w5",
+            "uri": "http://hl7.org/fhir/fivews",
+            "name": "FiveWs Pattern Mapping"
+        },
+        {
+            "identity": "v2",
+            "uri": "http://hl7.org/v2",
+            "name": "HL7 v2 Mapping"
+        },
+        {
+            "identity": "rim",
+            "uri": "http://hl7.org/v3",
+            "name": "RIM Mapping"
+        }
+    ],
+    "kind": "resource",
+    "abstract": false,
+    "type": "ExplanationOfBenefit",
+    "baseDefinition": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit",
+    "derivation": "constraint",
+    "snapshot": {
+        "element": [
+            {
+                "id": "ExplanationOfBenefit",
+                "path": "ExplanationOfBenefit",
+                "short": "Explanation of Benefit resource",
+                "definition": "This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.",
+                "alias": [
+                    "EOB"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit",
+                    "min": 0,
+                    "max": "*"
+                },
+                "constraint": [
+                    {
+                        "key": "dom-2",
+                        "severity": "error",
+                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
+                        "expression": "contained.contained.empty()",
+                        "xpath": "not(parent::f:contained and f:contained)",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-3",
+                        "severity": "error",
+                        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
+                        "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
+                        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-4",
+                        "severity": "error",
+                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
+                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
+                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-5",
+                        "severity": "error",
+                        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
+                        "expression": "contained.meta.security.empty()",
+                        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                                "valueBoolean": true
+                            },
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
+                                "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
+                            }
+                        ],
+                        "key": "dom-6",
+                        "severity": "warning",
+                        "human": "A resource should have narrative for robust management",
+                        "expression": "text.`div`.exists()",
+                        "xpath": "exists(f:text/h:div)",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "EOB-institutional-item-or-header-adjudication",
+                        "severity": "error",
+                        "human": "Institutional EOB:  Should have adjudication at the item or header level, but not both",
+                        "expression": "(adjudication.exists() != item.adjudication.exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    },
+                    {
+                        "key": "adjudication-has-amount-type-slice",
+                        "severity": "error",
+                        "human": "If Adjudication is present, it must have at least one adjudicationamounttype slice",
+                        "expression": "adjudication.exists() implies (adjudication.where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "Entity. Role, or Act"
+                    },
+                    {
+                        "identity": "workflow",
+                        "map": "Event"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.id",
+                "path": "ExplanationOfBenefit.id",
+                "short": "Logical id of this artifact",
+                "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
+                "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Resource.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta",
+                "path": "ExplanationOfBenefit.meta",
+                "short": "Metadata about the resource",
+                "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "Resource.meta",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Meta"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.id",
+                "path": "ExplanationOfBenefit.meta.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.extension",
+                "path": "ExplanationOfBenefit.meta.extension",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "value",
+                            "path": "url"
+                        }
+                    ],
+                    "description": "Extensions are always sliced by (at least) url",
+                    "rules": "open"
+                },
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.versionId",
+                "path": "ExplanationOfBenefit.meta.versionId",
+                "short": "Version specific identifier",
+                "definition": "The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.",
+                "comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Meta.versionId",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "id"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.lastUpdated",
+                "path": "ExplanationOfBenefit.meta.lastUpdated",
+                "short": "When the resource version last changed",
+                "definition": "When the resource last changed - e.g. when the version changed.",
+                "comment": "Defines the date the Resource was created or updated, whichever comes last (163). Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "Meta.lastUpdated",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "instant"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.source",
+                "path": "ExplanationOfBenefit.meta.source",
+                "short": "Identifies where the resource comes from",
+                "definition": "A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.",
+                "comment": "In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. \n\nThis element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Meta.source",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "uri"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.profile",
+                "path": "ExplanationOfBenefit.meta.profile",
+                "short": "Profiles this resource claims to conform to",
+                "definition": "A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).",
+                "comment": "CPCDS data element (190)",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "Meta.profile",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "canonical",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/StructureDefinition"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.security",
+                "path": "ExplanationOfBenefit.meta.security",
+                "short": "Security Labels applied to this resource",
+                "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
+                "comment": "The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Meta.security",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "SecurityLabels"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "extensible",
+                    "description": "Security Labels from the Healthcare Privacy and Security Classification System.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/security-labels"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.tag",
+                "path": "ExplanationOfBenefit.meta.tag",
+                "short": "Tags applied to this resource",
+                "definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
+                "comment": "The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Meta.tag",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Tags"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\".",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/common-tags"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.implicitRules",
+                "path": "ExplanationOfBenefit.implicitRules",
+                "short": "A set of rules under which this content was created",
+                "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
+                "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Resource.implicitRules",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "uri"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.language",
+                "path": "ExplanationOfBenefit.language",
+                "short": "Language of the resource content",
+                "definition": "The base language in which the resource is written.",
+                "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Resource.language",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+                            "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Language"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "preferred",
+                    "description": "A human language.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.text",
+                "path": "ExplanationOfBenefit.text",
+                "short": "Text summary of the resource, for human interpretation",
+                "definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
+                "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
+                "alias": [
+                    "narrative",
+                    "html",
+                    "xhtml",
+                    "display"
+                ],
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "DomainResource.text",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Narrative"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "Act.text?"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.contained",
+                "path": "ExplanationOfBenefit.contained",
+                "short": "Contained, inline Resources",
+                "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
+                "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
+                "alias": [
+                    "inline resources",
+                    "anonymous resources",
+                    "contained resources"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "DomainResource.contained",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Resource"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.extension",
+                "path": "ExplanationOfBenefit.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "DomainResource.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.modifierExtension",
+                "path": "ExplanationOfBenefit.modifierExtension",
+                "short": "Extensions that cannot be ignored",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "DomainResource.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier",
+                "path": "ExplanationOfBenefit.identifier",
+                "short": "Business Identifier for the resource",
+                "definition": "A unique identifier assigned to this explanation of benefit.",
+                "comment": "Identifier assigned by a payer for a claim received from a provider or subscriber. It is not the same identifier as that assigned by a provider. (35)",
+                "requirements": "Allows EOBs to be distinguished and referenced.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.identifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Identifier"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.identifier"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.identifier"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.id",
+                "path": "ExplanationOfBenefit.identifier.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.extension",
+                "path": "ExplanationOfBenefit.identifier.extension",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "value",
+                            "path": "url"
+                        }
+                    ],
+                    "description": "Extensions are always sliced by (at least) url",
+                    "rules": "open"
+                },
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.use",
+                "path": "ExplanationOfBenefit.identifier.use",
+                "short": "usual | official | temp | secondary | old (If known)",
+                "definition": "The purpose of this identifier.",
+                "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
+                "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.use",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "IdentifierUse"
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "Identifies the purpose for this identifier, if known .",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
+                },
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "N/A"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "Role.code or implied by context"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.type",
+                "path": "ExplanationOfBenefit.identifier.type",
+                "short": "Description of identifier",
+                "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
+                "comment": "Indicates that the claim identifier is that assigned by a payer for a claim received from a provider or subscriber. (183)",
+                "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimIdentifierType"
+                },
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.5"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "Role.code or implied by context"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.system",
+                "path": "ExplanationOfBenefit.identifier.system",
+                "short": "The namespace for the identifier value",
+                "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
+                "comment": "Identifier.system is always case sensitive.",
+                "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.system",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "uri"
+                    }
+                ],
+                "example": [
+                    {
+                        "label": "General",
+                        "valueUri": "http://www.acme.com/identifiers/patient"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.4 / EI-2-4"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "II.root or Role.id.root"
+                    },
+                    {
+                        "identity": "servd",
+                        "map": "./IdentifierType"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.value",
+                "path": "ExplanationOfBenefit.identifier.value",
+                "short": "The value that is unique",
+                "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
+                "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "example": [
+                    {
+                        "label": "General",
+                        "valueString": "123456"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.1 / EI.1"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
+                    },
+                    {
+                        "identity": "servd",
+                        "map": "./Value"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.period",
+                "path": "ExplanationOfBenefit.identifier.period",
+                "short": "Time period when id is/was valid for use",
+                "definition": "Time period during which identifier is/was valid for use.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.period",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.7 + CX.8"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "Role.effectiveTime or implied by context"
+                    },
+                    {
+                        "identity": "servd",
+                        "map": "./StartDate and ./EndDate"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.assigner",
+                "path": "ExplanationOfBenefit.identifier.assigner",
+                "short": "Organization that issued id (may be just text)",
+                "definition": "Organization that issued/manages the identifier.",
+                "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.assigner",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Organization"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.4 / (CX.4,CX.9,CX.10)"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
+                    },
+                    {
+                        "identity": "servd",
+                        "map": "./IdentifierIssuingAuthority"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.status",
+                "path": "ExplanationOfBenefit.status",
+                "short": "active | cancelled | draft | entered-in-error",
+                "definition": "The status of the resource instance.",
+                "comment": "Claim processing status code (140).  Expected values are active or cancelled.  To comply with the CMS rule, draft EOBs are not required",
+                "requirements": "Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.status",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": true,
+                "isModifierReason": "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ExplanationOfBenefitStatus"
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "A code specifying the state of the resource instance.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/explanationofbenefit-status|4.0.1"
+                },
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.status"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.status"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.type",
+                "path": "ExplanationOfBenefit.type",
+                "short": "Category or discipline",
+                "definition": "The category of claim, e.g. oral, pharmacy, vision, institutional, professional.",
+                "comment": "Specifies the type of claim. (e.g., inpatient insitutional, outpatient institutional, physician, etc.) (16).  Defines the Claims profiles.  Values from Claim Type Codes are required; a data absent reason is not allowed",
+                "requirements": "Claim type determine the general sets of business rules applied for information requirements and adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.type",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://terminology.hl7.org/CodeSystem/claim-type",
+                            "code": "institutional"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-type"
+                },
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.code"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.class"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.subType",
+                "path": "ExplanationOfBenefit.subType",
+                "short": "More granular claim type",
+                "definition": "A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Some jurisdictions need a finer grained claim type for routing and adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.subType",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ClaimSubType"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "A more granular claim typecode.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-subtype"
+                },
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.class"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.use",
+                "path": "ExplanationOfBenefit.use",
+                "short": "claim | preauthorization | predetermination",
+                "definition": "A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.",
+                "comment": "Expected value is claim. The CMS rule applies to adjudicated claims; it does not require preauthorizations or predeterminations",
+                "requirements": "This element is required to understand the nature of the request for adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.use",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "patternCode": "claim",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Use"
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "Complete, proposed, exploratory, other.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-use|4.0.1"
+                },
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.class"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.patient",
+                "path": "ExplanationOfBenefit.patient",
+                "short": "The recipient of the products and services",
+                "definition": "The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought.",
+                "comment": "Identifier for a member assigned by the Payer.  If members receive ID cards, that is the identifier that should be provided. (1). The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction. Additional required path:EOB.insurance.coverage(Coverage).beneficiary(Patient).identifier",
+                "requirements": "The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.patient",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.subject"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.subject[x]"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.subject"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod",
+                "path": "ExplanationOfBenefit.billablePeriod",
+                "short": "Relevant time frame for the claim",
+                "definition": "The period for which charges are being submitted.",
+                "comment": "Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and prodeterminations. Typically line item dates of service should fall within the billing period if one is specified.",
+                "requirements": "A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.billablePeriod",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.done[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.id",
+                "path": "ExplanationOfBenefit.billablePeriod.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.extension",
+                "path": "ExplanationOfBenefit.billablePeriod.extension",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "value",
+                            "path": "url"
+                        }
+                    ],
+                    "description": "Extensions are always sliced by (at least) url",
+                    "rules": "open"
+                },
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.start",
+                "path": "ExplanationOfBenefit.billablePeriod.start",
+                "short": "Starting time with inclusive boundary",
+                "definition": "The start of the period. The boundary is inclusive.",
+                "comment": "The first day on the billing statement covering services rendered to the beneficiary (i.e. 'Statement Covers From Date’). (177)",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Period.start",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "dateTime"
+                    }
+                ],
+                "condition": [
+                    "per-1"
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "DR.1"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "./low"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.end",
+                "path": "ExplanationOfBenefit.billablePeriod.end",
+                "short": "End time with inclusive boundary, if not ongoing",
+                "definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
+                "comment": "The last day on the billing statement covering services rendered to the beneficiary (i.e. 'Statement Covers Thru Date’). (178)",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Period.end",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "dateTime"
+                    }
+                ],
+                "meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
+                "condition": [
+                    "per-1"
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "DR.2"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "./high"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.created",
+                "path": "ExplanationOfBenefit.created",
+                "short": "Response creation date",
+                "definition": "The date this resource was created.",
+                "comment": "Date the claim was adjudicated (179)",
+                "requirements": "Need to record a timestamp for use by both the recipient and the issuer.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.created",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "dateTime"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.occurrence[x]"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.recorded"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.enterer",
+                "path": "ExplanationOfBenefit.enterer",
+                "short": "Author of the claim",
+                "definition": "Individual who created the claim, predetermination or preauthorization.",
+                "requirements": "Some jurisdictions require the contact information for personnel completing claims.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.enterer",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
+                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.performer.agent"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.author"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurer",
+                "path": "ExplanationOfBenefit.insurer",
+                "short": "Party responsible for reimbursement",
+                "definition": "The party responsible for authorization, adjudication and reimbursement.",
+                "comment": "Code of the payer responsible for the claim (2, 5).  Same as insurance.coverage.organization.  Party responsible for reimbursing the provider",
+                "requirements": "To be a valid claim, preauthorization or predetermination there must be a party who is responsible for adjudicating the contents against a policy which provides benefits for the patient.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurer",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.performer.agent"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.author"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.provider",
+                "path": "ExplanationOfBenefit.provider",
+                "short": "Party responsible for the claim",
+                "definition": "The provider which is responsible for the claim, predetermination or preauthorization.",
+                "comment": "The identifier assigned to the Billing Provider. (94)",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.provider",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.source"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.priority",
+                "path": "ExplanationOfBenefit.priority",
+                "short": "Desired processing urgency",
+                "definition": "The provider-required urgency of processing the request. Typical values include: stat, routine deferred.",
+                "comment": "If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request.",
+                "requirements": "The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.priority",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/process-priority"
+                },
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "Request.priority"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.fundsReserveRequested",
+                "path": "ExplanationOfBenefit.fundsReserveRequested",
+                "short": "For whom to reserve funds",
+                "definition": "A code to indicate whether and for whom funds are to be reserved for future claims.",
+                "comment": "This field is only used for preauthorizations.",
+                "requirements": "In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested.",
+                "alias": [
+                    "Fund pre-allocation"
+                ],
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.fundsReserveRequested",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "FundsReserve"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "For whom funds are to be reserved: (Patient, Provider, None).",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/fundsreserve"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.fundsReserve",
+                "path": "ExplanationOfBenefit.fundsReserve",
+                "short": "Funds reserved status",
+                "definition": "A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.",
+                "comment": "Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none.",
+                "requirements": "Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.fundsReserve",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "FundsReserve"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "For whom funds are to be reserved: (Patient, Provider, None).",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/fundsreserve"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.related",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "RelatedClaim"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.related",
+                "short": "Prior or corollary claims",
+                "definition": "Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.",
+                "comment": "If the current claim represents a claim that has been adjusted and was given a prior claim number, this field represents the prior claim number. If the current claim has been adjusted; i.e., replaced by or merged to another claim number, this data element represents that new number.(111, 112)",
+                "requirements": "For workplace or other accidents it is common to relate separate claims arising from the same event.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.related",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.related.id",
+                "path": "ExplanationOfBenefit.related.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.related.extension",
+                "path": "ExplanationOfBenefit.related.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.related.modifierExtension",
+                "path": "ExplanationOfBenefit.related.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.related.claim",
+                "path": "ExplanationOfBenefit.related.claim",
+                "short": "Reference to the related claim",
+                "definition": "Reference to a related claim.",
+                "requirements": "For workplace or other accidents it is common to relate separate claims arising from the same event.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.related.claim",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Claim"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.related.relationship",
+                "path": "ExplanationOfBenefit.related.relationship",
+                "short": "How the reference claim is related",
+                "definition": "A code to convey how the claims are related.",
+                "comment": "For example, prior claim or umbrella.",
+                "requirements": "Some insurers need a declaration of the type of relationship.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.related.relationship",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBRelatedClaimRelationshipCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.related.reference",
+                "path": "ExplanationOfBenefit.related.reference",
+                "short": "File or case reference",
+                "definition": "An alternate organizational reference to the case or file to which this particular claim pertains.",
+                "comment": "For example, Property/Casualty insurer claim number or Workers Compensation case number.",
+                "requirements": "In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.related.reference",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Identifier"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.prescription",
+                "path": "ExplanationOfBenefit.prescription",
+                "short": "Prescription authorizing services or products",
+                "definition": "Prescription to support the dispensing of pharmacy, device or vision products.",
+                "requirements": "Required to authorize the dispensing of controlled substances and devices.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.prescription",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
+                            "http://hl7.org/fhir/StructureDefinition/VisionPrescription"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.originalPrescription",
+                "path": "ExplanationOfBenefit.originalPrescription",
+                "short": "Original prescription if superceded by fulfiller",
+                "definition": "Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.",
+                "comment": "For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.",
+                "requirements": "Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.originalPrescription",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payee",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Payee"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.payee",
+                "short": "Recipient of benefits payable",
+                "definition": "The party to be reimbursed for cost of the products and services according to the terms of the policy.",
+                "comment": "Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and may choose to pay the subscriber instead.",
+                "requirements": "The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payee",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.id",
+                "path": "ExplanationOfBenefit.payee.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.extension",
+                "path": "ExplanationOfBenefit.payee.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.modifierExtension",
+                "path": "ExplanationOfBenefit.payee.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.type",
+                "path": "ExplanationOfBenefit.payee.type",
+                "short": "Category of recipient",
+                "definition": "Type of Party to be reimbursed: Subscriber, provider, other.",
+                "comment": "Identifies the type of recipient of the adjudication amount; i.e., provider, subscriber, beneficiary or another recipient. (120)",
+                "requirements": "Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payee.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayeeType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.party",
+                "path": "ExplanationOfBenefit.payee.party",
+                "short": "Recipient reference",
+                "definition": "Reference to the individual or organization to whom any payment will be made.",
+                "comment": "Recipient reference (121)",
+                "requirements": "Need to provide demographics if the payee is not 'subscriber' nor 'provider'.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payee.party",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization",
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient",
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.referral",
+                "path": "ExplanationOfBenefit.referral",
+                "short": "Treatment Referral",
+                "definition": "A reference to a referral resource.",
+                "comment": "The referral resource which lists the date, practitioner, reason and other supporting information.",
+                "requirements": "Some insurers require proof of referral to pay for services or to pay specialist rates for services.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.referral",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.cause"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.facility",
+                "path": "ExplanationOfBenefit.facility",
+                "short": "Servicing Facility",
+                "definition": "Facility where the services were provided.",
+                "requirements": "Insurance adjudication can be dependant on where services were delivered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.facility",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Location"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.performer.location"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.where[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.claim",
+                "path": "ExplanationOfBenefit.claim",
+                "short": "Claim reference",
+                "definition": "The business identifier for the instance of the adjudication request: claim predetermination or preauthorization.",
+                "requirements": "To provide a link to the original adjudication request.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.claim",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Claim"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.why[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.claimResponse",
+                "path": "ExplanationOfBenefit.claimResponse",
+                "short": "Claim response reference",
+                "definition": "The business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response.",
+                "requirements": "To provide a link to the original adjudication response.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.claimResponse",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/ClaimResponse"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.outcome",
+                "path": "ExplanationOfBenefit.outcome",
+                "short": "queued | complete | error | partial",
+                "definition": "The outcome of the claim, predetermination, or preauthorization processing.",
+                "comment": "Expected value is complete",
+                "requirements": "To advise the requestor of an overall processing outcome.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.outcome",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "RemittanceOutcome"
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "The result of the claim processing.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.disposition",
+                "path": "ExplanationOfBenefit.disposition",
+                "short": "Disposition Message",
+                "definition": "A human readable description of the status of the adjudication.",
+                "requirements": "Provided for user display.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.disposition",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.preAuthRef",
+                "path": "ExplanationOfBenefit.preAuthRef",
+                "short": "Preauthorization reference",
+                "definition": "Reference from the Insurer which is used in later communications which refers to this adjudication.",
+                "comment": "This value is only present on preauthorization adjudications.",
+                "requirements": "On subsequent claims, the insurer may require the provider to quote this value.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.preAuthRef",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.preAuthRefPeriod",
+                "path": "ExplanationOfBenefit.preAuthRefPeriod",
+                "short": "Preauthorization in-effect period",
+                "definition": "The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.",
+                "comment": "This value is only present on preauthorization adjudications.",
+                "requirements": "On subsequent claims, the insurer may require the provider to quote this value.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.preAuthRefPeriod",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "CareTeam"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.careTeam",
+                "short": "Care Team members",
+                "definition": "The members of the team who provided the products and services.",
+                "requirements": "Common to identify the responsible and supporting practitioners.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "EOB-inst-careTeam-practitioner",
+                        "severity": "error",
+                        "human": "Institutional EOB: Careteam roles refer to a practitioner",
+                        "expression": "(\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists() implies\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists().provider.all(resolve() is Practitioner)\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    },
+                    {
+                        "key": "EOB-inst-careTeam-organization",
+                        "severity": "error",
+                        "human": "Institutional EOB:  Careteam roles refer to an organization",
+                        "expression": "(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().provider.all(resolve() is Organization)\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.id",
+                "path": "ExplanationOfBenefit.careTeam.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.extension",
+                "path": "ExplanationOfBenefit.careTeam.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.modifierExtension",
+                "path": "ExplanationOfBenefit.careTeam.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.sequence",
+                "path": "ExplanationOfBenefit.careTeam.sequence",
+                "short": "Order of care team",
+                "definition": "A number to uniquely identify care team entries.",
+                "comment": "careTeam.sequence values uniquely identify careTeam members.  They do not necessarily indiate any order in which the patient was seen by the careTeam or identify any level of significance of the careTeam to the patient, etc.  Client app implementations should not assign any significance to the sequence values",
+                "requirements": "Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.provider",
+                "path": "ExplanationOfBenefit.careTeam.provider",
+                "short": "Practitioner or organization",
+                "definition": "Member of the team who provided the product or service.",
+                "comment": "The identifier assigned to the care team. (varies depending on the profile)",
+                "requirements": "Often a regulatory requirement to specify the responsible provider.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.provider",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization",
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.actor"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.responsible",
+                "path": "ExplanationOfBenefit.careTeam.responsible",
+                "short": "Indicator of the lead practitioner",
+                "definition": "The party who is billing and/or responsible for the claimed products or services.",
+                "comment": "Responsible might not be required when there is only a single provider listed.",
+                "requirements": "When multiple parties are present it is required to distinguish the lead or responsible individual.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.responsible",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.role",
+                "path": "ExplanationOfBenefit.careTeam.role",
+                "short": "Function within the team",
+                "definition": "The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.",
+                "comment": "The functional role of a provider on a claim. (165)",
+                "requirements": "When multiple parties are present it is required to distinguish the roles performed by each member.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.role",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInstitutionalCareTeamRole"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.qualification",
+                "path": "ExplanationOfBenefit.careTeam.qualification",
+                "short": "Practitioner credential or specialization",
+                "definition": "The qualification of the practitioner which is applicable for this service.",
+                "requirements": "Need to specify which qualification a provider is delivering the product or service under.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.qualification",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProviderQualification"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Provider professional qualifications.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/provider-qualification"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on $this pattern",
+                    "ordered": false,
+                    "rules": "open"
+                },
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Defines data elements not available in the base EOB resource",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "InformationCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The valuset used for additional information codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-exception"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "billingnetworkcontractingstatus",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Indicates that the Billing Provider has a contract with the Plan (regardless of the network) as of the effective date of service or admission. (101)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "billingnetworkcontractingstatus"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderContractingStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "admissionperiod",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "The Period.start date corresponds with the date the beneficiary was admitted to a facility and the onset of services. May precede the Statement From Date if this claim is for a beneficiary who has been continuously under care. The Period.end date corresponds with the date beneficiary was discharged from the facility, or died. Matches the final Statement Thru Date. When there is a discharge date, the Patient Discharge Status Code indicates the final disposition of the patient after discharge. (18, 19)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "admissionperiod"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "InformationCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The valuset used for additional information codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-exception"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "type",
+                            "path": "$this"
+                        }
+                    ],
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.timing[x]:timingPeriod",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "sliceName": "timingPeriod",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "clmrecvddate",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "The date the claim was received by the payer (88)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "clmrecvddate"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "InformationCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The valuset used for additional information codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-exception"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "typeofbill",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of institution, the second digit classifies the type of care being billed, and the third digit  identifies the frequency of the bill for a specific course of treatment or inpatient confinement. (17)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "typeofbill"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCTypeOfBill"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "pointoforigin",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Identifies the place where the patient was identified as needing admission to an institution. This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15). (13)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "pointoforigin"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPointOfOriginForAdmissionOrVisit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "admtype",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled. (14)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "admtype"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPriorityTypeOfAdmissionOrVisit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "discharge-status",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Patient’s status as of the discharge date for a facility stay. Information located on UB04. (Form Locator 17). (117)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "discharge-status"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPatientDischargeStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "drg",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Claim diagnosis related group (DRG). DRGs require the DRG system; i.e., MS-DRG / AP-DRG / APR-DRG, the DRG version and the code value (32, 33. 113)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "drg"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/CMSMS3MAPAPRDRG"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Diagnosis"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.diagnosis",
+                "short": "Pertinent diagnosis information",
+                "definition": "Information about diagnoses relevant to the claim items.",
+                "comment": "Diagnosis codes describe an individual's disease or medical condition. (6, 7, 8, 21, 22, 23, 30)",
+                "requirements": "Required for the adjudication by provided context for the services and product listed.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.id",
+                "path": "ExplanationOfBenefit.diagnosis.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.extension",
+                "path": "ExplanationOfBenefit.diagnosis.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.modifierExtension",
+                "path": "ExplanationOfBenefit.diagnosis.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.sequence",
+                "path": "ExplanationOfBenefit.diagnosis.sequence",
+                "short": "Diagnosis instance identifier",
+                "definition": "A number to uniquely identify diagnosis entries.",
+                "comment": "Diagnosis.sequence values do not necessarily indiate any order in which the diagnosis was reported or identified.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of diagnosis.type to identify primary, secondary, etc.",
+                "requirements": "Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                "path": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                "short": "Nature of illness or problem",
+                "definition": "The nature of illness or problem in a coded form or as a reference to an external defined Condition.",
+                "requirements": "Provides health context for the evaluation of the products and/or services.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/CDCICD910CMDiagnosisCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.type",
+                "path": "ExplanationOfBenefit.diagnosis.type",
+                "short": "Timing or nature of the diagnosis",
+                "definition": "When the condition was observed or the relative ranking.",
+                "comment": "Indicates if the inpatient institutional diagnosis is admitting, principal, other or an external cause of injury. (21, 22, 23)",
+                "requirements": "Often required to capture a particular diagnosis, for example: primary or discharge.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.type",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInpatientInstitutionalDiagnosisType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.onAdmission",
+                "path": "ExplanationOfBenefit.diagnosis.onAdmission",
+                "short": "Present on admission",
+                "definition": "Indication of whether the diagnosis was present on admission to a facility.",
+                "comment": "Used to capture whether a diagnosis was present at time of a patient's admission. (28)",
+                "requirements": "Many systems need to understand for adjudication if the diagnosis was present a time of admission.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.onAdmission",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPresentOnAdmission"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.packageCode",
+                "path": "ExplanationOfBenefit.diagnosis.packageCode",
+                "short": "Package billing code",
+                "definition": "A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.",
+                "comment": "For example, DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardio-infarction and a DRG for HeartAttack would assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.",
+                "requirements": "Required to relate the current  diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.packageCode",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "DiagnosisRelatedGroup"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The DRG codes associated with the diagnosis.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Procedure"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.procedure",
+                "short": "Clinical procedures performed",
+                "definition": "Procedures performed on the patient relevant to the billing items with the claim.",
+                "comment": "Medical procedure a patient received during inpatient stay. Current coding methods include: International Classification of Diseases Surgical Procedures (ICD-9). Information located on UB04 (Form Locator 74). (25, 27, 10, 12)",
+                "requirements": "The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.id",
+                "path": "ExplanationOfBenefit.procedure.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.extension",
+                "path": "ExplanationOfBenefit.procedure.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.modifierExtension",
+                "path": "ExplanationOfBenefit.procedure.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.sequence",
+                "path": "ExplanationOfBenefit.procedure.sequence",
+                "short": "Procedure instance identifier",
+                "definition": "A number to uniquely identify procedure entries.",
+                "comment": " procedure.sequence values do not necessarily indiate any order in which the procedure occurred.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of procedure.type to identify primary and secondary procedures",
+                "requirements": "Necessary to provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.type",
+                "path": "ExplanationOfBenefit.procedure.type",
+                "short": "Category of Procedure",
+                "definition": "When the condition was observed or the relative ranking.",
+                "comment": "Indicates if the inpatient institutional procedure (ICD-PCS) is the principal procedure or another procedure. (186)",
+                "requirements": "Often required to capture a particular diagnosis, for example: primary or discharge.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.type",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimProcedureType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.date",
+                "path": "ExplanationOfBenefit.procedure.date",
+                "short": "When the procedure was performed",
+                "definition": "Date and optionally time the procedure was performed.",
+                "requirements": "Required for auditing purposes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.date",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "dateTime"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.procedure[x]",
+                "path": "ExplanationOfBenefit.procedure.procedure[x]",
+                "short": "Specific clinical procedure",
+                "definition": "The code or reference to a Procedure resource which identifies the clinical intervention performed.",
+                "requirements": "This identifies the actual clinical procedure.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.procedure[x]",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/CMSICD910PCSProcedureCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.udi",
+                "path": "ExplanationOfBenefit.procedure.udi",
+                "short": "Unique device identifier",
+                "definition": "Unique Device Identifiers associated with this line item.",
+                "requirements": "The UDI code allows the insurer to obtain device level information on the product supplied.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.udi",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Device"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.precedence",
+                "path": "ExplanationOfBenefit.precedence",
+                "short": "Precedence (primary, secondary, etc.)",
+                "definition": "This indicates the relative order of a series of EOBs related to different coverages for the same suite of services.",
+                "requirements": "Needed to coordinate between multiple EOBs for the same suite of services.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.precedence",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Insurance"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.insurance",
+                "short": "Patient insurance information",
+                "definition": "Financial instruments for reimbursement for the health care products and services specified on the claim.",
+                "comment": "Identity of the payers responsible for the claim. (2, 141).  All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. An invariant is defined to enforce the following rule:  Will have multiple occurrences on secondary / tertiary, etc. claims.  Up to one occurrence, that of the ExplanationOfBenefit.insurer, will have a boolean value = 'True'",
+                "requirements": "At least one insurer is required for a claim to be a claim.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurance",
+                    "min": 1,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "EOB-insurance-focal",
+                        "severity": "error",
+                        "human": "EOB.insurance:  at most one with focal = true",
+                        "expression": "insurance.select (focal = true).count() < 2",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "Coverage"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.id",
+                "path": "ExplanationOfBenefit.insurance.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.extension",
+                "path": "ExplanationOfBenefit.insurance.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.modifierExtension",
+                "path": "ExplanationOfBenefit.insurance.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.focal",
+                "path": "ExplanationOfBenefit.insurance.focal",
+                "short": "Coverage to be used for adjudication",
+                "definition": "A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.",
+                "comment": "A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example, a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies. An invariant is defined to enforce the following rule:  Will have multiple occurrences on secondary / tertiary, etc. claims.  Up to one occurrence, that of the ExplanationOfBenefit.insurer, will have a boolean value = 'True'",
+                "requirements": "To identify which coverage in the list is being used to adjudicate this claim.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurance.focal",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.coverage",
+                "path": "ExplanationOfBenefit.insurance.coverage",
+                "short": "Insurance information",
+                "definition": "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.",
+                "comment": "Same as insurance.coverage.organization.  Party responsible for reimbursing the provider. When focal = true, Coverage.payer--> Organization.identifier.  When focal = false, EOB.insurance.coverage.display = [name of other carrier]",
+                "requirements": "Required to allow the adjudicator to locate the correct policy and history within their information system.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurance.coverage",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.preAuthRef",
+                "path": "ExplanationOfBenefit.insurance.preAuthRef",
+                "short": "Prior authorization reference number",
+                "definition": "Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.",
+                "comment": "This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.",
+                "requirements": "Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurance.preAuthRef",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.accident",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Accident"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.accident",
+                "short": "Details of the event",
+                "definition": "Details of a accident which resulted in injuries which required the products and services listed in the claim.",
+                "requirements": "When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.accident",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.id",
+                "path": "ExplanationOfBenefit.accident.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.extension",
+                "path": "ExplanationOfBenefit.accident.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.modifierExtension",
+                "path": "ExplanationOfBenefit.accident.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.date",
+                "path": "ExplanationOfBenefit.accident.date",
+                "short": "When the incident occurred",
+                "definition": "Date of an accident event  related to the products and services contained in the claim.",
+                "comment": "The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.",
+                "requirements": "Required for audit purposes and adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.accident.date",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.type",
+                "path": "ExplanationOfBenefit.accident.type",
+                "short": "The nature of the accident",
+                "definition": "The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.",
+                "requirements": "Coverage may be dependant on the type of accident.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.accident.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AccidentType"
+                        }
+                    ],
+                    "strength": "extensible",
+                    "description": "Type of accident: work place, auto, etc.",
+                    "valueSet": "http://terminology.hl7.org/ValueSet/v3-ActIncidentCode"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.location[x]",
+                "path": "ExplanationOfBenefit.accident.location[x]",
+                "short": "Where the event occurred",
+                "definition": "The physical location of the accident event.",
+                "requirements": "Required for audit purposes and determination of applicable insurance liability.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.accident.location[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Address"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Location"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Item"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item",
+                "short": "Product or service provided",
+                "definition": "A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.",
+                "requirements": "The items to be processed for adjudication.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "adjudication-has-amount-type-slice",
+                        "severity": "error",
+                        "human": "If Adjudication is present, it must have at least one adjudicationamounttype slice",
+                        "expression": "adjudication.exists() implies (adjudication.where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.id",
+                "path": "ExplanationOfBenefit.item.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.extension",
+                "path": "ExplanationOfBenefit.item.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.modifierExtension",
+                "path": "ExplanationOfBenefit.item.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.sequence",
+                "path": "ExplanationOfBenefit.item.sequence",
+                "short": "Item instance identifier",
+                "definition": "A number to uniquely identify item entries.",
+                "comment": "Line identification number that represents the number assigned in a source system for identification and processing. (36)",
+                "requirements": "Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.careTeamSequence",
+                "path": "ExplanationOfBenefit.item.careTeamSequence",
+                "short": "Applicable care team members",
+                "definition": "Care team members related to this service or product.",
+                "requirements": "Need to identify the individuals and their roles in the provision of the product or service.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.careTeamSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.diagnosisSequence",
+                "path": "ExplanationOfBenefit.item.diagnosisSequence",
+                "short": "Applicable diagnoses",
+                "definition": "Diagnoses applicable for this service or product.",
+                "requirements": "Need to related the product or service to the associated diagnoses.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.diagnosisSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.procedureSequence",
+                "path": "ExplanationOfBenefit.item.procedureSequence",
+                "short": "Applicable procedures",
+                "definition": "Procedures applicable for this service or product.",
+                "requirements": "Need to provide any listed specific procedures to support the product or service being claimed.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.procedureSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.informationSequence",
+                "path": "ExplanationOfBenefit.item.informationSequence",
+                "short": "Applicable exception and supporting information",
+                "definition": "Exceptions, special conditions and supporting information applicable for this service or product.",
+                "requirements": "Need to reference the supporting information items that relate directly to this product or service.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.informationSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.revenue",
+                "path": "ExplanationOfBenefit.item.revenue",
+                "short": "Revenue or cost center code",
+                "definition": "The type of revenue or cost center providing the product and/or service.",
+                "comment": "Code used on the UB-04 (Form Locator 42) to identify a specific accommodation, ancillary service, or billing calculation related to the service being billed (86)",
+                "requirements": "Needed in the processing of institutional claims.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.revenue",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCRevenueCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.category",
+                "path": "ExplanationOfBenefit.item.category",
+                "short": "Benefit classification",
+                "definition": "Code to identify the general type of benefits under which products and services are provided.",
+                "comment": "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
+                "requirements": "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.category",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitCategory"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Benefit categories such as: oral, medical, vision, oral-basic etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.productOrService",
+                "path": "ExplanationOfBenefit.item.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "Medical procedure a patient received from a health care provider. Current coding methods include: CPT-4 and HCFA Common Procedure Coding System Level II - (HCPCSII). (40)",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSProcedureCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.modifier",
+                "path": "ExplanationOfBenefit.item.modifier",
+                "short": "Product or service billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "Modifier(s) for the procedure represented on this line. Identifies special circumstances related to the performance of the service. (41)",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.programCode",
+                "path": "ExplanationOfBenefit.item.programCode",
+                "short": "Program the product or service is provided under",
+                "definition": "Identifies the program under which this may be recovered.",
+                "comment": "For example: Neonatal program, child dental program or drug users recovery program.",
+                "requirements": "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.programCode",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProgramCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Program specific reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.serviced[x]",
+                "path": "ExplanationOfBenefit.item.serviced[x]",
+                "short": "Date or dates of service or product delivery",
+                "definition": "The date or dates when the service or product was supplied, performed or completed.",
+                "requirements": "Needed to determine whether the  service or product was provided during the term of the insurance coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.serviced[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.done[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.location[x]",
+                "path": "ExplanationOfBenefit.item.location[x]",
+                "short": "Place of service or where product was supplied",
+                "definition": "Where the product or service was provided.",
+                "requirements": "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.location[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    },
+                    {
+                        "code": "Address"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Location"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServicePlace"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Place where the service is rendered.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-place"
+                },
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.where[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.quantity",
+                "path": "ExplanationOfBenefit.item.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "comment": "The quantity of units, times, days, visits, services, or treatments for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (42)",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.unitPrice",
+                "path": "ExplanationOfBenefit.item.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.factor",
+                "path": "ExplanationOfBenefit.item.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.net",
+                "path": "ExplanationOfBenefit.item.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.udi",
+                "path": "ExplanationOfBenefit.item.udi",
+                "short": "Unique device identifier",
+                "definition": "Unique Device Identifiers associated with this line item.",
+                "requirements": "The UDI code allows the insurer to obtain device level information on the product supplied.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.udi",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Device"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.bodySite",
+                "path": "ExplanationOfBenefit.item.bodySite",
+                "short": "Anatomical location",
+                "definition": "Physical service site on the patient (limb, tooth, etc.).",
+                "comment": "For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.",
+                "requirements": "Allows insurer to validate specific procedures.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.bodySite",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "OralSites"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The code for the teeth, quadrant, sextant and arch.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/tooth"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.subSite",
+                "path": "ExplanationOfBenefit.item.subSite",
+                "short": "Anatomical sub-location",
+                "definition": "A region or surface of the bodySite, e.g. limb region or tooth surface(s).",
+                "requirements": "Allows insurer to validate specific procedures.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.subSite",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Surface"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The code for the tooth surface and surface combinations.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/surface"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.encounter",
+                "path": "ExplanationOfBenefit.item.encounter",
+                "short": "Encounters related to this billed item",
+                "definition": "A billed item may include goods or services provided in multiple encounters.",
+                "requirements": "Used in some jurisdictions to link clinical events to claim items.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.encounter",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Encounter"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.noteNumber",
+                "path": "ExplanationOfBenefit.item.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "comment": "References number of the associated processNote entered",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Adjudication"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "short": "Adjudication details",
+                "definition": "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
+                "requirements": "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.id",
+                "path": "ExplanationOfBenefit.item.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.extension",
+                "path": "ExplanationOfBenefit.item.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "path": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Adjudication"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "adjudicationamounttype",
+                "short": "Adjudication details",
+                "definition": "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "requirements": "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.id",
+                "path": "ExplanationOfBenefit.item.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.extension",
+                "path": "ExplanationOfBenefit.item.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.modifierExtension",
+                "path": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Adjudication"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "denialreason",
+                "short": "Adjudication details",
+                "definition": "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "requirements": "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.id",
+                "path": "ExplanationOfBenefit.item.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.extension",
+                "path": "ExplanationOfBenefit.item.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.modifierExtension",
+                "path": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "denialreason"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Adjudication"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The adjudication codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Adjudication"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "allowedunits",
+                "short": "Adjudication details",
+                "definition": "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
+                "comment": "The quantity of units, times, days, visits, services, or treatments allowed for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (149)",
+                "requirements": "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.id",
+                "path": "ExplanationOfBenefit.item.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.extension",
+                "path": "ExplanationOfBenefit.item.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.modifierExtension",
+                "path": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "allowedunits"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Adjudication"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The adjudication codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Detail"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.detail",
+                "short": "Additional items",
+                "definition": "Second-tier of goods and services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.id",
+                "path": "ExplanationOfBenefit.item.detail.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.extension",
+                "path": "ExplanationOfBenefit.item.detail.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.modifierExtension",
+                "path": "ExplanationOfBenefit.item.detail.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.sequence",
+                "path": "ExplanationOfBenefit.item.detail.sequence",
+                "short": "Product or service provided",
+                "definition": "A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.",
+                "requirements": "The items to be processed for adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.revenue",
+                "path": "ExplanationOfBenefit.item.detail.revenue",
+                "short": "Revenue or cost center code",
+                "definition": "The type of revenue or cost center providing the product and/or service.",
+                "requirements": "Needed in the processing of institutional claims.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.revenue",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "RevenueCenter"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Codes for the revenue or cost centers supplying the service and/or products.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-revenue-center"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.category",
+                "path": "ExplanationOfBenefit.item.detail.category",
+                "short": "Benefit classification",
+                "definition": "Code to identify the general type of benefits under which products and services are provided.",
+                "comment": "Examples include: Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
+                "requirements": "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.category",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitCategory"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Benefit categories such as: oral, medical, vision, oral-basic etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.productOrService",
+                "path": "ExplanationOfBenefit.item.detail.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.modifier",
+                "path": "ExplanationOfBenefit.item.detail.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.programCode",
+                "path": "ExplanationOfBenefit.item.detail.programCode",
+                "short": "Program the product or service is provided under",
+                "definition": "Identifies the program under which this may be recovered.",
+                "comment": "For example: Neonatal program, child dental program or drug users recovery program.",
+                "requirements": "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.programCode",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProgramCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Program specific reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.quantity",
+                "path": "ExplanationOfBenefit.item.detail.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.unitPrice",
+                "path": "ExplanationOfBenefit.item.detail.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.factor",
+                "path": "ExplanationOfBenefit.item.detail.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.net",
+                "path": "ExplanationOfBenefit.item.detail.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.udi",
+                "path": "ExplanationOfBenefit.item.detail.udi",
+                "short": "Unique device identifier",
+                "definition": "Unique Device Identifiers associated with this line item.",
+                "requirements": "The UDI code allows the insurer to obtain device level information on the product supplied.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.udi",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Device"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.noteNumber",
+                "path": "ExplanationOfBenefit.item.detail.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.adjudication",
+                "path": "ExplanationOfBenefit.item.detail.adjudication",
+                "short": "Detail level adjudication details",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SubDetail"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.detail.subDetail",
+                "short": "Additional items",
+                "definition": "Third-tier of goods and services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.id",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.extension",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.modifierExtension",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.sequence",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.sequence",
+                "short": "Product or service provided",
+                "definition": "A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.",
+                "requirements": "The items to be processed for adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.revenue",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.revenue",
+                "short": "Revenue or cost center code",
+                "definition": "The type of revenue or cost center providing the product and/or service.",
+                "requirements": "Needed in the processing of institutional claims.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.revenue",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "RevenueCenter"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Codes for the revenue or cost centers supplying the service and/or products.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-revenue-center"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.category",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.category",
+                "short": "Benefit classification",
+                "definition": "Code to identify the general type of benefits under which products and services are provided.",
+                "comment": "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
+                "requirements": "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.category",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitCategory"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Benefit categories such as: oral, medical, vision, oral-basic etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.productOrService",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.modifier",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.programCode",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.programCode",
+                "short": "Program the product or service is provided under",
+                "definition": "Identifies the program under which this may be recovered.",
+                "comment": "For example: Neonatal program, child dental program or drug users recovery program.",
+                "requirements": "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.programCode",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProgramCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Program specific reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.quantity",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.unitPrice",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.factor",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.net",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.udi",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.udi",
+                "short": "Unique device identifier",
+                "definition": "Unique Device Identifiers associated with this line item.",
+                "requirements": "The UDI code allows the insurer to obtain device level information on the product supplied.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.udi",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Device"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.noteNumber",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.adjudication",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.adjudication",
+                "short": "Subdetail level adjudication details",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "740;600"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "AddedItem"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.addItem",
+                "short": "Insurer added line items",
+                "definition": "The first-tier service adjudications for payor added product or service lines.",
+                "requirements": "Insurers may redefine the provided product or service or may package and/or decompose groups of products and services. The addItems allows the insurer to provide their line item list with linkage to the submitted items/details/sub-details. In a preauthorization the insurer may use the addItem structure to provide additional information on authorized products and services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.id",
+                "path": "ExplanationOfBenefit.addItem.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.extension",
+                "path": "ExplanationOfBenefit.addItem.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.modifierExtension",
+                "path": "ExplanationOfBenefit.addItem.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.itemSequence",
+                "path": "ExplanationOfBenefit.addItem.itemSequence",
+                "short": "Item sequence number",
+                "definition": "Claim items which this service line is intended to replace.",
+                "requirements": "Provides references to the claim items.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.itemSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detailSequence",
+                "path": "ExplanationOfBenefit.addItem.detailSequence",
+                "short": "Detail sequence number",
+                "definition": "The sequence number of the details within the claim item which this line is intended to replace.",
+                "requirements": "Provides references to the claim details within the claim item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detailSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.subDetailSequence",
+                "path": "ExplanationOfBenefit.addItem.subDetailSequence",
+                "short": "Subdetail sequence number",
+                "definition": "The sequence number of the sub-details woithin the details within the claim item which this line is intended to replace.",
+                "requirements": "Provides references to the claim sub-details within the claim detail.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.subDetailSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.provider",
+                "path": "ExplanationOfBenefit.addItem.provider",
+                "short": "Authorized providers",
+                "definition": "The providers who are authorized for the services rendered to the patient.",
+                "requirements": "Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.provider",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
+                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
+                            "http://hl7.org/fhir/StructureDefinition/Organization"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.source"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.productOrService",
+                "path": "ExplanationOfBenefit.addItem.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.modifier",
+                "path": "ExplanationOfBenefit.addItem.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.programCode",
+                "path": "ExplanationOfBenefit.addItem.programCode",
+                "short": "Program the product or service is provided under",
+                "definition": "Identifies the program under which this may be recovered.",
+                "comment": "For example: Neonatal program, child dental program or drug users recovery program.",
+                "requirements": "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.programCode",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProgramCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Program specific reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.serviced[x]",
+                "path": "ExplanationOfBenefit.addItem.serviced[x]",
+                "short": "Date or dates of service or product delivery",
+                "definition": "The date or dates when the service or product was supplied, performed or completed.",
+                "requirements": "Needed to determine whether the  service or product was provided during the term of the insurance coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.serviced[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.done[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.location[x]",
+                "path": "ExplanationOfBenefit.addItem.location[x]",
+                "short": "Place of service or where product was supplied",
+                "definition": "Where the product or service was provided.",
+                "requirements": "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.location[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    },
+                    {
+                        "code": "Address"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Location"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServicePlace"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Place where the service is rendered.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-place"
+                },
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.where[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.quantity",
+                "path": "ExplanationOfBenefit.addItem.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.unitPrice",
+                "path": "ExplanationOfBenefit.addItem.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.factor",
+                "path": "ExplanationOfBenefit.addItem.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.net",
+                "path": "ExplanationOfBenefit.addItem.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.bodySite",
+                "path": "ExplanationOfBenefit.addItem.bodySite",
+                "short": "Anatomical location",
+                "definition": "Physical service site on the patient (limb, tooth, etc.).",
+                "comment": "For example, providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed.",
+                "requirements": "Allows insurer to validate specific procedures.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.bodySite",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "OralSites"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The code for the teeth, quadrant, sextant and arch.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/tooth"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.subSite",
+                "path": "ExplanationOfBenefit.addItem.subSite",
+                "short": "Anatomical sub-location",
+                "definition": "A region or surface of the bodySite, e.g. limb region or tooth surface(s).",
+                "requirements": "Allows insurer to validate specific procedures.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.subSite",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Surface"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The code for the tooth surface and surface combinations.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/surface"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.noteNumber",
+                "path": "ExplanationOfBenefit.addItem.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.adjudication",
+                "path": "ExplanationOfBenefit.addItem.adjudication",
+                "short": "Added items adjudication",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "740;600"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "AddedItemDetail"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.addItem.detail",
+                "short": "Insurer added line items",
+                "definition": "The second-tier service adjudications for payor added services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.id",
+                "path": "ExplanationOfBenefit.addItem.detail.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.extension",
+                "path": "ExplanationOfBenefit.addItem.detail.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.modifierExtension",
+                "path": "ExplanationOfBenefit.addItem.detail.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.productOrService",
+                "path": "ExplanationOfBenefit.addItem.detail.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.modifier",
+                "path": "ExplanationOfBenefit.addItem.detail.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.quantity",
+                "path": "ExplanationOfBenefit.addItem.detail.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.unitPrice",
+                "path": "ExplanationOfBenefit.addItem.detail.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.factor",
+                "path": "ExplanationOfBenefit.addItem.detail.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.net",
+                "path": "ExplanationOfBenefit.addItem.detail.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.noteNumber",
+                "path": "ExplanationOfBenefit.addItem.detail.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.adjudication",
+                "path": "ExplanationOfBenefit.addItem.detail.adjudication",
+                "short": "Added items adjudication",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "740;600"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "AddedItemDetailSubDetail"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail",
+                "short": "Insurer added line items",
+                "definition": "The third-tier service adjudications for payor added services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.id",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.extension",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.productOrService",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.modifier",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.quantity",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.factor",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.net",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.adjudication",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.adjudication",
+                "short": "Added items adjudication",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication",
+                "path": "ExplanationOfBenefit.adjudication",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "short": "Header-level adjudication",
+                "definition": "The adjudication results which are presented at the header level rather than at the line-item or add-item levels.",
+                "requirements": "Some insurers will receive line-items but provide the adjudication only at a summary or header-level.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.id",
+                "path": "ExplanationOfBenefit.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.extension",
+                "path": "ExplanationOfBenefit.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.modifierExtension",
+                "path": "ExplanationOfBenefit.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.reason",
+                "path": "ExplanationOfBenefit.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.amount",
+                "path": "ExplanationOfBenefit.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.value",
+                "path": "ExplanationOfBenefit.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype",
+                "path": "ExplanationOfBenefit.adjudication",
+                "sliceName": "adjudicationamounttype",
+                "short": "Header-level adjudication",
+                "definition": "The adjudication results which are presented at the header level rather than at the line-item or add-item levels.",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "requirements": "Some insurers will receive line-items but provide the adjudication only at a summary or header-level.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.id",
+                "path": "ExplanationOfBenefit.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.extension",
+                "path": "ExplanationOfBenefit.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.modifierExtension",
+                "path": "ExplanationOfBenefit.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.reason",
+                "path": "ExplanationOfBenefit.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.value",
+                "path": "ExplanationOfBenefit.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason",
+                "path": "ExplanationOfBenefit.adjudication",
+                "sliceName": "denialreason",
+                "short": "Header-level adjudication",
+                "definition": "The adjudication results which are presented at the header level rather than at the line-item or add-item levels.",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "requirements": "Some insurers will receive line-items but provide the adjudication only at a summary or header-level.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.id",
+                "path": "ExplanationOfBenefit.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.extension",
+                "path": "ExplanationOfBenefit.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.modifierExtension",
+                "path": "ExplanationOfBenefit.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "denialreason"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Adjudication"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The adjudication codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.reason",
+                "path": "ExplanationOfBenefit.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.amount",
+                "path": "ExplanationOfBenefit.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.value",
+                "path": "ExplanationOfBenefit.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.total",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "'360;620"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Total"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.total",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "open"
+                },
+                "short": "Adjudication totals",
+                "definition": "Categorized monetary totals for the adjudication.",
+                "comment": "Totals for amounts submitted, co-pays, benefits payable etc.",
+                "requirements": "To provide the requestor with financial totals by category for the adjudication.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.total",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total.id",
+                "path": "ExplanationOfBenefit.total.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total.extension",
+                "path": "ExplanationOfBenefit.total.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total.modifierExtension",
+                "path": "ExplanationOfBenefit.total.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to convey the type of total provided.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBTotalCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "short": "Financial total for the category",
+                "definition": "Monetary total amount associated with the category.",
+                "comment": "Total amount for each category (i.e., submitted, allowed, etc.) (148)",
+                "requirements": "Needed to convey the total monetary amount.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.amount",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "'360;620"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Total"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.total",
+                "sliceName": "adjudicationamounttype",
+                "short": "Adjudication totals",
+                "definition": "Categorized monetary totals for the adjudication.",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "requirements": "To provide the requestor with financial totals by category for the adjudication.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.total",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.id",
+                "path": "ExplanationOfBenefit.total.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.extension",
+                "path": "ExplanationOfBenefit.total.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.modifierExtension",
+                "path": "ExplanationOfBenefit.total.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to convey the type of total provided.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "short": "Financial total for the category",
+                "definition": "Monetary total amount associated with the category.",
+                "requirements": "Needed to convey the total monetary amount.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.amount",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "'360;620"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Total"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.total",
+                "sliceName": "inoutnetwork",
+                "short": "Adjudication totals",
+                "definition": "Categorized monetary totals for the adjudication.",
+                "comment": "Indicates the in network or out of network payment status of the claim. (142)",
+                "requirements": "To provide the requestor with financial totals by category for the adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.id",
+                "path": "ExplanationOfBenefit.total.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.extension",
+                "path": "ExplanationOfBenefit.total.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.modifierExtension",
+                "path": "ExplanationOfBenefit.total.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to convey the type of total provided.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "short": "Financial total for the category",
+                "definition": "Monetary total amount associated with the category.",
+                "requirements": "Needed to convey the total monetary amount.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.amount",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.payment",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "360;650"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Payment"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.payment",
+                "short": "Payment Details",
+                "definition": "Payment details for the adjudication of the claim.",
+                "requirements": "Needed to convey references to the financial instrument that has been used if payment has been made.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.id",
+                "path": "ExplanationOfBenefit.payment.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.extension",
+                "path": "ExplanationOfBenefit.payment.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.modifierExtension",
+                "path": "ExplanationOfBenefit.payment.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.type",
+                "path": "ExplanationOfBenefit.payment.type",
+                "short": "Partial or complete payment",
+                "definition": "Whether this represents partial or complete payment of the benefits payable.",
+                "comment": "Indicates whether the claim was paid or denied. (91)",
+                "requirements": "To advise the requestor when the insurer believes all payments to have been completed.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerClaimPaymentStatusCode"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.adjustment",
+                "path": "ExplanationOfBenefit.payment.adjustment",
+                "short": "Payment adjustment for non-claim issues",
+                "definition": "Total amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication.",
+                "comment": "Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider.",
+                "requirements": "To advise the requestor of adjustments applied to the payment.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.adjustment",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.adjustmentReason",
+                "path": "ExplanationOfBenefit.payment.adjustmentReason",
+                "short": "Explanation for the variance",
+                "definition": "Reason for the payment adjustment.",
+                "requirements": "Needed to clarify the monetary adjustment.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.adjustmentReason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "PaymentAdjustmentReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Payment Adjustment reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/payment-adjustment-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.date",
+                "path": "ExplanationOfBenefit.payment.date",
+                "short": "Expected date of payment",
+                "definition": "Estimated date the payment will be issued or the actual issue date of payment.",
+                "comment": "The date the claim was paid. (107)",
+                "requirements": "To advise the payee when payment can be expected.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.date",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.amount",
+                "path": "ExplanationOfBenefit.payment.amount",
+                "short": "Payable amount after adjustment",
+                "definition": "Benefits payable less any payment adjustment.",
+                "requirements": "Needed to provide the actual payment amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.identifier",
+                "path": "ExplanationOfBenefit.payment.identifier",
+                "short": "Business identifier for the payment",
+                "definition": "Issuer's unique identifier for the payment instrument.",
+                "comment": "For example: EFT number or check number.",
+                "requirements": "Enable the receiver to reconcile when payment received.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.identifier",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Identifier"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.formCode",
+                "path": "ExplanationOfBenefit.formCode",
+                "short": "Printed form identifier",
+                "definition": "A code for the form to be used for printing the content.",
+                "comment": "May be needed to identify specific jurisdictional forms.",
+                "requirements": "Needed to specify the specific form used for producing output for this response.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.formCode",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Forms"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The forms codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/forms"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.form",
+                "path": "ExplanationOfBenefit.form",
+                "short": "Printed reference or actual form",
+                "definition": "The actual form, by reference or inclusion, for printing the content or an EOB.",
+                "comment": "Needed to permit insurers to include the actual form.",
+                "requirements": "Needed to include the specific form used for producing output for this response.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.form",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Attachment"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Note"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.processNote",
+                "short": "Note concerning adjudication",
+                "definition": "A note that describes or explains adjudication results in a human readable form.",
+                "requirements": "Provides the insurer specific textual explanations associated with the processing.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.id",
+                "path": "ExplanationOfBenefit.processNote.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.extension",
+                "path": "ExplanationOfBenefit.processNote.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.modifierExtension",
+                "path": "ExplanationOfBenefit.processNote.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.number",
+                "path": "ExplanationOfBenefit.processNote.number",
+                "short": "Note instance identifier",
+                "definition": "A number to uniquely identify a note entry.",
+                "requirements": "Necessary to provide a mechanism to link from adjudications.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote.number",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.type",
+                "path": "ExplanationOfBenefit.processNote.type",
+                "short": "display | print | printoper",
+                "definition": "The business purpose of the note text.",
+                "requirements": "To convey the expectation for when the text is used.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "NoteType"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "The presentation types of notes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/note-type|4.0.1"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.text",
+                "path": "ExplanationOfBenefit.processNote.text",
+                "short": "Note explanatory text",
+                "definition": "The explanation or description associated with the processing.",
+                "comment": "Payment denial explanation to a member, typically goes on the EOB when the payment is denied or disallowed (181)",
+                "requirements": "Required to provide human readable explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote.text",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.language",
+                "path": "ExplanationOfBenefit.processNote.language",
+                "short": "Language of the text",
+                "definition": "A code to define the language used in the text of the note.",
+                "comment": "Only required if the language is different from the resource language.",
+                "requirements": "Note text may vary from the resource defined language.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote.language",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+                            "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Language"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "preferred",
+                    "description": "A human language.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitPeriod",
+                "path": "ExplanationOfBenefit.benefitPeriod",
+                "short": "When the benefits are applicable",
+                "definition": "The term of the benefits documented in this response.",
+                "comment": "Not applicable when use=claim.",
+                "requirements": "Needed as coverages may be multi-year while benefits tend to be annual therefore a separate expression of the benefit period is needed.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitPeriod",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "BenefitBalance"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.benefitBalance",
+                "short": "Balance by Benefit Category",
+                "definition": "Balance by Benefit Category.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.id",
+                "path": "ExplanationOfBenefit.benefitBalance.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.extension",
+                "path": "ExplanationOfBenefit.benefitBalance.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.modifierExtension",
+                "path": "ExplanationOfBenefit.benefitBalance.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.category",
+                "path": "ExplanationOfBenefit.benefitBalance.category",
+                "short": "Benefit classification",
+                "definition": "Code to identify the general type of benefits under which products and services are provided.",
+                "comment": "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
+                "requirements": "Needed to convey the category of service or product for which eligibility is sought.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitCategory"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Benefit categories such as: oral, medical, vision, oral-basic etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.excluded",
+                "path": "ExplanationOfBenefit.benefitBalance.excluded",
+                "short": "Excluded from the plan",
+                "definition": "True if the indicated class of service is excluded from the plan, missing or False indicates the product or service is included in the coverage.",
+                "requirements": "Needed to identify items that are specifically excluded from the coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.excluded",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.name",
+                "path": "ExplanationOfBenefit.benefitBalance.name",
+                "short": "Short name for the benefit",
+                "definition": "A short name or tag for the benefit.",
+                "comment": "For example: MED01, or DENT2.",
+                "requirements": "Required to align with other plan names.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.name",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.description",
+                "path": "ExplanationOfBenefit.benefitBalance.description",
+                "short": "Description of the benefit or services covered",
+                "definition": "A richer description of the benefit or services covered.",
+                "comment": "For example, 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'.",
+                "requirements": "Needed for human readable reference.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.description",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.network",
+                "path": "ExplanationOfBenefit.benefitBalance.network",
+                "short": "In or out of network",
+                "definition": "Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers.",
+                "requirements": "Needed as in or out of network providers are treated differently under the coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.network",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitNetwork"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Code to classify in or out of network services.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/benefit-network"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.unit",
+                "path": "ExplanationOfBenefit.benefitBalance.unit",
+                "short": "Individual or family",
+                "definition": "Indicates if the benefits apply to an individual or to the family.",
+                "requirements": "Needed for the understanding of the benefits.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.unit",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitUnit"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Unit covered/serviced - individual or family.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/benefit-unit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.term",
+                "path": "ExplanationOfBenefit.benefitBalance.term",
+                "short": "Annual or lifetime",
+                "definition": "The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.",
+                "requirements": "Needed for the understanding of the benefits.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.term",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitTerm"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Coverage unit - annual, lifetime.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/benefit-term"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Benefit"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.benefitBalance.financial",
+                "short": "Benefit Summary",
+                "definition": "Benefits Used to date.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.financial",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.id",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.extension",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.modifierExtension",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.type",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.type",
+                "short": "Benefit classification",
+                "definition": "Classification of benefit being provided.",
+                "comment": "For example: deductible, visits, benefit amount.",
+                "requirements": "Needed to convey the nature of the benefit.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.financial.type",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitType"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Deductable, visits, co-pay, etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/benefit-type"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.allowed[x]",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.allowed[x]",
+                "short": "Benefits allowed",
+                "definition": "The quantity of the benefit which is permitted under the coverage.",
+                "requirements": "Needed to convey the benefits offered under the coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.financial.allowed[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "unsignedInt"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.used[x]",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.used[x]",
+                "short": "Benefits used",
+                "definition": "The quantity of the benefit which have been consumed to date.",
+                "requirements": "Needed to convey the benefits consumed to date.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.financial.used[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "unsignedInt"
+                    },
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            }
+        ]
+    },
+    "differential": {
+        "element": [
+            {
+                "id": "ExplanationOfBenefit",
+                "path": "ExplanationOfBenefit",
+                "constraint": [
+                    {
+                        "key": "dom-2",
+                        "severity": "error",
+                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
+                        "expression": "contained.contained.empty()",
+                        "xpath": "not(parent::f:contained and f:contained)",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-3",
+                        "severity": "error",
+                        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
+                        "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
+                        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-4",
+                        "severity": "error",
+                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
+                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
+                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-5",
+                        "severity": "error",
+                        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
+                        "expression": "contained.meta.security.empty()",
+                        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                                "valueBoolean": true
+                            },
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
+                                "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
+                            }
+                        ],
+                        "key": "dom-6",
+                        "severity": "warning",
+                        "human": "A resource should have narrative for robust management",
+                        "expression": "text.`div`.exists()",
+                        "xpath": "exists(f:text/h:div)",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "EOB-institutional-item-or-header-adjudication",
+                        "severity": "error",
+                        "human": "Institutional EOB:  Should have adjudication at the item or header level, but not both",
+                        "expression": "(adjudication.exists() != item.adjudication.exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    },
+                    {
+                        "key": "adjudication-has-amount-type-slice",
+                        "severity": "error",
+                        "human": "If Adjudication is present, it must have at least one adjudicationamounttype slice",
+                        "expression": "adjudication.exists() implies (adjudication.where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.type",
+                "path": "ExplanationOfBenefit.type",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://terminology.hl7.org/CodeSystem/claim-type",
+                            "code": "institutional"
+                        }
+                    ]
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod",
+                "path": "ExplanationOfBenefit.billablePeriod",
+                "min": 1
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.start",
+                "path": "ExplanationOfBenefit.billablePeriod.start",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.end",
+                "path": "ExplanationOfBenefit.billablePeriod.end",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.created",
+                "path": "ExplanationOfBenefit.created",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.provider",
+                "path": "ExplanationOfBenefit.provider",
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"
+                        ]
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam",
+                "path": "ExplanationOfBenefit.careTeam",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "EOB-inst-careTeam-practitioner",
+                        "severity": "error",
+                        "human": "Institutional EOB: Careteam roles refer to a practitioner",
+                        "expression": "(\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists() implies\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists().provider.all(resolve() is Practitioner)\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    },
+                    {
+                        "key": "EOB-inst-careTeam-organization",
+                        "severity": "error",
+                        "human": "Institutional EOB:  Careteam roles refer to an organization",
+                        "expression": "(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().provider.all(resolve() is Organization)\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.role",
+                "path": "ExplanationOfBenefit.careTeam.role",
+                "min": 1,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInstitutionalCareTeamRole"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on $this pattern",
+                    "ordered": false,
+                    "rules": "open"
+                },
+                "min": 1
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "billingnetworkcontractingstatus",
+                "comment": "Indicates that the Billing Provider has a contract with the Plan (regardless of the network) as of the effective date of service or admission. (101)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "billingnetworkcontractingstatus"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderContractingStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "admissionperiod",
+                "comment": "The Period.start date corresponds with the date the beneficiary was admitted to a facility and the onset of services. May precede the Statement From Date if this claim is for a beneficiary who has been continuously under care. The Period.end date corresponds with the date beneficiary was discharged from the facility, or died. Matches the final Statement Thru Date. When there is a discharge date, the Patient Discharge Status Code indicates the final disposition of the patient after discharge. (18, 19)",
+                "min": 1,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "admissionperiod"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "type",
+                            "path": "$this"
+                        }
+                    ],
+                    "ordered": false,
+                    "rules": "open"
+                },
+                "min": 1
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admissionperiod.timingPeriod",
+                "path": "ExplanationOfBenefit.supportingInfo.timingPeriod",
+                "min": 1,
+                "max": "1",
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "clmrecvddate",
+                "comment": "The date the claim was received by the payer (88)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "clmrecvddate"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "min": 1,
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "typeofbill",
+                "comment": "UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of institution, the second digit classifies the type of care being billed, and the third digit  identifies the frequency of the bill for a specific course of treatment or inpatient confinement. (17)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "typeofbill"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCTypeOfBill"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "pointoforigin",
+                "comment": "Identifies the place where the patient was identified as needing admission to an institution. This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15). (13)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "pointoforigin"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPointOfOriginForAdmissionOrVisit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "admtype",
+                "comment": "Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled. (14)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "admtype"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPriorityTypeOfAdmissionOrVisit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "discharge-status",
+                "comment": "Patient’s status as of the discharge date for a facility stay. Information located on UB04. (Form Locator 17). (117)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "discharge-status"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPatientDischargeStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "drg",
+                "comment": "Claim diagnosis related group (DRG). DRGs require the DRG system; i.e., MS-DRG / AP-DRG / APR-DRG, the DRG version and the code value (32, 33. 113)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "drg"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:drg.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/CMSMS3MAPAPRDRG"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis",
+                "path": "ExplanationOfBenefit.diagnosis",
+                "comment": "Diagnosis codes describe an individual's disease or medical condition. (6, 7, 8, 21, 22, 23, 30)",
+                "min": 1,
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.sequence",
+                "path": "ExplanationOfBenefit.diagnosis.sequence",
+                "comment": "Diagnosis.sequence values do not necessarily indiate any order in which the diagnosis was reported or identified.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of diagnosis.type to identify primary, secondary, etc."
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                "path": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/CDCICD910CMDiagnosisCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.type",
+                "path": "ExplanationOfBenefit.diagnosis.type",
+                "comment": "Indicates if the inpatient institutional diagnosis is admitting, principal, other or an external cause of injury. (21, 22, 23)",
+                "min": 1,
+                "max": "1",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInpatientInstitutionalDiagnosisType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.onAdmission",
+                "path": "ExplanationOfBenefit.diagnosis.onAdmission",
+                "comment": "Used to capture whether a diagnosis was present at time of a patient's admission. (28)",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPresentOnAdmission"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure",
+                "path": "ExplanationOfBenefit.procedure",
+                "comment": "Medical procedure a patient received during inpatient stay. Current coding methods include: International Classification of Diseases Surgical Procedures (ICD-9). Information located on UB04 (Form Locator 74). (25, 27, 10, 12)",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.sequence",
+                "path": "ExplanationOfBenefit.procedure.sequence",
+                "comment": " procedure.sequence values do not necessarily indiate any order in which the procedure occurred.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of procedure.type to identify primary and secondary procedures"
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.type",
+                "path": "ExplanationOfBenefit.procedure.type",
+                "comment": "Indicates if the inpatient institutional procedure (ICD-PCS) is the principal procedure or another procedure. (186)",
+                "min": 1,
+                "max": "1",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimProcedureType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.date",
+                "path": "ExplanationOfBenefit.procedure.date",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.procedure[x]",
+                "path": "ExplanationOfBenefit.procedure.procedure[x]",
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/CMSICD910PCSProcedureCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance",
+                "path": "ExplanationOfBenefit.insurance",
+                "max": "1"
+            },
+            {
+                "id": "ExplanationOfBenefit.item",
+                "path": "ExplanationOfBenefit.insurance",
+                "constraint": [
+                    {
+                        "key": "adjudication-has-amount-type-slice",
+                        "severity": "error",
+                        "human": "If Adjudication is present, it must have at least one adjudicationamounttype slice",
+                        "expression": "adjudication.exists() implies (adjudication.where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.revenue",
+                "path": "ExplanationOfBenefit.item.revenue",
+                "comment": "Code used on the UB-04 (Form Locator 42) to identify a specific accommodation, ancillary service, or billing calculation related to the service being billed (86)",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCRevenueCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.productOrService",
+                "path": "ExplanationOfBenefit.item.productOrService",
+                "comment": "Medical procedure a patient received from a health care provider. Current coding methods include: CPT-4 and HCFA Common Procedure Coding System Level II - (HCPCSII). (40)",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSProcedureCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.modifier",
+                "path": "ExplanationOfBenefit.item.modifier",
+                "comment": "Modifier(s) for the procedure represented on this line. Identifies special circumstances related to the performance of the service. (41)",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.quantity",
+                "path": "ExplanationOfBenefit.item.quantity",
+                "comment": "The quantity of units, times, days, visits, services, or treatments for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (42)",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication",
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype",
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "adjudicationamounttype",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "min": 0,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason",
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "denialreason",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "min": 0,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "denialreason"
+                        }
+                    ]
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits",
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "allowedunits",
+                "comment": "The quantity of units, times, days, visits, services, or treatments allowed for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (149)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "allowedunits"
+                        }
+                    ]
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication",
+                "path": "ExplanationOfBenefit.adjudication",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype",
+                "path": "ExplanationOfBenefit.adjudication",
+                "sliceName": "adjudicationamounttype",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "min": 0,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.adjudication.amount",
+                "min": 1
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason",
+                "path": "ExplanationOfBenefit.adjudication",
+                "sliceName": "denialreason",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "min": 0,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "denialreason"
+                        }
+                    ]
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.reason",
+                "path": "ExplanationOfBenefit.adjudication.reason",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total",
+                "path": "ExplanationOfBenefit.total",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "open"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBTotalCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "comment": "Total amount for each category (i.e., submitted, allowed, etc.) (148)"
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype",
+                "path": "ExplanationOfBenefit.total",
+                "sliceName": "adjudicationamounttype",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "min": 1,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork",
+                "path": "ExplanationOfBenefit.total",
+                "sliceName": "inoutnetwork",
+                "comment": "Indicates the in network or out of network payment status of the claim. (142)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.date",
+                "path": "ExplanationOfBenefit.payment.date",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.text",
+                "path": "ExplanationOfBenefit.processNote.text",
+                "mustSupport": true
+            }
+        ]
+    }
+}
\ No newline at end of file
diff --git a/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.json b/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.json
index 1281e67694b..1004e4ac062 100644
--- a/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.json
+++ b/conformance/fhir-ig-carin-bb/src/main/resources/hl7/fhir/us/carin-bb/package/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.json
@@ -1 +1,16879 @@
-{"resourceType":"StructureDefinition","id":"C4BB-ExplanationOfBenefit-Outpatient-Institutional","text":{"status":"extensions","div":"<div xmlns=\"http://www.w3.org/1999/xhtml\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the element can appear in the instance\">Card.</a></th><th style=\"width: 100px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the element\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_resource.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit\">ExplanationOfBenefit</a><a name=\"ExplanationOfBenefit\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: black; null\" title=\"This element has or is affected by some invariants (EOB-institutional-item-or-header-adjudication)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"StructureDefinition-C4BB-ExplanationOfBenefit.html\">C4BBExplanationOfBenefit</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of Benefit resource</span><br/><span style=\"font-weight:bold\">EOB-institutional-item-or-header-adjudication: </span>Institutional EOB:  Should have adjudication at the item or header level, but not both</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.type\">type</a><a name=\"ExplanationOfBenefit.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Category or discipline</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck101.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"http://terminology.hl7.org/2.0.0/CodeSystem-claim-type.html\">http://terminology.hl7.org/CodeSystem/claim-type</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">institutional</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.created\">created</a><a name=\"ExplanationOfBenefit.created\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Response creation date</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.provider\">provider</a><a name=\"ExplanationOfBenefit.provider\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-C4BB-Organization.html\">C4BB Organization</a>)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Party responsible for the claim</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam\">careTeam</a><a name=\"ExplanationOfBenefit.careTeam\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: black; null\" title=\"This element has or is affected by some invariants (EOB-inst-careTeam-practitioner, EOB-inst-careTeam-organization, EOB-careteam-qualification)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Care Team members</span><br/><span style=\"font-weight:bold\">EOB-inst-careTeam-practitioner: </span>Institutional EOB: Careteam roles refer to a practitioner<br/><span style=\"font-weight:bold\">EOB-inst-careTeam-organization: </span>Institutional EOB:  Careteam roles refer to an organization<br/><span style=\"font-weight:bold\">EOB-careteam-qualification: </span>Care Team Performing physician's qualifications are from US-Core-Provider-Specialty Value Set</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam.role\">role</a><a name=\"ExplanationOfBenefit.careTeam.role\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Function within the team</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimInstitutionalCareTeamRole.html\">C4BB Claim Institutional Care Team Role</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam.qualification\">qualification</a><a name=\"ExplanationOfBenefit.careTeam.qualification\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Practitioner credential or specialization</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/ValueSet-us-core-provider-specialty.html\">US Core Provider Speciality (NUCC)</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo\">supportingInfo</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Supporting information</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by pattern:category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus\" title=\"Slice billingnetworkcontractingstatus\">supportingInfo:billingnetworkcontractingstatus</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">billingnetworkcontractingstatus</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBPayerProviderContractingStatus.html\">C4BB Payer Provider Contracting Status</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate\" title=\"Slice clmrecvddate\">supportingInfo:clmrecvddate</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">clmrecvddate</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]\">timing[x]</a><a name=\"ExplanationOfBenefit.supportingInfo.timing_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">When it occurred</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill\" title=\"Slice typeofbill\">supportingInfo:typeofbill</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">typeofbill</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCTypeOfBill.html\">NUBC Type of Bill Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin\" title=\"Slice pointoforigin\">supportingInfo:pointoforigin</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">pointoforigin</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPointOfOriginForAdmissionOrVisit.html\">NUBC Point Of Origin</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype\" title=\"Slice admtype\">supportingInfo:admtype</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">admtype</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPriorityTypeOfAdmissionOrVisit.html\">NUBC Priority (Type) of Admission or Visit</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status\" title=\"Slice discharge-status\">supportingInfo:discharge-status</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">discharge-status</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPatientDischargeStatus.html\">NUBC Patient Discharge Status Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis\">diagnosis</a><a name=\"ExplanationOfBenefit.diagnosis\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Pertinent diagnosis information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.sequence\">sequence</a><a name=\"ExplanationOfBenefit.diagnosis.sequence\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#positiveInt\">positiveInt</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Diagnosis instance identifier</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.diagnosis[x]\">diagnosis[x]</a><a name=\"ExplanationOfBenefit.diagnosis.diagnosis_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Nature of illness or problem</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-CDCICD910CMDiagnosisCodes.html\">Diagnosis Codes - International Classification of Diseases, Clinical Modification (ICD-9-CM, ICD-10-CM)</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.type\">type</a><a name=\"ExplanationOfBenefit.diagnosis.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Timing or nature of the diagnosis</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimOutpatientInstitutionalDiagnosisType.html\">C4BB Claim Outpatient Institutional Diagnosis Type</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item\">item</a><a name=\"ExplanationOfBenefit.item\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Product or service provided</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.revenue\">revenue</a><a name=\"ExplanationOfBenefit.item.revenue\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Revenue or cost center code</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCRevenueCodes.html\">NUBC Revenue Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.productOrService\">productOrService</a><a name=\"ExplanationOfBenefit.item.productOrService\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Billing, service, product, or drug code</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AMACPTCMSHCPCSProcedureCodes.html\">Current Procedural Terminology (CPT) -  Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes - Procedure Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.modifier\">modifier</a><a name=\"ExplanationOfBenefit.item.modifier\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Product or service billing modifiers</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AMACPTCMSHCPCSModifiers.html\">Current Procedural Terminology (CPT) -  Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes - Procedure Modifier Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck112.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.serviced[x]\">serviced[x]</a><a name=\"ExplanationOfBenefit.item.serviced_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Date or dates of service or product delivery</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by type:$this</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.servicedDate\">servicedDate</a><a name=\"ExplanationOfBenefit.item.servicedDate\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Date or dates of service or product delivery</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.quantity\">quantity</a><a name=\"ExplanationOfBenefit.item.quantity\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#SimpleQuantity\" title=\"Quantity\">SimpleQuantity</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Count of products or services</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication\">adjudication</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic\" title=\"This element must be supported\">S</span><span style=\"padding-left: 3px; padding-right: 3px; color: black; null; font-style: italic\" title=\"This element has or is affected by some invariants (adjudication-has-amount-type-slice)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Adjudication details</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Closed by pattern:category</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">adjudication-has-amount-type-slice: </span><span style=\"font-style: italic\">If Adjudication is present, it must have at least one adjudicationamounttype slice</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1033.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> adjudication:All Slices<a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudicationCategoryDiscriminator.html\">C4BB Adjudication Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">adjudication:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.item.adjudication.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Monetary amount</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason\" title=\"Slice denialreason\">adjudication:denialreason</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">denialreason</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason.reason\">reason</a><a name=\"ExplanationOfBenefit.item.adjudication.reason\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of adjudication outcome</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes.html\">X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits\" title=\"Slice allowedunits\">adjudication:allowedunits</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck102501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">allowedunits</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits.value\">value</a><a name=\"ExplanationOfBenefit.item.adjudication.value\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#decimal\">decimal</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Non-monitary value</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication\">adjudication</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic\" title=\"This element must be supported\">S</span><span style=\"padding-left: 3px; padding-right: 3px; color: black; null; font-style: italic\" title=\"This element has or is affected by some invariants (adjudication-has-amount-type-slice)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Header-level adjudication</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Closed by pattern:category</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">adjudication-has-amount-type-slice: </span><span style=\"font-style: italic\">If Adjudication is present, it must have at least one adjudicationamounttype slice</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck133.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> adjudication:All Slices<a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudicationCategoryDiscriminator.html\">C4BB Adjudication Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">adjudication:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Header-level adjudication</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.adjudication.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Monetary amount</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason\" title=\"Slice denialreason\">adjudication:denialreason</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Header-level adjudication</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">denialreason</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason.reason\">reason</a><a name=\"ExplanationOfBenefit.adjudication.reason\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of adjudication outcome</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes.html\">X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total\">total</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">1</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Adjudication totals</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by pattern:category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck133.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> total:All Slices<a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1330.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBTotalCategoryDiscriminator.html\">C4BB Total Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#extensible\" title=\"To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.\">extensible</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total.amount\">amount</a><a name=\"ExplanationOfBenefit.total.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Financial total for the category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">total:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication totals</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.total.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Financial total for the category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:inoutnetwork\" title=\"Slice inoutnetwork\">total:inoutnetwork</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication totals</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:inoutnetwork.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBPayerBenefitPaymentStatus.html\">C4BB Payer Benefit Payment Status</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.payment\">payment</a><a name=\"ExplanationOfBenefit.payment\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.payment.date\">date</a><a name=\"ExplanationOfBenefit.payment.date\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Expected date of payment</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.processNote\">processNote</a><a name=\"ExplanationOfBenefit.processNote\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.processNote.text\">text</a><a name=\"ExplanationOfBenefit.processNote.text\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Note explanatory text</span></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"},"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-category","valueString":"Financial.General"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category","valueCode":"patient"}],"url":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional","version":"1.0.0","name":"C4BBExplanationOfBenefitOutpatientInstitutional","title":"C4BB ExplanationOfBenefit Outpatient Institutional","status":"active","date":"2020-11-23T16:49:10+00:00","publisher":"HL7 Financial Management Working Group","contact":[{"name":"HL7 Financial Management Working Group","telecom":[{"system":"url","value":"http://www.hl7.org/Special/committees/fm/index.cfm"},{"system":"email","value":"fm@lists.HL7.org"}]}],"description":"This profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for outpatient services, which may include including the use of equipment and supplies, laboratory services, radiology services and other charges. Outpatient claims are submitted for services rendered at an institution that are not part of an overnight stay. \nThe claims data is based on the institutional claim form UB-04, submission standards adopted by the Department of Health and Human Services.","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"US"}]}],"fhirVersion":"4.0.1","mapping":[{"identity":"workflow","uri":"http://hl7.org/fhir/workflow","name":"Workflow Pattern"},{"identity":"w5","uri":"http://hl7.org/fhir/fivews","name":"FiveWs Pattern Mapping"},{"identity":"v2","uri":"http://hl7.org/v2","name":"HL7 v2 Mapping"},{"identity":"rim","uri":"http://hl7.org/v3","name":"RIM Mapping"}],"kind":"resource","abstract":false,"type":"ExplanationOfBenefit","baseDefinition":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit","derivation":"constraint","snapshot":{"element":[{"id":"ExplanationOfBenefit","path":"ExplanationOfBenefit","short":"Explanation of Benefit resource","definition":"This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.","alias":["EOB"],"min":0,"max":"*","base":{"path":"ExplanationOfBenefit","min":0,"max":"*"},"constraint":[{"key":"dom-2","severity":"error","human":"If the resource is contained in another resource, it SHALL NOT contain nested Resources","expression":"contained.contained.empty()","xpath":"not(parent::f:contained and f:contained)","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-3","severity":"error","human":"If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource","expression":"contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()","xpath":"not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-4","severity":"error","human":"If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated","expression":"contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()","xpath":"not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-5","severity":"error","human":"If a resource is contained in another resource, it SHALL NOT have a security label","expression":"contained.meta.security.empty()","xpath":"not(exists(f:contained/*/f:meta/f:security))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice","valueBoolean":true},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation","valueMarkdown":"When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."}],"key":"dom-6","severity":"warning","human":"A resource should have narrative for robust management","expression":"text.`div`.exists()","xpath":"exists(f:text/h:div)","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"EOB-institutional-item-or-header-adjudication","severity":"error","human":"Institutional EOB:  Should have adjudication at the item or header level, but not both","expression":"(adjudication.exists() != item.adjudication.exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"Entity. Role, or Act"},{"identity":"workflow","map":"Event"}]},{"id":"ExplanationOfBenefit.id","path":"ExplanationOfBenefit.id","short":"Logical id of this artifact","definition":"The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.","comment":"The only time that a resource does not have an id is when it is being submitted to the server using a create operation.","min":0,"max":"1","base":{"path":"Resource.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta","path":"ExplanationOfBenefit.meta","short":"Metadata about the resource","definition":"The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.","min":1,"max":"1","base":{"path":"Resource.meta","min":0,"max":"1"},"type":[{"code":"Meta"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.id","path":"ExplanationOfBenefit.meta.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.meta.extension","path":"ExplanationOfBenefit.meta.extension","slicing":{"discriminator":[{"type":"value","path":"url"}],"description":"Extensions are always sliced by (at least) url","rules":"open"},"short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.meta.versionId","path":"ExplanationOfBenefit.meta.versionId","short":"Version specific identifier","definition":"The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.","comment":"The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.","min":0,"max":"1","base":{"path":"Meta.versionId","min":0,"max":"1"},"type":[{"code":"id"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.lastUpdated","path":"ExplanationOfBenefit.meta.lastUpdated","short":"When the resource version last changed","definition":"When the resource last changed - e.g. when the version changed.","comment":"Defines the date the Resource was created or updated, whichever comes last (163). Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last","min":1,"max":"1","base":{"path":"Meta.lastUpdated","min":0,"max":"1"},"type":[{"code":"instant"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.source","path":"ExplanationOfBenefit.meta.source","short":"Identifies where the resource comes from","definition":"A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.","comment":"In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. \n\nThis element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.","min":0,"max":"1","base":{"path":"Meta.source","min":0,"max":"1"},"type":[{"code":"uri"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.profile","path":"ExplanationOfBenefit.meta.profile","short":"Profiles this resource claims to conform to","definition":"A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).","comment":"CPCDS data element (190)","min":1,"max":"*","base":{"path":"Meta.profile","min":0,"max":"*"},"type":[{"code":"canonical","targetProfile":["http://hl7.org/fhir/StructureDefinition/StructureDefinition"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.meta.security","path":"ExplanationOfBenefit.meta.security","short":"Security Labels applied to this resource","definition":"Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.","comment":"The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.","min":0,"max":"*","base":{"path":"Meta.security","min":0,"max":"*"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"SecurityLabels"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"extensible","description":"Security Labels from the Healthcare Privacy and Security Classification System.","valueSet":"http://hl7.org/fhir/ValueSet/security-labels"}},{"id":"ExplanationOfBenefit.meta.tag","path":"ExplanationOfBenefit.meta.tag","short":"Tags applied to this resource","definition":"Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.","comment":"The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.","min":0,"max":"*","base":{"path":"Meta.tag","min":0,"max":"*"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Tags"}],"strength":"example","description":"Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\".","valueSet":"http://hl7.org/fhir/ValueSet/common-tags"}},{"id":"ExplanationOfBenefit.implicitRules","path":"ExplanationOfBenefit.implicitRules","short":"A set of rules under which this content was created","definition":"A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.","comment":"Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.","min":0,"max":"1","base":{"path":"Resource.implicitRules","min":0,"max":"1"},"type":[{"code":"uri"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":true,"isModifierReason":"This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation","isSummary":true},{"id":"ExplanationOfBenefit.language","path":"ExplanationOfBenefit.language","short":"Language of the resource content","definition":"The base language in which the resource is written.","comment":"Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).","min":0,"max":"1","base":{"path":"Resource.language","min":0,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet","valueCanonical":"http://hl7.org/fhir/ValueSet/all-languages"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Language"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"preferred","description":"A human language.","valueSet":"http://hl7.org/fhir/ValueSet/languages"}},{"id":"ExplanationOfBenefit.text","path":"ExplanationOfBenefit.text","short":"Text summary of the resource, for human interpretation","definition":"A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.","comment":"Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.","alias":["narrative","html","xhtml","display"],"min":0,"max":"1","base":{"path":"DomainResource.text","min":0,"max":"1"},"type":[{"code":"Narrative"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"Act.text?"}]},{"id":"ExplanationOfBenefit.contained","path":"ExplanationOfBenefit.contained","short":"Contained, inline Resources","definition":"These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.","comment":"This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.","alias":["inline resources","anonymous resources","contained resources"],"min":0,"max":"*","base":{"path":"DomainResource.contained","min":0,"max":"*"},"type":[{"code":"Resource"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.extension","path":"ExplanationOfBenefit.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"DomainResource.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.modifierExtension","path":"ExplanationOfBenefit.modifierExtension","short":"Extensions that cannot be ignored","definition":"May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"DomainResource.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them","isSummary":false,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.identifier","path":"ExplanationOfBenefit.identifier","short":"Business Identifier for the resource","definition":"A unique identifier assigned to this explanation of benefit.","comment":"Identifier assigned by a payer for a claim received from a provider or subscriber. It is not the same identifier as that assigned by a provider. (35)","requirements":"Allows EOBs to be distinguished and referenced.","min":1,"max":"*","base":{"path":"ExplanationOfBenefit.identifier","min":0,"max":"*"},"type":[{"code":"Identifier"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"mapping":[{"identity":"workflow","map":"Event.identifier"},{"identity":"w5","map":"FiveWs.identifier"}]},{"id":"ExplanationOfBenefit.identifier.id","path":"ExplanationOfBenefit.identifier.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.identifier.extension","path":"ExplanationOfBenefit.identifier.extension","slicing":{"discriminator":[{"type":"value","path":"url"}],"description":"Extensions are always sliced by (at least) url","rules":"open"},"short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.identifier.use","path":"ExplanationOfBenefit.identifier.use","short":"usual | official | temp | secondary | old (If known)","definition":"The purpose of this identifier.","comment":"Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.","requirements":"Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.","min":0,"max":"1","base":{"path":"Identifier.use","min":0,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":true,"isModifierReason":"This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.","isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"IdentifierUse"}],"strength":"required","description":"Identifies the purpose for this identifier, if known .","valueSet":"http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"},"mapping":[{"identity":"v2","map":"N/A"},{"identity":"rim","map":"Role.code or implied by context"}]},{"id":"ExplanationOfBenefit.identifier.type","path":"ExplanationOfBenefit.identifier.type","short":"Description of identifier","definition":"A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.","comment":"Indicates that the claim identifier is that assigned by a payer for a claim received from a provider or subscriber. (183)","requirements":"Allows users to make use of identifiers when the identifier system is not known.","min":1,"max":"1","base":{"path":"Identifier.type","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"binding":{"strength":"extensible","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimIdentifierType"},"mapping":[{"identity":"v2","map":"CX.5"},{"identity":"rim","map":"Role.code or implied by context"}]},{"id":"ExplanationOfBenefit.identifier.system","path":"ExplanationOfBenefit.identifier.system","short":"The namespace for the identifier value","definition":"Establishes the namespace for the value - that is, a URL that describes a set values that are unique.","comment":"Identifier.system is always case sensitive.","requirements":"There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.","min":0,"max":"1","base":{"path":"Identifier.system","min":0,"max":"1"},"type":[{"code":"uri"}],"example":[{"label":"General","valueUri":"http://www.acme.com/identifiers/patient"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"CX.4 / EI-2-4"},{"identity":"rim","map":"II.root or Role.id.root"},{"identity":"servd","map":"./IdentifierType"}]},{"id":"ExplanationOfBenefit.identifier.value","path":"ExplanationOfBenefit.identifier.value","short":"The value that is unique","definition":"The portion of the identifier typically relevant to the user and which is unique within the context of the system.","comment":"If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.","min":0,"max":"1","base":{"path":"Identifier.value","min":0,"max":"1"},"type":[{"code":"string"}],"example":[{"label":"General","valueString":"123456"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"CX.1 / EI.1"},{"identity":"rim","map":"II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"},{"identity":"servd","map":"./Value"}]},{"id":"ExplanationOfBenefit.identifier.period","path":"ExplanationOfBenefit.identifier.period","short":"Time period when id is/was valid for use","definition":"Time period during which identifier is/was valid for use.","min":0,"max":"1","base":{"path":"Identifier.period","min":0,"max":"1"},"type":[{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"CX.7 + CX.8"},{"identity":"rim","map":"Role.effectiveTime or implied by context"},{"identity":"servd","map":"./StartDate and ./EndDate"}]},{"id":"ExplanationOfBenefit.identifier.assigner","path":"ExplanationOfBenefit.identifier.assigner","short":"Organization that issued id (may be just text)","definition":"Organization that issued/manages the identifier.","comment":"The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.","min":0,"max":"1","base":{"path":"Identifier.assigner","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Organization"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"CX.4 / (CX.4,CX.9,CX.10)"},{"identity":"rim","map":"II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"},{"identity":"servd","map":"./IdentifierIssuingAuthority"}]},{"id":"ExplanationOfBenefit.status","path":"ExplanationOfBenefit.status","short":"active | cancelled | draft | entered-in-error","definition":"The status of the resource instance.","comment":"Claim processing status code (140).  Expected values are active or cancelled.  To comply with the CMS rule, draft EOBs are not required","requirements":"Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.status","min":1,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":true,"isModifierReason":"This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid","isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ExplanationOfBenefitStatus"}],"strength":"required","description":"A code specifying the state of the resource instance.","valueSet":"http://hl7.org/fhir/ValueSet/explanationofbenefit-status|4.0.1"},"mapping":[{"identity":"workflow","map":"Event.status"},{"identity":"w5","map":"FiveWs.status"}]},{"id":"ExplanationOfBenefit.type","path":"ExplanationOfBenefit.type","short":"Category or discipline","definition":"The category of claim, e.g. oral, pharmacy, vision, institutional, professional.","comment":"Specifies the type of claim. (e.g., inpatient insitutional, outpatient institutional, physician, etc.) (16).  Defines the Claims profiles.  Values from Claim Type Codes are required; a data absent reason is not allowed","requirements":"Claim type determine the general sets of business rules applied for information requirements and adjudication.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.type","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"patternCodeableConcept":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/claim-type","code":"institutional"}]},"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/ValueSet/claim-type"},"mapping":[{"identity":"workflow","map":"Event.code"},{"identity":"w5","map":"FiveWs.class"}]},{"id":"ExplanationOfBenefit.subType","path":"ExplanationOfBenefit.subType","short":"More granular claim type","definition":"A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.","comment":"This may contain the local bill type codes such as the US UB-04 bill type code.","requirements":"Some jurisdictions need a finer grained claim type for routing and adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.subType","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ClaimSubType"}],"strength":"example","description":"A more granular claim typecode.","valueSet":"http://hl7.org/fhir/ValueSet/claim-subtype"},"mapping":[{"identity":"w5","map":"FiveWs.class"}]},{"id":"ExplanationOfBenefit.use","path":"ExplanationOfBenefit.use","short":"claim | preauthorization | predetermination","definition":"A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.","comment":"Expected value is claim. The CMS rule applies to adjudicated claims; it does not require preauthorizations or predeterminations","requirements":"This element is required to understand the nature of the request for adjudication.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.use","min":1,"max":"1"},"type":[{"code":"code"}],"patternCode":"claim","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Use"}],"strength":"required","description":"Complete, proposed, exploratory, other.","valueSet":"http://hl7.org/fhir/ValueSet/claim-use|4.0.1"},"mapping":[{"identity":"w5","map":"FiveWs.class"}]},{"id":"ExplanationOfBenefit.patient","path":"ExplanationOfBenefit.patient","short":"The recipient of the products and services","definition":"The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought.","comment":"Identifier for a member assigned by the Payer.  If members receive ID cards, that is the identifier that should be provided. (1). The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction. Additional required path:EOB.insurance.coverage(Coverage).beneficiary(Patient).identifier","requirements":"The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.patient","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Event.subject"},{"identity":"w5","map":"FiveWs.subject[x]"},{"identity":"w5","map":"FiveWs.subject"}]},{"id":"ExplanationOfBenefit.billablePeriod","path":"ExplanationOfBenefit.billablePeriod","short":"Relevant time frame for the claim","definition":"The period for which charges are being submitted.","comment":"Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and prodeterminations. Typically line item dates of service should fall within the billing period if one is specified.","requirements":"A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.billablePeriod","min":0,"max":"1"},"type":[{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"w5","map":"FiveWs.done[x]"}]},{"id":"ExplanationOfBenefit.billablePeriod.id","path":"ExplanationOfBenefit.billablePeriod.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.billablePeriod.extension","path":"ExplanationOfBenefit.billablePeriod.extension","slicing":{"discriminator":[{"type":"value","path":"url"}],"description":"Extensions are always sliced by (at least) url","rules":"open"},"short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.billablePeriod.start","path":"ExplanationOfBenefit.billablePeriod.start","short":"Starting time with inclusive boundary","definition":"The start of the period. The boundary is inclusive.","comment":"The first day on the billing statement covering services rendered to the beneficiary (i.e. 'Statement Covers From Date’). (177)","min":0,"max":"1","base":{"path":"Period.start","min":0,"max":"1"},"type":[{"code":"dateTime"}],"condition":["per-1"],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"DR.1"},{"identity":"rim","map":"./low"}]},{"id":"ExplanationOfBenefit.billablePeriod.end","path":"ExplanationOfBenefit.billablePeriod.end","short":"End time with inclusive boundary, if not ongoing","definition":"The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.","comment":"The last day on the billing statement covering services rendered to the beneficiary (i.e. 'Statement Covers Thru Date’). (178)","min":0,"max":"1","base":{"path":"Period.end","min":0,"max":"1"},"type":[{"code":"dateTime"}],"meaningWhenMissing":"If the end of the period is missing, it means that the period is ongoing","condition":["per-1"],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"DR.2"},{"identity":"rim","map":"./high"}]},{"id":"ExplanationOfBenefit.created","path":"ExplanationOfBenefit.created","short":"Response creation date","definition":"The date this resource was created.","comment":"Date the claim was adjudicated (179)","requirements":"Need to record a timestamp for use by both the recipient and the issuer.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.created","min":1,"max":"1"},"type":[{"code":"dateTime"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Event.occurrence[x]"},{"identity":"w5","map":"FiveWs.recorded"}]},{"id":"ExplanationOfBenefit.enterer","path":"ExplanationOfBenefit.enterer","short":"Author of the claim","definition":"Individual who created the claim, predetermination or preauthorization.","requirements":"Some jurisdictions require the contact information for personnel completing claims.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.enterer","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Practitioner","http://hl7.org/fhir/StructureDefinition/PractitionerRole"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"workflow","map":"Event.performer.agent"},{"identity":"w5","map":"FiveWs.author"}]},{"id":"ExplanationOfBenefit.insurer","path":"ExplanationOfBenefit.insurer","short":"Party responsible for reimbursement","definition":"The party responsible for authorization, adjudication and reimbursement.","comment":"Code of the payer responsible for the claim (2, 5).  Same as insurance.coverage.organization.  Party responsible for reimbursing the provider","requirements":"To be a valid claim, preauthorization or predetermination there must be a party who is responsible for adjudicating the contents against a policy which provides benefits for the patient.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.insurer","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"workflow","map":"Event.performer.agent"},{"identity":"w5","map":"FiveWs.author"}]},{"id":"ExplanationOfBenefit.provider","path":"ExplanationOfBenefit.provider","short":"Party responsible for the claim","definition":"The provider which is responsible for the claim, predetermination or preauthorization.","comment":"The identifier assigned to the Billing Provider. (94)","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.provider","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"w5","map":"FiveWs.source"}]},{"id":"ExplanationOfBenefit.priority","path":"ExplanationOfBenefit.priority","short":"Desired processing urgency","definition":"The provider-required urgency of processing the request. Typical values include: stat, routine deferred.","comment":"If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request.","requirements":"The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.priority","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/ValueSet/process-priority"},"mapping":[{"identity":"v2","map":"Request.priority"}]},{"id":"ExplanationOfBenefit.fundsReserveRequested","path":"ExplanationOfBenefit.fundsReserveRequested","short":"For whom to reserve funds","definition":"A code to indicate whether and for whom funds are to be reserved for future claims.","comment":"This field is only used for preauthorizations.","requirements":"In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested.","alias":["Fund pre-allocation"],"min":0,"max":"1","base":{"path":"ExplanationOfBenefit.fundsReserveRequested","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"FundsReserve"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"example","description":"For whom funds are to be reserved: (Patient, Provider, None).","valueSet":"http://hl7.org/fhir/ValueSet/fundsreserve"}},{"id":"ExplanationOfBenefit.fundsReserve","path":"ExplanationOfBenefit.fundsReserve","short":"Funds reserved status","definition":"A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.","comment":"Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none.","requirements":"Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.fundsReserve","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"FundsReserve"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"example","description":"For whom funds are to be reserved: (Patient, Provider, None).","valueSet":"http://hl7.org/fhir/ValueSet/fundsreserve"}},{"id":"ExplanationOfBenefit.related","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"RelatedClaim"}],"path":"ExplanationOfBenefit.related","short":"Prior or corollary claims","definition":"Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.","comment":"If the current claim represents a claim that has been adjusted and was given a prior claim number, this field represents the prior claim number. If the current claim has been adjusted; i.e., replaced by or merged to another claim number, this data element represents that new number.(111, 112)","requirements":"For workplace or other accidents it is common to relate separate claims arising from the same event.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.related","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.related.id","path":"ExplanationOfBenefit.related.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.related.extension","path":"ExplanationOfBenefit.related.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.related.modifierExtension","path":"ExplanationOfBenefit.related.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.related.claim","path":"ExplanationOfBenefit.related.claim","short":"Reference to the related claim","definition":"Reference to a related claim.","requirements":"For workplace or other accidents it is common to relate separate claims arising from the same event.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.related.claim","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Claim"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.related.relationship","path":"ExplanationOfBenefit.related.relationship","short":"How the reference claim is related","definition":"A code to convey how the claims are related.","comment":"For example, prior claim or umbrella.","requirements":"Some insurers need a declaration of the type of relationship.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.related.relationship","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBRelatedClaimRelationshipCodes"}},{"id":"ExplanationOfBenefit.related.reference","path":"ExplanationOfBenefit.related.reference","short":"File or case reference","definition":"An alternate organizational reference to the case or file to which this particular claim pertains.","comment":"For example, Property/Casualty insurer claim number or Workers Compensation case number.","requirements":"In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.related.reference","min":0,"max":"1"},"type":[{"code":"Identifier"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.prescription","path":"ExplanationOfBenefit.prescription","short":"Prescription authorizing services or products","definition":"Prescription to support the dispensing of pharmacy, device or vision products.","requirements":"Required to authorize the dispensing of controlled substances and devices.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.prescription","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/MedicationRequest","http://hl7.org/fhir/StructureDefinition/VisionPrescription"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.originalPrescription","path":"ExplanationOfBenefit.originalPrescription","short":"Original prescription if superceded by fulfiller","definition":"Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.","comment":"For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.","requirements":"Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.originalPrescription","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/MedicationRequest"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payee","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Payee"}],"path":"ExplanationOfBenefit.payee","short":"Recipient of benefits payable","definition":"The party to be reimbursed for cost of the products and services according to the terms of the policy.","comment":"Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and may choose to pay the subscriber instead.","requirements":"The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payee","min":0,"max":"1"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payee.id","path":"ExplanationOfBenefit.payee.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.payee.extension","path":"ExplanationOfBenefit.payee.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.payee.modifierExtension","path":"ExplanationOfBenefit.payee.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.payee.type","path":"ExplanationOfBenefit.payee.type","short":"Category of recipient","definition":"Type of Party to be reimbursed: Subscriber, provider, other.","comment":"Identifies the type of recipient of the adjudication amount; i.e., provider, subscriber, beneficiary or another recipient. (120)","requirements":"Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.payee.type","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayeeType"}},{"id":"ExplanationOfBenefit.payee.party","path":"ExplanationOfBenefit.payee.party","short":"Recipient reference","definition":"Reference to the individual or organization to whom any payment will be made.","comment":"Recipient reference (121)","requirements":"Need to provide demographics if the payee is not 'subscriber' nor 'provider'.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.payee.party","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization","http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient","http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.referral","path":"ExplanationOfBenefit.referral","short":"Treatment Referral","definition":"A reference to a referral resource.","comment":"The referral resource which lists the date, practitioner, reason and other supporting information.","requirements":"Some insurers require proof of referral to pay for services or to pay specialist rates for services.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.referral","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/ServiceRequest"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.cause"}]},{"id":"ExplanationOfBenefit.facility","path":"ExplanationOfBenefit.facility","short":"Servicing Facility","definition":"Facility where the services were provided.","requirements":"Insurance adjudication can be dependant on where services were delivered.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.facility","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Location"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"workflow","map":"Event.performer.location"},{"identity":"w5","map":"FiveWs.where[x]"}]},{"id":"ExplanationOfBenefit.claim","path":"ExplanationOfBenefit.claim","short":"Claim reference","definition":"The business identifier for the instance of the adjudication request: claim predetermination or preauthorization.","requirements":"To provide a link to the original adjudication request.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.claim","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Claim"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.why[x]"}]},{"id":"ExplanationOfBenefit.claimResponse","path":"ExplanationOfBenefit.claimResponse","short":"Claim response reference","definition":"The business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response.","requirements":"To provide a link to the original adjudication response.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.claimResponse","min":0,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/ClaimResponse"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.outcome","path":"ExplanationOfBenefit.outcome","short":"queued | complete | error | partial","definition":"The outcome of the claim, predetermination, or preauthorization processing.","comment":"Expected value is complete","requirements":"To advise the requestor of an overall processing outcome.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.outcome","min":1,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"RemittanceOutcome"}],"strength":"required","description":"The result of the claim processing.","valueSet":"http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1"}},{"id":"ExplanationOfBenefit.disposition","path":"ExplanationOfBenefit.disposition","short":"Disposition Message","definition":"A human readable description of the status of the adjudication.","requirements":"Provided for user display.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.disposition","min":0,"max":"1"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.preAuthRef","path":"ExplanationOfBenefit.preAuthRef","short":"Preauthorization reference","definition":"Reference from the Insurer which is used in later communications which refers to this adjudication.","comment":"This value is only present on preauthorization adjudications.","requirements":"On subsequent claims, the insurer may require the provider to quote this value.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.preAuthRef","min":0,"max":"*"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.preAuthRefPeriod","path":"ExplanationOfBenefit.preAuthRefPeriod","short":"Preauthorization in-effect period","definition":"The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.","comment":"This value is only present on preauthorization adjudications.","requirements":"On subsequent claims, the insurer may require the provider to quote this value.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.preAuthRefPeriod","min":0,"max":"*"},"type":[{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.careTeam","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"CareTeam"}],"path":"ExplanationOfBenefit.careTeam","short":"Care Team members","definition":"The members of the team who provided the products and services.","requirements":"Common to identify the responsible and supporting practitioners.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.careTeam","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"EOB-inst-careTeam-practitioner","severity":"error","human":"Institutional EOB: Careteam roles refer to a practitioner","expression":"(\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists() implies\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists().provider.all(resolve() is Practitioner)\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"},{"key":"EOB-inst-careTeam-organization","severity":"error","human":"Institutional EOB:  Careteam roles refer to an organization","expression":"(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().provider.all(resolve() is Organization)\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"},{"key":"EOB-careteam-qualification","severity":"error","human":"Care Team Performing physician's qualifications are from US-Core-Provider-Specialty Value Set","expression":"(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().qualification.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty')\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.careTeam.id","path":"ExplanationOfBenefit.careTeam.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.careTeam.extension","path":"ExplanationOfBenefit.careTeam.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.careTeam.modifierExtension","path":"ExplanationOfBenefit.careTeam.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.careTeam.sequence","path":"ExplanationOfBenefit.careTeam.sequence","short":"Order of care team","definition":"A number to uniquely identify care team entries.","comment":"careTeam.sequence values uniquely identify careTeam members.  They do not necessarily indiate any order in which the patient was seen by the careTeam or identify any level of significance of the careTeam to the patient, etc.  Client app implementations should not assign any significance to the sequence values","requirements":"Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.careTeam.provider","path":"ExplanationOfBenefit.careTeam.provider","short":"Practitioner or organization","definition":"Member of the team who provided the product or service.","comment":"The identifier assigned to the care team. (varies depending on the profile)","requirements":"Often a regulatory requirement to specify the responsible provider.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.provider","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization","http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.actor"}]},{"id":"ExplanationOfBenefit.careTeam.responsible","path":"ExplanationOfBenefit.careTeam.responsible","short":"Indicator of the lead practitioner","definition":"The party who is billing and/or responsible for the claimed products or services.","comment":"Responsible might not be required when there is only a single provider listed.","requirements":"When multiple parties are present it is required to distinguish the lead or responsible individual.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.responsible","min":0,"max":"1"},"type":[{"code":"boolean"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.careTeam.role","path":"ExplanationOfBenefit.careTeam.role","short":"Function within the team","definition":"The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.","comment":"The functional role of a provider on a claim. (165)","requirements":"When multiple parties are present it is required to distinguish the roles performed by each member.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.role","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInstitutionalCareTeamRole"}},{"id":"ExplanationOfBenefit.careTeam.qualification","path":"ExplanationOfBenefit.careTeam.qualification","short":"Practitioner credential or specialization","definition":"The qualification of the practitioner which is applicable for this service.","requirements":"Need to specify which qualification a provider is delivering the product or service under.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.careTeam.qualification","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty"}},{"id":"ExplanationOfBenefit.supportingInfo","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"SupportingInformation"}],"path":"ExplanationOfBenefit.supportingInfo","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on $this pattern","ordered":false,"rules":"open"},"short":"Supporting information","definition":"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.","comment":"Defines data elements not available in the base EOB resource","requirements":"Typically these information codes are required to support the services rendered or the adjudication of the services rendered.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.supportingInfo","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo.id","path":"ExplanationOfBenefit.supportingInfo.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo.extension","path":"ExplanationOfBenefit.supportingInfo.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo.modifierExtension","path":"ExplanationOfBenefit.supportingInfo.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.supportingInfo.sequence","path":"ExplanationOfBenefit.supportingInfo.sequence","short":"Information instance identifier","definition":"A number to uniquely identify supporting information entries.","comment":"Client app implementations should look-up supportingInfo elements based on category values instead of sequence values","requirements":"Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo.category","path":"ExplanationOfBenefit.supportingInfo.category","short":"Classification of the supplied information","definition":"The general class of the information supplied: information; exception; accident, employment; onset, etc.","comment":"This may contain a category for the local bill type codes.","requirements":"Required to group or associate information items with common characteristics. For example: admission information or prior treatments.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.category","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"strength":"extensible","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"}},{"id":"ExplanationOfBenefit.supportingInfo.code","path":"ExplanationOfBenefit.supportingInfo.code","short":"Type of information","definition":"System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.","comment":"This may contain the local bill type codes such as the US UB-04 bill type code.","requirements":"Required to identify the kind of additional information.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.code","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"InformationCode"}],"strength":"example","description":"The valuset used for additional information codes.","valueSet":"http://hl7.org/fhir/ValueSet/claim-exception"}},{"id":"ExplanationOfBenefit.supportingInfo.timing[x]","path":"ExplanationOfBenefit.supportingInfo.timing[x]","short":"When it occurred","definition":"The date when or period to which this information refers.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.timing[x]","min":0,"max":"1"},"type":[{"code":"date"},{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo.value[x]","path":"ExplanationOfBenefit.supportingInfo.value[x]","short":"Data to be provided","definition":"Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.","comment":"Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.","requirements":"To convey the data content to be provided when the information is more than a simple code or period.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.value[x]","min":0,"max":"1"},"type":[{"code":"boolean"},{"code":"string"},{"code":"Quantity"},{"code":"Attachment"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Resource"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo.reason","path":"ExplanationOfBenefit.supportingInfo.reason","short":"Explanation for the information","definition":"Provides the reason in the situation where a reason code is required in addition to the content.","comment":"For example: the reason for the additional stay, or why a tooth is  missing.","requirements":"Needed when the supporting information has both a date and amount/value and requires explanation.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.reason","min":0,"max":"1"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"MissingReason"}],"strength":"example","description":"Reason codes for the missing teeth.","valueSet":"http://hl7.org/fhir/ValueSet/missing-tooth-reason"}},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"SupportingInformation"}],"path":"ExplanationOfBenefit.supportingInfo","sliceName":"billingnetworkcontractingstatus","short":"Supporting information","definition":"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.","comment":"Indicates that the Billing Provider has a contract with the Plan (regardless of the network) as of the effective date of service or admission. (101)","requirements":"Typically these information codes are required to support the services rendered or the adjudication of the services rendered.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.id","path":"ExplanationOfBenefit.supportingInfo.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.extension","path":"ExplanationOfBenefit.supportingInfo.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.modifierExtension","path":"ExplanationOfBenefit.supportingInfo.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.sequence","path":"ExplanationOfBenefit.supportingInfo.sequence","short":"Information instance identifier","definition":"A number to uniquely identify supporting information entries.","comment":"Client app implementations should look-up supportingInfo elements based on category values instead of sequence values","requirements":"Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category","path":"ExplanationOfBenefit.supportingInfo.category","short":"Classification of the supplied information","definition":"The general class of the information supplied: information; exception; accident, employment; onset, etc.","comment":"This may contain a category for the local bill type codes.","requirements":"Required to group or associate information items with common characteristics. 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This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo:clmrecvddate.extension","path":"ExplanationOfBenefit.supportingInfo.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo:clmrecvddate.modifierExtension","path":"ExplanationOfBenefit.supportingInfo.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. 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The first digit of the three-digit number denotes the type of institution, the second digit classifies the type of care being billed, and the third digit  identifies the frequency of the bill for a specific course of treatment or inpatient confinement. 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Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  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For example, could contain a PDF in an Attachment of the Police Report for an Accident.","requirements":"To convey the data content to be provided when the information is more than a simple code or period.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.value[x]","min":0,"max":"1"},"type":[{"code":"boolean"},{"code":"string"},{"code":"Quantity"},{"code":"Attachment"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Resource"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:admtype.reason","path":"ExplanationOfBenefit.supportingInfo.reason","short":"Explanation for the information","definition":"Provides the reason in the situation where a reason code is required in addition to the content.","comment":"For example: the reason for the additional stay, or why a tooth is  missing.","requirements":"Needed when the supporting information has both a date and amount/value and requires explanation.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.reason","min":0,"max":"1"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"MissingReason"}],"strength":"example","description":"Reason codes for the missing teeth.","valueSet":"http://hl7.org/fhir/ValueSet/missing-tooth-reason"}},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"SupportingInformation"}],"path":"ExplanationOfBenefit.supportingInfo","sliceName":"discharge-status","short":"Supporting information","definition":"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.","comment":"Patient’s status as of the discharge date for a facility stay. Information located on UB04. (Form Locator 17). (117)","requirements":"Typically these information codes are required to support the services rendered or the adjudication of the services rendered.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.id","path":"ExplanationOfBenefit.supportingInfo.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.extension","path":"ExplanationOfBenefit.supportingInfo.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.modifierExtension","path":"ExplanationOfBenefit.supportingInfo.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.sequence","path":"ExplanationOfBenefit.supportingInfo.sequence","short":"Information instance identifier","definition":"A number to uniquely identify supporting information entries.","comment":"Client app implementations should look-up supportingInfo elements based on category values instead of sequence values","requirements":"Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.category","path":"ExplanationOfBenefit.supportingInfo.category","short":"Classification of the supplied information","definition":"The general class of the information supplied: information; exception; accident, employment; onset, etc.","comment":"This may contain a category for the local bill type codes.","requirements":"Required to group or associate information items with common characteristics. For example: admission information or prior treatments.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.category","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"discharge-status"}]},"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"extensible","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"}},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.code","path":"ExplanationOfBenefit.supportingInfo.code","short":"Type of information","definition":"System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.","comment":"This may contain the local bill type codes such as the US UB-04 bill type code.","requirements":"Required to identify the kind of additional information.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.code","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPatientDischargeStatus"}},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.timing[x]","path":"ExplanationOfBenefit.supportingInfo.timing[x]","short":"When it occurred","definition":"The date when or period to which this information refers.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.timing[x]","min":0,"max":"1"},"type":[{"code":"date"},{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.value[x]","path":"ExplanationOfBenefit.supportingInfo.value[x]","short":"Data to be provided","definition":"Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.","comment":"Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.","requirements":"To convey the data content to be provided when the information is more than a simple code or period.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.value[x]","min":0,"max":"1"},"type":[{"code":"boolean"},{"code":"string"},{"code":"Quantity"},{"code":"Attachment"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Resource"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.reason","path":"ExplanationOfBenefit.supportingInfo.reason","short":"Explanation for the information","definition":"Provides the reason in the situation where a reason code is required in addition to the content.","comment":"For example: the reason for the additional stay, or why a tooth is  missing.","requirements":"Needed when the supporting information has both a date and amount/value and requires explanation.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.supportingInfo.reason","min":0,"max":"1"},"type":[{"code":"Coding"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"MissingReason"}],"strength":"example","description":"Reason codes for the missing teeth.","valueSet":"http://hl7.org/fhir/ValueSet/missing-tooth-reason"}},{"id":"ExplanationOfBenefit.diagnosis","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Diagnosis"}],"path":"ExplanationOfBenefit.diagnosis","short":"Pertinent diagnosis information","definition":"Information about diagnoses relevant to the claim items.","comment":"Diagnosis codes describe an individual's disease or medical condition. (6, 7, 8, 21, 22, 23, 30)","requirements":"Required for the adjudication by provided context for the services and product listed.","min":1,"max":"*","base":{"path":"ExplanationOfBenefit.diagnosis","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.diagnosis.id","path":"ExplanationOfBenefit.diagnosis.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.diagnosis.extension","path":"ExplanationOfBenefit.diagnosis.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.diagnosis.modifierExtension","path":"ExplanationOfBenefit.diagnosis.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.diagnosis.sequence","path":"ExplanationOfBenefit.diagnosis.sequence","short":"Diagnosis instance identifier","definition":"A number to uniquely identify diagnosis entries.","comment":"Diagnosis.sequence values do not necessarily indiate any order in which the diagnosis was reported or identified.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of diagnosis.type to identify primary, secondary, etc.","requirements":"Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.diagnosis.diagnosis[x]","path":"ExplanationOfBenefit.diagnosis.diagnosis[x]","short":"Nature of illness or problem","definition":"The nature of illness or problem in a coded form or as a reference to an external defined Condition.","requirements":"Provides health context for the evaluation of the products and/or services.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.diagnosis[x]","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/CDCICD910CMDiagnosisCodes"}},{"id":"ExplanationOfBenefit.diagnosis.type","path":"ExplanationOfBenefit.diagnosis.type","short":"Timing or nature of the diagnosis","definition":"When the condition was observed or the relative ranking.","comment":"Indicates if the outpatient institutional diagnosis is principal, other, an external cause of injury or a patient reason for visit. (21, 22, 23)","requirements":"Often required to capture a particular diagnosis, for example: primary or discharge.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.type","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimOutpatientInstitutionalDiagnosisType"}},{"id":"ExplanationOfBenefit.diagnosis.onAdmission","path":"ExplanationOfBenefit.diagnosis.onAdmission","short":"Present on admission","definition":"Indication of whether the diagnosis was present on admission to a facility.","requirements":"Many systems need to understand for adjudication if the diagnosis was present a time of admission.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.onAdmission","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"DiagnosisOnAdmission"}],"strength":"example","description":"Present on admission.","valueSet":"http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission"}},{"id":"ExplanationOfBenefit.diagnosis.packageCode","path":"ExplanationOfBenefit.diagnosis.packageCode","short":"Package billing code","definition":"A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.","comment":"For example, DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardio-infarction and a DRG for HeartAttack would assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.","requirements":"Required to relate the current  diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.diagnosis.packageCode","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"DiagnosisRelatedGroup"}],"strength":"example","description":"The DRG codes associated with the diagnosis.","valueSet":"http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup"}},{"id":"ExplanationOfBenefit.procedure","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Procedure"}],"path":"ExplanationOfBenefit.procedure","short":"Clinical procedures performed","definition":"Procedures performed on the patient relevant to the billing items with the claim.","requirements":"The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.procedure","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.procedure.id","path":"ExplanationOfBenefit.procedure.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.procedure.extension","path":"ExplanationOfBenefit.procedure.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.procedure.modifierExtension","path":"ExplanationOfBenefit.procedure.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.procedure.sequence","path":"ExplanationOfBenefit.procedure.sequence","short":"Procedure instance identifier","definition":"A number to uniquely identify procedure entries.","requirements":"Necessary to provide a mechanism to link to claim details.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.procedure.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.procedure.type","path":"ExplanationOfBenefit.procedure.type","short":"Category of Procedure","definition":"When the condition was observed or the relative ranking.","requirements":"Often required to capture a particular diagnosis, for example: primary or discharge.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.procedure.type","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ProcedureType"}],"strength":"example","description":"Example procedure type codes.","valueSet":"http://hl7.org/fhir/ValueSet/ex-procedure-type"}},{"id":"ExplanationOfBenefit.procedure.date","path":"ExplanationOfBenefit.procedure.date","short":"When the procedure was performed","definition":"Date and optionally time the procedure was performed.","requirements":"Required for auditing purposes.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.procedure.date","min":0,"max":"1"},"type":[{"code":"dateTime"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.procedure.procedure[x]","path":"ExplanationOfBenefit.procedure.procedure[x]","short":"Specific clinical procedure","definition":"The code or reference to a Procedure resource which identifies the clinical intervention performed.","requirements":"This identifies the actual clinical procedure.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.procedure.procedure[x]","min":1,"max":"1"},"type":[{"code":"CodeableConcept"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Procedure"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ICD10_Procedures"}],"strength":"example","description":"ICD10 Procedure codes.","valueSet":"http://hl7.org/fhir/ValueSet/icd-10-procedures"}},{"id":"ExplanationOfBenefit.procedure.udi","path":"ExplanationOfBenefit.procedure.udi","short":"Unique device identifier","definition":"Unique Device Identifiers associated with this line item.","requirements":"The UDI code allows the insurer to obtain device level information on the product supplied.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.procedure.udi","min":0,"max":"*"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Device"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.precedence","path":"ExplanationOfBenefit.precedence","short":"Precedence (primary, secondary, etc.)","definition":"This indicates the relative order of a series of EOBs related to different coverages for the same suite of services.","requirements":"Needed to coordinate between multiple EOBs for the same suite of services.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.precedence","min":0,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.insurance","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Insurance"}],"path":"ExplanationOfBenefit.insurance","short":"Patient insurance information","definition":"Financial instruments for reimbursement for the health care products and services specified on the claim.","comment":"Identity of the payers responsible for the claim. (2, 141).  All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. An invariant is defined to enforce the following rule:  Will have multiple occurrences on secondary / tertiary, etc. claims.  Up to one occurrence, that of the ExplanationOfBenefit.insurer, will have a boolean value = 'True'","requirements":"At least one insurer is required for a claim to be a claim.","min":1,"max":"*","base":{"path":"ExplanationOfBenefit.insurance","min":1,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"EOB-insurance-focal","severity":"error","human":"EOB.insurance:  at most one with focal = true","expression":"insurance.select (focal = true).count() < 2","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit"}],"mustSupport":true,"isModifier":false,"isSummary":true,"mapping":[{"identity":"v2","map":"Coverage"}]},{"id":"ExplanationOfBenefit.insurance.id","path":"ExplanationOfBenefit.insurance.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.insurance.extension","path":"ExplanationOfBenefit.insurance.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.insurance.modifierExtension","path":"ExplanationOfBenefit.insurance.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.insurance.focal","path":"ExplanationOfBenefit.insurance.focal","short":"Coverage to be used for adjudication","definition":"A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.","comment":"A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example, a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies. An invariant is defined to enforce the following rule:  Will have multiple occurrences on secondary / tertiary, etc. claims.  Up to one occurrence, that of the ExplanationOfBenefit.insurer, will have a boolean value = 'True'","requirements":"To identify which coverage in the list is being used to adjudicate this claim.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.insurance.focal","min":1,"max":"1"},"type":[{"code":"boolean"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.insurance.coverage","path":"ExplanationOfBenefit.insurance.coverage","short":"Insurance information","definition":"Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.","comment":"Same as insurance.coverage.organization.  Party responsible for reimbursing the provider. When focal = true, Coverage.payer--> Organization.identifier.  When focal = false, EOB.insurance.coverage.display = [name of other carrier]","requirements":"Required to allow the adjudicator to locate the correct policy and history within their information system.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.insurance.coverage","min":1,"max":"1"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.insurance.preAuthRef","path":"ExplanationOfBenefit.insurance.preAuthRef","short":"Prior authorization reference number","definition":"Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.","comment":"This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.","requirements":"Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.insurance.preAuthRef","min":0,"max":"*"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.accident","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Accident"}],"path":"ExplanationOfBenefit.accident","short":"Details of the event","definition":"Details of a accident which resulted in injuries which required the products and services listed in the claim.","requirements":"When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.accident","min":0,"max":"1"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.accident.id","path":"ExplanationOfBenefit.accident.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.accident.extension","path":"ExplanationOfBenefit.accident.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.accident.modifierExtension","path":"ExplanationOfBenefit.accident.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.accident.date","path":"ExplanationOfBenefit.accident.date","short":"When the incident occurred","definition":"Date of an accident event  related to the products and services contained in the claim.","comment":"The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.","requirements":"Required for audit purposes and adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.accident.date","min":0,"max":"1"},"type":[{"code":"date"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.accident.type","path":"ExplanationOfBenefit.accident.type","short":"The nature of the accident","definition":"The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.","requirements":"Coverage may be dependant on the type of accident.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.accident.type","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"AccidentType"}],"strength":"extensible","description":"Type of accident: work place, auto, etc.","valueSet":"http://terminology.hl7.org/ValueSet/v3-ActIncidentCode"}},{"id":"ExplanationOfBenefit.accident.location[x]","path":"ExplanationOfBenefit.accident.location[x]","short":"Where the event occurred","definition":"The physical location of the accident event.","requirements":"Required for audit purposes and determination of applicable insurance liability.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.accident.location[x]","min":0,"max":"1"},"type":[{"code":"Address"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Location"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Item"}],"path":"ExplanationOfBenefit.item","short":"Product or service provided","definition":"A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.","comment":"Put the comment here for item","requirements":"The items to be processed for adjudication.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.id","path":"ExplanationOfBenefit.item.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.extension","path":"ExplanationOfBenefit.item.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.modifierExtension","path":"ExplanationOfBenefit.item.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.item.sequence","path":"ExplanationOfBenefit.item.sequence","short":"Item instance identifier","definition":"A number to uniquely identify item entries.","comment":"Line identification number that represents the number assigned in a source system for identification and processing. (36)","requirements":"Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.careTeamSequence","path":"ExplanationOfBenefit.item.careTeamSequence","short":"Applicable care team members","definition":"Care team members related to this service or product.","requirements":"Need to identify the individuals and their roles in the provision of the product or service.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.careTeamSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.diagnosisSequence","path":"ExplanationOfBenefit.item.diagnosisSequence","short":"Applicable diagnoses","definition":"Diagnoses applicable for this service or product.","requirements":"Need to related the product or service to the associated diagnoses.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.diagnosisSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.procedureSequence","path":"ExplanationOfBenefit.item.procedureSequence","short":"Applicable procedures","definition":"Procedures applicable for this service or product.","requirements":"Need to provide any listed specific procedures to support the product or service being claimed.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.procedureSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.informationSequence","path":"ExplanationOfBenefit.item.informationSequence","short":"Applicable exception and supporting information","definition":"Exceptions, special conditions and supporting information applicable for this service or product.","requirements":"Need to reference the supporting information items that relate directly to this product or service.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.informationSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.revenue","path":"ExplanationOfBenefit.item.revenue","short":"Revenue or cost center code","definition":"The type of revenue or cost center providing the product and/or service.","comment":"Code used on the UB-04 (Form Locator 42) to identify a specific accommodation, ancillary service, or billing calculation related to the service being billed (86)","requirements":"Needed in the processing of institutional claims.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.revenue","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCRevenueCodes"}},{"id":"ExplanationOfBenefit.item.category","path":"ExplanationOfBenefit.item.category","short":"Benefit classification","definition":"Code to identify the general type of benefits under which products and services are provided.","comment":"Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.","requirements":"Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.category","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitCategory"}],"strength":"example","description":"Benefit categories such as: oral, medical, vision, oral-basic etc.","valueSet":"http://hl7.org/fhir/ValueSet/ex-benefitcategory"}},{"id":"ExplanationOfBenefit.item.productOrService","path":"ExplanationOfBenefit.item.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"Medical procedure a patient received from a health care provider. Current coding methods include: CPT-4 and HCFA Common Procedure Coding System Level II - (HCPCSII). (40)","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSProcedureCodes"}},{"id":"ExplanationOfBenefit.item.modifier","path":"ExplanationOfBenefit.item.modifier","short":"Product or service billing modifiers","definition":"Item typification or modifiers codes to convey additional context for the product or service.","comment":"Modifier(s) for the procedure represented on this line. Identifies special circumstances related to the performance of the service. (41)","requirements":"To support inclusion of the item for adjudication or to charge an elevated fee.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.modifier","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers"}},{"id":"ExplanationOfBenefit.item.programCode","path":"ExplanationOfBenefit.item.programCode","short":"Program the product or service is provided under","definition":"Identifies the program under which this may be recovered.","comment":"For example: Neonatal program, child dental program or drug users recovery program.","requirements":"Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.programCode","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ProgramCode"}],"strength":"example","description":"Program specific reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/ex-program-code"}},{"id":"ExplanationOfBenefit.item.serviced[x]","path":"ExplanationOfBenefit.item.serviced[x]","slicing":{"discriminator":[{"type":"type","path":"$this"}],"ordered":false,"rules":"closed"},"short":"Date or dates of service or product delivery","definition":"The date or dates when the service or product was supplied, performed or completed.","requirements":"Needed to determine whether the  service or product was provided during the term of the insurance coverage.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.serviced[x]","min":0,"max":"1"},"type":[{"code":"date"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.done[x]"}]},{"id":"ExplanationOfBenefit.item.serviced[x]:servicedDate","path":"ExplanationOfBenefit.item.serviced[x]","sliceName":"servicedDate","short":"Date or dates of service or product delivery","definition":"The date or dates when the service or product was supplied, performed or completed.","requirements":"Needed to determine whether the  service or product was provided during the term of the insurance coverage.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.serviced[x]","min":0,"max":"1"},"type":[{"code":"date"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.done[x]"}]},{"id":"ExplanationOfBenefit.item.location[x]","path":"ExplanationOfBenefit.item.location[x]","short":"Place of service or where product was supplied","definition":"Where the product or service was provided.","requirements":"The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.location[x]","min":0,"max":"1"},"type":[{"code":"CodeableConcept"},{"code":"Address"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Location"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServicePlace"}],"strength":"example","description":"Place where the service is rendered.","valueSet":"http://hl7.org/fhir/ValueSet/service-place"},"mapping":[{"identity":"w5","map":"FiveWs.where[x]"}]},{"id":"ExplanationOfBenefit.item.quantity","path":"ExplanationOfBenefit.item.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","comment":"The quantity of units, times, days, visits, services, or treatments for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (42)","requirements":"Required when the product or service code does not convey the quantity provided.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.quantity","min":0,"max":"1"},"type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.unitPrice","path":"ExplanationOfBenefit.item.unitPrice","short":"Fee, charge or cost per item","definition":"If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.","requirements":"The amount charged to the patient by the provider for a single unit.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.unitPrice","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.factor","path":"ExplanationOfBenefit.item.factor","short":"Price scaling factor","definition":"A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.","comment":"To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).","requirements":"When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.factor","min":0,"max":"1"},"type":[{"code":"decimal"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.net","path":"ExplanationOfBenefit.item.net","short":"Total item cost","definition":"The quantity times the unit price for an additional service or product or charge.","comment":"For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.","requirements":"Provides the total amount claimed  for the group (if a grouper) or the line item.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.net","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.udi","path":"ExplanationOfBenefit.item.udi","short":"Unique device identifier","definition":"Unique Device Identifiers associated with this line item.","requirements":"The UDI code allows the insurer to obtain device level information on the product 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For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.item.adjudication:denialreason.category","path":"ExplanationOfBenefit.item.adjudication.category","short":"Type of adjudication information","definition":"A code to indicate the information type of this adjudication record. 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Mutually exclusive to the amount element above.","comment":"For example: eligible percentage or co-payment percentage.","requirements":"Some adjudication categories convey a percentage or a fixed value.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.adjudication.value","min":0,"max":"1"},"type":[{"code":"decimal"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Adjudication"}],"path":"ExplanationOfBenefit.item.adjudication","sliceName":"allowedunits","short":"Adjudication details","definition":"If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.","comment":"The quantity of units, times, days, visits, services, or treatments allowed for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. 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This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.extension","path":"ExplanationOfBenefit.item.adjudication.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.modifierExtension","path":"ExplanationOfBenefit.item.adjudication.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.category","path":"ExplanationOfBenefit.item.adjudication.category","short":"Type of adjudication information","definition":"A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.","comment":"For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.","requirements":"Needed to enable understanding of the context of the other information in the adjudication.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.adjudication.category","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator","code":"allowedunits"}]},"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Adjudication"}],"strength":"example","description":"The adjudication codes.","valueSet":"http://hl7.org/fhir/ValueSet/adjudication"}},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.reason","path":"ExplanationOfBenefit.item.adjudication.reason","short":"Explanation of adjudication outcome","definition":"A code supporting the understanding of the adjudication result and explaining variance from expected amount.","comment":"For example, may indicate that the funds for this benefit type have been exhausted.","requirements":"To support understanding of variance from adjudication expectations.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.adjudication.reason","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"AdjudicationReason"}],"strength":"example","description":"Adjudication reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/adjudication-reason"}},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.amount","path":"ExplanationOfBenefit.item.adjudication.amount","short":"Monetary amount","definition":"Monetary amount associated with the category.","comment":"For example, amount submitted, eligible amount, co-payment, and benefit payable.","requirements":"Most adjuciation categories convey a monetary amount.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.adjudication.amount","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.value","path":"ExplanationOfBenefit.item.adjudication.value","short":"Non-monitary value","definition":"A non-monetary value associated with the category. 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This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.detail.extension","path":"ExplanationOfBenefit.item.detail.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.detail.modifierExtension","path":"ExplanationOfBenefit.item.detail.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. 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For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.item.detail.sequence","path":"ExplanationOfBenefit.item.detail.sequence","short":"Product or service provided","definition":"A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.","requirements":"The items to be processed for adjudication.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.revenue","path":"ExplanationOfBenefit.item.detail.revenue","short":"Revenue or cost center code","definition":"The type of revenue or cost center providing the product and/or service.","requirements":"Needed in the processing of institutional claims.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.revenue","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"RevenueCenter"}],"strength":"example","description":"Codes for the revenue or cost centers supplying the service and/or products.","valueSet":"http://hl7.org/fhir/ValueSet/ex-revenue-center"}},{"id":"ExplanationOfBenefit.item.detail.category","path":"ExplanationOfBenefit.item.detail.category","short":"Benefit classification","definition":"Code to identify the general type of benefits under which products and services are provided.","comment":"Examples include: Medical Care, Periodontics, Renal Dialysis, Vision Coverage.","requirements":"Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.category","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitCategory"}],"strength":"example","description":"Benefit categories such as: oral, medical, vision, oral-basic etc.","valueSet":"http://hl7.org/fhir/ValueSet/ex-benefitcategory"}},{"id":"ExplanationOfBenefit.item.detail.productOrService","path":"ExplanationOfBenefit.item.detail.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product 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classifications.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.programCode","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ProgramCode"}],"strength":"example","description":"Program specific reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/ex-program-code"}},{"id":"ExplanationOfBenefit.item.detail.quantity","path":"ExplanationOfBenefit.item.detail.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","requirements":"Required when the product or service code does not convey the 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unit.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.unitPrice","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.factor","path":"ExplanationOfBenefit.item.detail.factor","short":"Price scaling factor","definition":"A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.","comment":"To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).","requirements":"When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.factor","min":0,"max":"1"},"type":[{"code":"decimal"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.net","path":"ExplanationOfBenefit.item.detail.net","short":"Total item cost","definition":"The quantity times the unit price for an additional service or product or charge.","comment":"For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.","requirements":"Provides the total amount claimed  for the group (if a grouper) or the line item.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.net","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.udi","path":"ExplanationOfBenefit.item.detail.udi","short":"Unique device identifier","definition":"Unique Device Identifiers associated with this line item.","requirements":"The UDI code allows the insurer to obtain device level information on the product supplied.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.udi","min":0,"max":"*"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Device"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.noteNumber","path":"ExplanationOfBenefit.item.detail.noteNumber","short":"Applicable note numbers","definition":"The numbers associated with notes below which apply to the adjudication of this item.","requirements":"Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.noteNumber","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.adjudication","path":"ExplanationOfBenefit.item.detail.adjudication","short":"Detail level adjudication details","definition":"The adjudication results.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.adjudication","min":0,"max":"*"},"contentReference":"http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"SubDetail"}],"path":"ExplanationOfBenefit.item.detail.subDetail","short":"Additional items","definition":"Third-tier of goods and services.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.id","path":"ExplanationOfBenefit.item.detail.subDetail.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.detail.subDetail.extension","path":"ExplanationOfBenefit.item.detail.subDetail.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.item.detail.subDetail.modifierExtension","path":"ExplanationOfBenefit.item.detail.subDetail.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.item.detail.subDetail.sequence","path":"ExplanationOfBenefit.item.detail.subDetail.sequence","short":"Product or service provided","definition":"A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.","requirements":"The items to be processed for adjudication.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.sequence","min":1,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.revenue","path":"ExplanationOfBenefit.item.detail.subDetail.revenue","short":"Revenue or cost center code","definition":"The type of revenue or cost center providing the product and/or service.","requirements":"Needed in the processing of institutional claims.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.revenue","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"RevenueCenter"}],"strength":"example","description":"Codes for the revenue or cost centers supplying the service and/or products.","valueSet":"http://hl7.org/fhir/ValueSet/ex-revenue-center"}},{"id":"ExplanationOfBenefit.item.detail.subDetail.category","path":"ExplanationOfBenefit.item.detail.subDetail.category","short":"Benefit classification","definition":"Code to identify the general type of benefits under which products and services are provided.","comment":"Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.","requirements":"Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.category","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitCategory"}],"strength":"example","description":"Benefit categories such as: oral, medical, vision, oral-basic etc.","valueSet":"http://hl7.org/fhir/ValueSet/ex-benefitcategory"}},{"id":"ExplanationOfBenefit.item.detail.subDetail.productOrService","path":"ExplanationOfBenefit.item.detail.subDetail.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product 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id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Modifiers"}],"strength":"example","description":"Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.","valueSet":"http://hl7.org/fhir/ValueSet/claim-modifiers"}},{"id":"ExplanationOfBenefit.item.detail.subDetail.programCode","path":"ExplanationOfBenefit.item.detail.subDetail.programCode","short":"Program the product or service is provided under","definition":"Identifies the program under which this may be recovered.","comment":"For example: Neonatal program, child dental program or drug users recovery program.","requirements":"Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.programCode","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ProgramCode"}],"strength":"example","description":"Program specific reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/ex-program-code"}},{"id":"ExplanationOfBenefit.item.detail.subDetail.quantity","path":"ExplanationOfBenefit.item.detail.subDetail.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","requirements":"Required when the product or service code does not convey the quantity provided.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.quantity","min":0,"max":"1"},"type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.unitPrice","path":"ExplanationOfBenefit.item.detail.subDetail.unitPrice","short":"Fee, charge or cost per item","definition":"If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.","requirements":"The amount charged to the patient by the provider for a single 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Quantity and factor are assumed to be 1 if not supplied.","requirements":"Provides the total amount claimed  for the group (if a grouper) or the line item.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.net","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.udi","path":"ExplanationOfBenefit.item.detail.subDetail.udi","short":"Unique device identifier","definition":"Unique Device Identifiers associated with this line item.","requirements":"The UDI code allows the insurer to obtain device level information on the product supplied.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.udi","min":0,"max":"*"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Device"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.noteNumber","path":"ExplanationOfBenefit.item.detail.subDetail.noteNumber","short":"Applicable note numbers","definition":"The numbers associated with notes below which apply to the adjudication of this item.","requirements":"Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.noteNumber","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.item.detail.subDetail.adjudication","path":"ExplanationOfBenefit.item.detail.subDetail.adjudication","short":"Subdetail level adjudication details","definition":"The adjudication results.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.item.detail.subDetail.adjudication","min":0,"max":"*"},"contentReference":"http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint","valueString":"740;600"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"AddedItem"}],"path":"ExplanationOfBenefit.addItem","short":"Insurer added line items","definition":"The first-tier service adjudications for payor added product or service lines.","requirements":"Insurers may redefine the provided product or service or may package and/or decompose groups of products and services. The addItems allows the insurer to provide their line item list with linkage to the submitted items/details/sub-details. In a preauthorization the insurer may use the addItem structure to provide additional information on authorized products and services.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.id","path":"ExplanationOfBenefit.addItem.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.extension","path":"ExplanationOfBenefit.addItem.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.modifierExtension","path":"ExplanationOfBenefit.addItem.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.addItem.itemSequence","path":"ExplanationOfBenefit.addItem.itemSequence","short":"Item sequence number","definition":"Claim items which this service line is intended to replace.","requirements":"Provides references to the claim items.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.itemSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detailSequence","path":"ExplanationOfBenefit.addItem.detailSequence","short":"Detail sequence number","definition":"The sequence number of the details within the claim item which this line is intended to replace.","requirements":"Provides references to the claim details within the claim item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detailSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.subDetailSequence","path":"ExplanationOfBenefit.addItem.subDetailSequence","short":"Subdetail sequence number","definition":"The sequence number of the sub-details woithin the details within the claim item which this line is intended to replace.","requirements":"Provides references to the claim sub-details within the claim detail.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.subDetailSequence","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.provider","path":"ExplanationOfBenefit.addItem.provider","short":"Authorized providers","definition":"The providers who are authorized for the services rendered to the patient.","requirements":"Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.provider","min":0,"max":"*"},"type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Practitioner","http://hl7.org/fhir/StructureDefinition/PractitionerRole","http://hl7.org/fhir/StructureDefinition/Organization"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.source"}]},{"id":"ExplanationOfBenefit.addItem.productOrService","path":"ExplanationOfBenefit.addItem.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product codes.","valueSet":"http://hl7.org/fhir/ValueSet/service-uscls"}},{"id":"ExplanationOfBenefit.addItem.modifier","path":"ExplanationOfBenefit.addItem.modifier","short":"Service/Product billing modifiers","definition":"Item typification or modifiers codes to convey additional context for the product or service.","comment":"For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.","requirements":"To support inclusion of the item for adjudication or to charge an elevated fee.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.modifier","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Modifiers"}],"strength":"example","description":"Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.","valueSet":"http://hl7.org/fhir/ValueSet/claim-modifiers"}},{"id":"ExplanationOfBenefit.addItem.programCode","path":"ExplanationOfBenefit.addItem.programCode","short":"Program the product or service is provided under","definition":"Identifies the program under which this may be recovered.","comment":"For example: Neonatal program, child dental program or drug users recovery program.","requirements":"Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.programCode","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ProgramCode"}],"strength":"example","description":"Program specific reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/ex-program-code"}},{"id":"ExplanationOfBenefit.addItem.serviced[x]","path":"ExplanationOfBenefit.addItem.serviced[x]","short":"Date or dates of service or product delivery","definition":"The date or dates when the service or product was supplied, performed or completed.","requirements":"Needed to determine whether the  service or product was provided during the term of the insurance coverage.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.serviced[x]","min":0,"max":"1"},"type":[{"code":"date"},{"code":"Period"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"w5","map":"FiveWs.done[x]"}]},{"id":"ExplanationOfBenefit.addItem.location[x]","path":"ExplanationOfBenefit.addItem.location[x]","short":"Place of service or where product was supplied","definition":"Where the product or service was provided.","requirements":"The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.location[x]","min":0,"max":"1"},"type":[{"code":"CodeableConcept"},{"code":"Address"},{"code":"Reference","targetProfile":["http://hl7.org/fhir/StructureDefinition/Location"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServicePlace"}],"strength":"example","description":"Place where the service is rendered.","valueSet":"http://hl7.org/fhir/ValueSet/service-place"},"mapping":[{"identity":"w5","map":"FiveWs.where[x]"}]},{"id":"ExplanationOfBenefit.addItem.quantity","path":"ExplanationOfBenefit.addItem.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","requirements":"Required when the product or service code does not convey the quantity provided.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.quantity","min":0,"max":"1"},"type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.unitPrice","path":"ExplanationOfBenefit.addItem.unitPrice","short":"Fee, charge or cost per item","definition":"If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.","requirements":"The amount charged to the patient by the provider for a single unit.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.unitPrice","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.factor","path":"ExplanationOfBenefit.addItem.factor","short":"Price scaling factor","definition":"A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.","comment":"To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).","requirements":"When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.factor","min":0,"max":"1"},"type":[{"code":"decimal"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.net","path":"ExplanationOfBenefit.addItem.net","short":"Total item cost","definition":"The quantity times the unit price for an additional service or product or charge.","comment":"For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.","requirements":"Provides the total amount claimed  for the group (if a grouper) or the line item.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.net","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.bodySite","path":"ExplanationOfBenefit.addItem.bodySite","short":"Anatomical location","definition":"Physical service site on the patient (limb, tooth, etc.).","comment":"For example, providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed.","requirements":"Allows insurer to validate specific procedures.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.bodySite","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"OralSites"}],"strength":"example","description":"The code for the teeth, quadrant, sextant and arch.","valueSet":"http://hl7.org/fhir/ValueSet/tooth"}},{"id":"ExplanationOfBenefit.addItem.subSite","path":"ExplanationOfBenefit.addItem.subSite","short":"Anatomical sub-location","definition":"A region or surface of the bodySite, e.g. limb region or tooth surface(s).","requirements":"Allows insurer to validate specific procedures.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.subSite","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Surface"}],"strength":"example","description":"The code for the tooth surface and surface combinations.","valueSet":"http://hl7.org/fhir/ValueSet/surface"}},{"id":"ExplanationOfBenefit.addItem.noteNumber","path":"ExplanationOfBenefit.addItem.noteNumber","short":"Applicable note numbers","definition":"The numbers associated with notes below which apply to the adjudication of this item.","requirements":"Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.noteNumber","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.adjudication","path":"ExplanationOfBenefit.addItem.adjudication","short":"Added items adjudication","definition":"The adjudication results.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.adjudication","min":0,"max":"*"},"contentReference":"http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint","valueString":"740;600"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"AddedItemDetail"}],"path":"ExplanationOfBenefit.addItem.detail","short":"Insurer added line items","definition":"The second-tier service adjudications for payor added services.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detail","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.id","path":"ExplanationOfBenefit.addItem.detail.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.detail.extension","path":"ExplanationOfBenefit.addItem.detail.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.detail.modifierExtension","path":"ExplanationOfBenefit.addItem.detail.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.addItem.detail.productOrService","path":"ExplanationOfBenefit.addItem.detail.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product codes.","valueSet":"http://hl7.org/fhir/ValueSet/service-uscls"}},{"id":"ExplanationOfBenefit.addItem.detail.modifier","path":"ExplanationOfBenefit.addItem.detail.modifier","short":"Service/Product billing modifiers","definition":"Item typification or modifiers codes to convey additional context for the product or service.","comment":"For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.","requirements":"To support inclusion of the item for adjudication or to charge an elevated fee.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detail.modifier","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Modifiers"}],"strength":"example","description":"Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.","valueSet":"http://hl7.org/fhir/ValueSet/claim-modifiers"}},{"id":"ExplanationOfBenefit.addItem.detail.quantity","path":"ExplanationOfBenefit.addItem.detail.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","requirements":"Required when the product or service code does not convey the quantity provided.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.quantity","min":0,"max":"1"},"type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.unitPrice","path":"ExplanationOfBenefit.addItem.detail.unitPrice","short":"Fee, charge or cost per item","definition":"If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.","requirements":"The amount charged to the patient by the provider for a single unit.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.unitPrice","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.factor","path":"ExplanationOfBenefit.addItem.detail.factor","short":"Price scaling factor","definition":"A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.","comment":"To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).","requirements":"When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.factor","min":0,"max":"1"},"type":[{"code":"decimal"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.net","path":"ExplanationOfBenefit.addItem.detail.net","short":"Total item cost","definition":"The quantity times the unit price for an additional service or product or charge.","comment":"For example, the formula: quantity * unitPrice * factor  = net. 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Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension","path":"ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.productOrService","path":"ExplanationOfBenefit.addItem.detail.subDetail.productOrService","short":"Billing, service, product, or drug code","definition":"When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.","comment":"If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.","requirements":"Necessary to state what was provided or done.","alias":["Drug Code","Bill Code","Service Code"],"min":1,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.productOrService","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"ServiceProduct"}],"strength":"example","description":"Allowable service and product codes.","valueSet":"http://hl7.org/fhir/ValueSet/service-uscls"}},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.modifier","path":"ExplanationOfBenefit.addItem.detail.subDetail.modifier","short":"Service/Product billing modifiers","definition":"Item typification or modifiers codes to convey additional context for the product or service.","comment":"For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.","requirements":"To support inclusion of the item for adjudication or to charge an elevated fee.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.modifier","min":0,"max":"*"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Modifiers"}],"strength":"example","description":"Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.","valueSet":"http://hl7.org/fhir/ValueSet/claim-modifiers"}},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.quantity","path":"ExplanationOfBenefit.addItem.detail.subDetail.quantity","short":"Count of products or services","definition":"The number of repetitions of a service or product.","requirements":"Required when the product or service code does not convey the quantity provided.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.quantity","min":0,"max":"1"},"type":[{"code":"Quantity","profile":["http://hl7.org/fhir/StructureDefinition/SimpleQuantity"]}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.unitPrice","path":"ExplanationOfBenefit.addItem.detail.subDetail.unitPrice","short":"Fee, charge or cost per item","definition":"If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.","requirements":"The amount charged to the patient by the provider for a single unit.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.unitPrice","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.factor","path":"ExplanationOfBenefit.addItem.detail.subDetail.factor","short":"Price scaling factor","definition":"A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. 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Quantity and factor are assumed to be 1 if not supplied.","requirements":"Provides the total amount claimed  for the group (if a grouper) or the line item.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.net","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.noteNumber","path":"ExplanationOfBenefit.addItem.detail.subDetail.noteNumber","short":"Applicable note numbers","definition":"The numbers associated with notes below which apply to the adjudication of this item.","requirements":"Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.noteNumber","min":0,"max":"*"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.addItem.detail.subDetail.adjudication","path":"ExplanationOfBenefit.addItem.detail.subDetail.adjudication","short":"Added items adjudication","definition":"The adjudication results.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.addItem.detail.subDetail.adjudication","min":0,"max":"*"},"contentReference":"http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.adjudication","path":"ExplanationOfBenefit.adjudication","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on value pattern","ordered":false,"rules":"closed"},"short":"Header-level adjudication","definition":"The adjudication results which are presented at the header level rather than at the line-item or add-item levels.","requirements":"Some insurers will receive line-items but provide the adjudication only at a summary or header-level.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.adjudication","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"adjudication-has-amount-type-slice","severity":"error","human":"If Adjudication is present, it must have at least one adjudicationamounttype slice","expression":"(exists() implies where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.adjudication.id","path":"ExplanationOfBenefit.adjudication.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). 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For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.total.category","path":"ExplanationOfBenefit.total.category","short":"Type of adjudication information","definition":"A code to indicate the information type of this adjudication record. 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(187)","requirements":"To provide the requestor with financial totals by category for the adjudication.","min":1,"max":"*","base":{"path":"ExplanationOfBenefit.total","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.total:adjudicationamounttype.id","path":"ExplanationOfBenefit.total.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.total:adjudicationamounttype.extension","path":"ExplanationOfBenefit.total.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.total:adjudicationamounttype.modifierExtension","path":"ExplanationOfBenefit.total.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.total:adjudicationamounttype.category","path":"ExplanationOfBenefit.total.category","short":"Type of adjudication information","definition":"A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.","comment":"For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.","requirements":"Needed to convey the type of total provided.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.total.category","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"}},{"id":"ExplanationOfBenefit.total:adjudicationamounttype.amount","path":"ExplanationOfBenefit.total.amount","short":"Financial total for the category","definition":"Monetary total amount associated with the category.","requirements":"Needed to convey the total monetary amount.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.total.amount","min":1,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.total:inoutnetwork","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint","valueString":"'360;620"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Total"}],"path":"ExplanationOfBenefit.total","sliceName":"inoutnetwork","short":"Adjudication totals","definition":"Categorized monetary totals for the adjudication.","comment":"Indicates the in network or out of network payment status of the claim. (142)","requirements":"To provide the requestor with financial totals by category for the adjudication.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.total","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":true},{"id":"ExplanationOfBenefit.total:inoutnetwork.id","path":"ExplanationOfBenefit.total.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). 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Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.total:inoutnetwork.modifierExtension","path":"ExplanationOfBenefit.total.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.total:inoutnetwork.category","path":"ExplanationOfBenefit.total.category","short":"Type of adjudication information","definition":"A code to indicate the information type of this adjudication record. 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This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.payment.extension","path":"ExplanationOfBenefit.payment.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  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Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.payment.type","path":"ExplanationOfBenefit.payment.type","short":"Partial or complete payment","definition":"Whether this represents partial or complete payment of the benefits payable.","comment":"Indicates whether the claim was paid or denied. (91)","requirements":"To advise the requestor when the insurer believes all payments to have been completed.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.type","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerClaimPaymentStatusCode"}},{"id":"ExplanationOfBenefit.payment.adjustment","path":"ExplanationOfBenefit.payment.adjustment","short":"Payment adjustment for non-claim issues","definition":"Total amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication.","comment":"Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider.","requirements":"To advise the requestor of adjustments applied to the payment.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.adjustment","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payment.adjustmentReason","path":"ExplanationOfBenefit.payment.adjustmentReason","short":"Explanation for the variance","definition":"Reason for the payment adjustment.","requirements":"Needed to clarify the monetary adjustment.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.adjustmentReason","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"PaymentAdjustmentReason"}],"strength":"example","description":"Payment Adjustment reason codes.","valueSet":"http://hl7.org/fhir/ValueSet/payment-adjustment-reason"}},{"id":"ExplanationOfBenefit.payment.date","path":"ExplanationOfBenefit.payment.date","short":"Expected date of payment","definition":"Estimated date the payment will be issued or the actual issue date of payment.","comment":"The date the claim was paid. (107)","requirements":"To advise the payee when payment can be expected.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.date","min":0,"max":"1"},"type":[{"code":"date"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payment.amount","path":"ExplanationOfBenefit.payment.amount","short":"Payable amount after adjustment","definition":"Benefits payable less any payment adjustment.","requirements":"Needed to provide the actual payment amount.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.amount","min":0,"max":"1"},"type":[{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.payment.identifier","path":"ExplanationOfBenefit.payment.identifier","short":"Business identifier for the payment","definition":"Issuer's unique identifier for the payment instrument.","comment":"For example: EFT number or check number.","requirements":"Enable the receiver to reconcile when payment received.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.payment.identifier","min":0,"max":"1"},"type":[{"code":"Identifier"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.formCode","path":"ExplanationOfBenefit.formCode","short":"Printed form identifier","definition":"A code for the form to be used for printing the content.","comment":"May be needed to identify specific jurisdictional forms.","requirements":"Needed to specify the specific form used for producing output for this response.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.formCode","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Forms"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"example","description":"The forms codes.","valueSet":"http://hl7.org/fhir/ValueSet/forms"}},{"id":"ExplanationOfBenefit.form","path":"ExplanationOfBenefit.form","short":"Printed reference or actual form","definition":"The actual form, by reference or inclusion, for printing the content or an EOB.","comment":"Needed to permit insurers to include the actual form.","requirements":"Needed to include the specific form used for producing output for this response.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.form","min":0,"max":"1"},"type":[{"code":"Attachment"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.processNote","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Note"}],"path":"ExplanationOfBenefit.processNote","short":"Note concerning adjudication","definition":"A note that describes or explains adjudication results in a human readable form.","requirements":"Provides the insurer specific textual explanations associated with the processing.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.processNote","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.processNote.id","path":"ExplanationOfBenefit.processNote.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.processNote.extension","path":"ExplanationOfBenefit.processNote.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.processNote.modifierExtension","path":"ExplanationOfBenefit.processNote.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.processNote.number","path":"ExplanationOfBenefit.processNote.number","short":"Note instance identifier","definition":"A number to uniquely identify a note entry.","requirements":"Necessary to provide a mechanism to link from adjudications.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.processNote.number","min":0,"max":"1"},"type":[{"code":"positiveInt"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.processNote.type","path":"ExplanationOfBenefit.processNote.type","short":"display | print | printoper","definition":"The business purpose of the note text.","requirements":"To convey the expectation for when the text is used.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.processNote.type","min":0,"max":"1"},"type":[{"code":"code"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"NoteType"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"required","description":"The presentation types of notes.","valueSet":"http://hl7.org/fhir/ValueSet/note-type|4.0.1"}},{"id":"ExplanationOfBenefit.processNote.text","path":"ExplanationOfBenefit.processNote.text","short":"Note explanatory text","definition":"The explanation or description associated with the processing.","comment":"Payment denial explanation to a member, typically goes on the EOB when the payment is denied or disallowed (181)","requirements":"Required to provide human readable explanation.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.processNote.text","min":0,"max":"1"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"mustSupport":true,"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.processNote.language","path":"ExplanationOfBenefit.processNote.language","short":"Language of the text","definition":"A code to define the language used in the text of the note.","comment":"Only required if the language is different from the resource language.","requirements":"Note text may vary from the resource defined language.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.processNote.language","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet","valueCanonical":"http://hl7.org/fhir/ValueSet/all-languages"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"Language"},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding","valueBoolean":true}],"strength":"preferred","description":"A human 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This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.benefitBalance.extension","path":"ExplanationOfBenefit.benefitBalance.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  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For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.benefitBalance.category","path":"ExplanationOfBenefit.benefitBalance.category","short":"Benefit classification","definition":"Code to identify the general type of benefits under which products and services are provided.","comment":"Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.","requirements":"Needed to convey the category of service or product for which eligibility is sought.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.category","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > 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coverage.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.excluded","min":0,"max":"1"},"type":[{"code":"boolean"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance.name","path":"ExplanationOfBenefit.benefitBalance.name","short":"Short name for the benefit","definition":"A short name or tag for the benefit.","comment":"For example: MED01, or DENT2.","requirements":"Required to align with other plan names.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.name","min":0,"max":"1"},"type":[{"code":"string"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > 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id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitNetwork"}],"strength":"example","description":"Code to classify in or out of network services.","valueSet":"http://hl7.org/fhir/ValueSet/benefit-network"}},{"id":"ExplanationOfBenefit.benefitBalance.unit","path":"ExplanationOfBenefit.benefitBalance.unit","short":"Individual or family","definition":"Indicates if the benefits apply to an individual or to the family.","requirements":"Needed for the understanding of the benefits.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.unit","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitUnit"}],"strength":"example","description":"Unit covered/serviced - individual or family.","valueSet":"http://hl7.org/fhir/ValueSet/benefit-unit"}},{"id":"ExplanationOfBenefit.benefitBalance.term","path":"ExplanationOfBenefit.benefitBalance.term","short":"Annual or lifetime","definition":"The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.","requirements":"Needed for the understanding of the benefits.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.term","min":0,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitTerm"}],"strength":"example","description":"Coverage unit - annual, lifetime.","valueSet":"http://hl7.org/fhir/ValueSet/benefit-term"}},{"id":"ExplanationOfBenefit.benefitBalance.financial","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name","valueString":"Benefit"}],"path":"ExplanationOfBenefit.benefitBalance.financial","short":"Benefit Summary","definition":"Benefits Used to date.","min":0,"max":"*","base":{"path":"ExplanationOfBenefit.benefitBalance.financial","min":0,"max":"*"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance.financial.id","path":"ExplanationOfBenefit.benefitBalance.financial.id","representation":["xmlAttr"],"short":"Unique id for inter-element referencing","definition":"Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.","min":0,"max":"1","base":{"path":"Element.id","min":0,"max":"1"},"type":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type","valueUrl":"string"}],"code":"http://hl7.org/fhirpath/System.String"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.benefitBalance.financial.extension","path":"ExplanationOfBenefit.benefitBalance.financial.extension","short":"Additional content defined by implementations","definition":"May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","alias":["extensions","user content"],"min":0,"max":"*","base":{"path":"Element.extension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":false,"isSummary":false,"mapping":[{"identity":"rim","map":"n/a"}]},{"id":"ExplanationOfBenefit.benefitBalance.financial.modifierExtension","path":"ExplanationOfBenefit.benefitBalance.financial.modifierExtension","short":"Extensions that cannot be ignored even if unrecognized","definition":"May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).","comment":"There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.","requirements":"Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).","alias":["extensions","user content","modifiers"],"min":0,"max":"*","base":{"path":"BackboneElement.modifierExtension","min":0,"max":"*"},"type":[{"code":"Extension"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"ext-1","severity":"error","human":"Must have either extensions or value[x], not both","expression":"extension.exists() != value.exists()","xpath":"exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])","source":"http://hl7.org/fhir/StructureDefinition/Extension"}],"isModifier":true,"isModifierReason":"Modifier extensions are expected to modify the meaning or interpretation of the element that contains them","isSummary":true,"mapping":[{"identity":"rim","map":"N/A"}]},{"id":"ExplanationOfBenefit.benefitBalance.financial.type","path":"ExplanationOfBenefit.benefitBalance.financial.type","short":"Benefit classification","definition":"Classification of benefit being provided.","comment":"For example: deductible, visits, benefit amount.","requirements":"Needed to convey the nature of the benefit.","min":1,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.financial.type","min":1,"max":"1"},"type":[{"code":"CodeableConcept"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false,"binding":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName","valueString":"BenefitType"}],"strength":"example","description":"Deductable, visits, co-pay, etc.","valueSet":"http://hl7.org/fhir/ValueSet/benefit-type"}},{"id":"ExplanationOfBenefit.benefitBalance.financial.allowed[x]","path":"ExplanationOfBenefit.benefitBalance.financial.allowed[x]","short":"Benefits allowed","definition":"The quantity of the benefit which is permitted under the coverage.","requirements":"Needed to convey the benefits offered under the coverage.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.financial.allowed[x]","min":0,"max":"1"},"type":[{"code":"unsignedInt"},{"code":"string"},{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false},{"id":"ExplanationOfBenefit.benefitBalance.financial.used[x]","path":"ExplanationOfBenefit.benefitBalance.financial.used[x]","short":"Benefits used","definition":"The quantity of the benefit which have been consumed to date.","requirements":"Needed to convey the benefits consumed to date.","min":0,"max":"1","base":{"path":"ExplanationOfBenefit.benefitBalance.financial.used[x]","min":0,"max":"1"},"type":[{"code":"unsignedInt"},{"code":"Money"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"}],"isModifier":false,"isSummary":false}]},"differential":{"element":[{"id":"ExplanationOfBenefit","path":"ExplanationOfBenefit","constraint":[{"key":"dom-2","severity":"error","human":"If the resource is contained in another resource, it SHALL NOT contain nested Resources","expression":"contained.contained.empty()","xpath":"not(parent::f:contained and f:contained)","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-3","severity":"error","human":"If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource","expression":"contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()","xpath":"not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-4","severity":"error","human":"If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated","expression":"contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()","xpath":"not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"dom-5","severity":"error","human":"If a resource is contained in another resource, it SHALL NOT have a security label","expression":"contained.meta.security.empty()","xpath":"not(exists(f:contained/*/f:meta/f:security))","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice","valueBoolean":true},{"url":"http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation","valueMarkdown":"When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."}],"key":"dom-6","severity":"warning","human":"A resource should have narrative for robust management","expression":"text.`div`.exists()","xpath":"exists(f:text/h:div)","source":"http://hl7.org/fhir/StructureDefinition/DomainResource"},{"key":"EOB-institutional-item-or-header-adjudication","severity":"error","human":"Institutional EOB:  Should have adjudication at the item or header level, but not both","expression":"(adjudication.exists() != item.adjudication.exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"}]},{"id":"ExplanationOfBenefit.type","path":"ExplanationOfBenefit.type","patternCodeableConcept":{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/claim-type","code":"institutional"}]}},{"id":"ExplanationOfBenefit.created","path":"ExplanationOfBenefit.created","mustSupport":true},{"id":"ExplanationOfBenefit.provider","path":"ExplanationOfBenefit.provider","type":[{"code":"Reference","targetProfile":["http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"]}]},{"id":"ExplanationOfBenefit.careTeam","path":"ExplanationOfBenefit.careTeam","constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"EOB-inst-careTeam-practitioner","severity":"error","human":"Institutional EOB: Careteam roles refer to a practitioner","expression":"(\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists() implies\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists().provider.all(resolve() is Practitioner)\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"},{"key":"EOB-inst-careTeam-organization","severity":"error","human":"Institutional EOB:  Careteam roles refer to an organization","expression":"(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().provider.all(resolve() is Organization)\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"},{"key":"EOB-careteam-qualification","severity":"error","human":"Care Team Performing physician's qualifications are from US-Core-Provider-Specialty Value Set","expression":"(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().qualification.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty')\n)","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"}]},{"id":"ExplanationOfBenefit.careTeam.role","path":"ExplanationOfBenefit.careTeam.role","min":1,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInstitutionalCareTeamRole"}},{"id":"ExplanationOfBenefit.careTeam.qualification","path":"ExplanationOfBenefit.careTeam.qualification","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty"}},{"id":"ExplanationOfBenefit.supportingInfo","path":"ExplanationOfBenefit.supportingInfo","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on $this pattern","ordered":false,"rules":"open"}},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus","path":"ExplanationOfBenefit.supportingInfo","sliceName":"billingnetworkcontractingstatus","comment":"Indicates that the Billing Provider has a contract with the Plan (regardless of the network) as of the effective date of service or admission. (101)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"billingnetworkcontractingstatus"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderContractingStatus"}},{"id":"ExplanationOfBenefit.supportingInfo:clmrecvddate","path":"ExplanationOfBenefit.supportingInfo","sliceName":"clmrecvddate","comment":"The date the claim was received by the payer (88)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:clmrecvddate.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"clmrecvddate"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]","path":"ExplanationOfBenefit.supportingInfo.timing[x]","min":1,"type":[{"code":"date"}],"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:typeofbill","path":"ExplanationOfBenefit.supportingInfo","sliceName":"typeofbill","comment":"UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of institution, the second digit classifies the type of care being billed, and the third digit  identifies the frequency of the bill for a specific course of treatment or inpatient confinement. (17)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:typeofbill.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"typeofbill"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:typeofbill.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCTypeOfBill"}},{"id":"ExplanationOfBenefit.supportingInfo:pointoforigin","path":"ExplanationOfBenefit.supportingInfo","sliceName":"pointoforigin","comment":"Identifies the place where the patient was identified as needing admission to an institution. This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15). (13)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:pointoforigin.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"pointoforigin"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:pointoforigin.code","path":"ExplanationOfBenefit.supportingInfo.code","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPointOfOriginForAdmissionOrVisit"}},{"id":"ExplanationOfBenefit.supportingInfo:admtype","path":"ExplanationOfBenefit.supportingInfo","sliceName":"admtype","comment":"Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled. (14)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:admtype.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"admtype"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:admtype.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPriorityTypeOfAdmissionOrVisit"}},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status","path":"ExplanationOfBenefit.supportingInfo","sliceName":"discharge-status","comment":"Patient’s status as of the discharge date for a facility stay. Information located on UB04. (Form Locator 17). (117)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.category","path":"ExplanationOfBenefit.supportingInfo.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType","code":"discharge-status"}]},"mustSupport":true},{"id":"ExplanationOfBenefit.supportingInfo:discharge-status.code","path":"ExplanationOfBenefit.supportingInfo.code","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPatientDischargeStatus"}},{"id":"ExplanationOfBenefit.diagnosis","path":"ExplanationOfBenefit.diagnosis","comment":"Diagnosis codes describe an individual's disease or medical condition. (6, 7, 8, 21, 22, 23, 30)","min":1},{"id":"ExplanationOfBenefit.diagnosis.sequence","path":"ExplanationOfBenefit.diagnosis.sequence","comment":"Diagnosis.sequence values do not necessarily indiate any order in which the diagnosis was reported or identified.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of diagnosis.type to identify primary, secondary, etc."},{"id":"ExplanationOfBenefit.diagnosis.diagnosis[x]","path":"ExplanationOfBenefit.diagnosis.diagnosis[x]","type":[{"code":"CodeableConcept"}],"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/CDCICD910CMDiagnosisCodes"}},{"id":"ExplanationOfBenefit.diagnosis.type","path":"ExplanationOfBenefit.diagnosis.type","comment":"Indicates if the outpatient institutional diagnosis is principal, other, an external cause of injury or a patient reason for visit. (21, 22, 23)","min":1,"max":"1","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimOutpatientInstitutionalDiagnosisType"}},{"id":"ExplanationOfBenefit.item","path":"ExplanationOfBenefit.item","comment":"Put the comment here for item"},{"id":"ExplanationOfBenefit.item.revenue","path":"ExplanationOfBenefit.item.revenue","comment":"Code used on the UB-04 (Form Locator 42) to identify a specific accommodation, ancillary service, or billing calculation related to the service being billed (86)","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCRevenueCodes"}},{"id":"ExplanationOfBenefit.item.productOrService","path":"ExplanationOfBenefit.item.productOrService","comment":"Medical procedure a patient received from a health care provider. Current coding methods include: CPT-4 and HCFA Common Procedure Coding System Level II - (HCPCSII). (40)","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSProcedureCodes"}},{"id":"ExplanationOfBenefit.item.modifier","path":"ExplanationOfBenefit.item.modifier","comment":"Modifier(s) for the procedure represented on this line. Identifies special circumstances related to the performance of the service. (41)","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers"}},{"id":"ExplanationOfBenefit.item.serviced[x]","path":"ExplanationOfBenefit.item.serviced[x]","slicing":{"discriminator":[{"type":"type","path":"$this"}],"ordered":false,"rules":"open"},"type":[{"code":"date"}]},{"id":"ExplanationOfBenefit.item.servicedDate","path":"ExplanationOfBenefit.item.servicedDate","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.item.quantity","path":"ExplanationOfBenefit.item.quantity","comment":"The quantity of units, times, days, visits, services, or treatments for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (42)","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication","path":"ExplanationOfBenefit.item.adjudication","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on value pattern","ordered":false,"rules":"closed"},"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"adjudication-has-amount-type-slice","severity":"error","human":"If Adjudication is present, it must have at least one adjudicationamounttype slice","expression":"(exists() implies where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"}],"mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication.category","path":"ExplanationOfBenefit.item.adjudication.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"}},{"id":"ExplanationOfBenefit.item.adjudication:adjudicationamounttype","path":"ExplanationOfBenefit.item.adjudication","sliceName":"adjudicationamounttype","comment":"Describes the various amount fields used when payers receive and adjudicate a claim. (187)","min":0,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category","path":"ExplanationOfBenefit.item.adjudication.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"}},{"id":"ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount","path":"ExplanationOfBenefit.item.adjudication.amount","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication:denialreason","path":"ExplanationOfBenefit.item.adjudication","sliceName":"denialreason","comment":"Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)","min":0,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication:denialreason.category","path":"ExplanationOfBenefit.item.adjudication.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator","code":"denialreason"}]}},{"id":"ExplanationOfBenefit.item.adjudication:denialreason.reason","path":"ExplanationOfBenefit.item.adjudication.reason","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"}},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits","path":"ExplanationOfBenefit.item.adjudication","sliceName":"allowedunits","comment":"The quantity of units, times, days, visits, services, or treatments allowed for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (149)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.category","path":"ExplanationOfBenefit.item.adjudication.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator","code":"allowedunits"}]}},{"id":"ExplanationOfBenefit.item.adjudication:allowedunits.value","path":"ExplanationOfBenefit.item.adjudication.value","mustSupport":true},{"id":"ExplanationOfBenefit.adjudication","path":"ExplanationOfBenefit.adjudication","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on value pattern","ordered":false,"rules":"closed"},"type":[{"code":"BackboneElement"}],"constraint":[{"key":"ele-1","severity":"error","human":"All FHIR elements must have a @value or children","expression":"hasValue() or (children().count() > id.count())","xpath":"@value|f:*|h:div","source":"http://hl7.org/fhir/StructureDefinition/Element"},{"key":"adjudication-has-amount-type-slice","severity":"error","human":"If Adjudication is present, it must have at least one adjudicationamounttype slice","expression":"(exists() implies where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())","source":"http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"}],"mustSupport":true},{"id":"ExplanationOfBenefit.adjudication.category","path":"ExplanationOfBenefit.adjudication.category","mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"}},{"id":"ExplanationOfBenefit.adjudication:adjudicationamounttype","path":"ExplanationOfBenefit.adjudication","sliceName":"adjudicationamounttype","comment":"Describes the various amount fields used when payers receive and adjudicate a claim. (187)","min":0,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.adjudication:adjudicationamounttype.category","path":"ExplanationOfBenefit.adjudication.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"}},{"id":"ExplanationOfBenefit.adjudication:adjudicationamounttype.amount","path":"ExplanationOfBenefit.adjudication.amount","min":1,"mustSupport":true},{"id":"ExplanationOfBenefit.adjudication:denialreason","path":"ExplanationOfBenefit.adjudication","sliceName":"denialreason","comment":"Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)","min":0,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.adjudication:denialreason.category","path":"ExplanationOfBenefit.adjudication.category","patternCodeableConcept":{"coding":[{"system":"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator","code":"denialreason"}]}},{"id":"ExplanationOfBenefit.adjudication:denialreason.reason","path":"ExplanationOfBenefit.adjudication.reason","comment":"Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)","min":1,"mustSupport":true,"binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"}},{"id":"ExplanationOfBenefit.total","path":"ExplanationOfBenefit.total","slicing":{"discriminator":[{"type":"pattern","path":"category"}],"description":"Slice based on value pattern","ordered":false,"rules":"open"}},{"id":"ExplanationOfBenefit.total.category","path":"ExplanationOfBenefit.total.category","mustSupport":true,"binding":{"strength":"extensible","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBTotalCategoryDiscriminator"}},{"id":"ExplanationOfBenefit.total.amount","path":"ExplanationOfBenefit.total.amount","comment":"Total amount for each category (i.e., submitted, allowed, etc.) (148)"},{"id":"ExplanationOfBenefit.total:adjudicationamounttype","path":"ExplanationOfBenefit.total","sliceName":"adjudicationamounttype","comment":"Describes the various amount fields used when payers receive and adjudicate a claim. (187)","min":1,"max":"*","mustSupport":true},{"id":"ExplanationOfBenefit.total:adjudicationamounttype.category","path":"ExplanationOfBenefit.total.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"}},{"id":"ExplanationOfBenefit.total:adjudicationamounttype.amount","path":"ExplanationOfBenefit.total.amount","mustSupport":true},{"id":"ExplanationOfBenefit.total:inoutnetwork","path":"ExplanationOfBenefit.total","sliceName":"inoutnetwork","comment":"Indicates the in network or out of network payment status of the claim. (142)","min":0,"max":"1","mustSupport":true},{"id":"ExplanationOfBenefit.total:inoutnetwork.category","path":"ExplanationOfBenefit.total.category","binding":{"strength":"required","valueSet":"http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus"}},{"id":"ExplanationOfBenefit.payment.date","path":"ExplanationOfBenefit.payment.date","mustSupport":true},{"id":"ExplanationOfBenefit.processNote.text","path":"ExplanationOfBenefit.processNote.text","mustSupport":true}]}}
\ No newline at end of file
+{
+    "resourceType": "StructureDefinition",
+    "id": "C4BB-ExplanationOfBenefit-Outpatient-Institutional",
+    "text": {
+        "status": "extensions",
+        "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the element can appear in the instance\">Card.</a></th><th style=\"width: 100px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the element\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_resource.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit\">ExplanationOfBenefit</a><a name=\"ExplanationOfBenefit\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: black; null\" title=\"This element has or is affected by some invariants (EOB-institutional-item-or-header-adjudication)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"StructureDefinition-C4BB-ExplanationOfBenefit.html\">C4BBExplanationOfBenefit</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of Benefit resource</span><br/><span style=\"font-weight:bold\">EOB-institutional-item-or-header-adjudication: </span>Institutional EOB:  Should have adjudication at the item or header level, but not both</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.type\">type</a><a name=\"ExplanationOfBenefit.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Category or discipline</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck101.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"http://terminology.hl7.org/2.0.0/CodeSystem-claim-type.html\">http://terminology.hl7.org/CodeSystem/claim-type</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">institutional</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.created\">created</a><a name=\"ExplanationOfBenefit.created\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Response creation date</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.provider\">provider</a><a name=\"ExplanationOfBenefit.provider\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/references.html\">Reference</a>(<a href=\"StructureDefinition-C4BB-Organization.html\">C4BB Organization</a>)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Party responsible for the claim</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam\">careTeam</a><a name=\"ExplanationOfBenefit.careTeam\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: black; null\" title=\"This element has or is affected by some invariants (EOB-inst-careTeam-practitioner, EOB-inst-careTeam-organization, EOB-careteam-qualification)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Care Team members</span><br/><span style=\"font-weight:bold\">EOB-inst-careTeam-practitioner: </span>Institutional EOB: Careteam roles refer to a practitioner<br/><span style=\"font-weight:bold\">EOB-inst-careTeam-organization: </span>Institutional EOB:  Careteam roles refer to an organization<br/><span style=\"font-weight:bold\">EOB-careteam-qualification: </span>Care Team Performing physician's qualifications are from US-Core-Provider-Specialty Value Set</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam.role\">role</a><a name=\"ExplanationOfBenefit.careTeam.role\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Function within the team</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimInstitutionalCareTeamRole.html\">C4BB Claim Institutional Care Team Role</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.careTeam.qualification\">qualification</a><a name=\"ExplanationOfBenefit.careTeam.qualification\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Practitioner credential or specialization</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/ValueSet-us-core-provider-specialty.html\">US Core Provider Speciality (NUCC)</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo\">supportingInfo</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Supporting information</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by pattern:category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus\" title=\"Slice billingnetworkcontractingstatus\">supportingInfo:billingnetworkcontractingstatus</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">billingnetworkcontractingstatus</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBPayerProviderContractingStatus.html\">C4BB Payer Provider Contracting Status</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate\" title=\"Slice clmrecvddate\">supportingInfo:clmrecvddate</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">clmrecvddate</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_primitive.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Primitive Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]\">timing[x]</a><a name=\"ExplanationOfBenefit.supportingInfo.timing_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">When it occurred</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill\" title=\"Slice typeofbill\">supportingInfo:typeofbill</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">typeofbill</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:typeofbill.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCTypeOfBill.html\">NUBC Type of Bill Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin\" title=\"Slice pointoforigin\">supportingInfo:pointoforigin</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">pointoforigin</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:pointoforigin.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPointOfOriginForAdmissionOrVisit.html\">NUBC Point Of Origin</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype\" title=\"Slice admtype\">supportingInfo:admtype</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">admtype</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:admtype.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPriorityTypeOfAdmissionOrVisit.html\">NUBC Priority (Type) of Admission or Visit</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status\" title=\"Slice discharge-status\">supportingInfo:discharge-status</a><a name=\"ExplanationOfBenefit.supportingInfo\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Supporting information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status.category\">category</a><a name=\"ExplanationOfBenefit.supportingInfo.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Classification of the supplied information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBSupportingInfoType.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">discharge-status</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.supportingInfo:discharge-status.code\">code</a><a name=\"ExplanationOfBenefit.supportingInfo.code\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCPatientDischargeStatus.html\">NUBC Patient Discharge Status Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis\">diagnosis</a><a name=\"ExplanationOfBenefit.diagnosis\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Pertinent diagnosis information</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.sequence\">sequence</a><a name=\"ExplanationOfBenefit.diagnosis.sequence\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#positiveInt\">positiveInt</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Diagnosis instance identifier</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_datatype.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Data Type\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.diagnosis[x]\">diagnosis[x]</a><a name=\"ExplanationOfBenefit.diagnosis.diagnosis_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Nature of illness or problem</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-CDCICD910CMDiagnosisCodes.html\">Diagnosis Codes - International Classification of Diseases, Clinical Modification (ICD-9-CM, ICD-10-CM)</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.diagnosis.type\">type</a><a name=\"ExplanationOfBenefit.diagnosis.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Timing or nature of the diagnosis</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBClaimOutpatientInstitutionalDiagnosisType.html\">C4BB Claim Outpatient Institutional Diagnosis Type</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item\">item</a><a name=\"ExplanationOfBenefit.item\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Product or service provided</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.revenue\">revenue</a><a name=\"ExplanationOfBenefit.item.revenue\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Revenue or cost center code</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AHANUBCRevenueCodes.html\">NUBC Revenue Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.productOrService\">productOrService</a><a name=\"ExplanationOfBenefit.item.productOrService\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Billing, service, product, or drug code</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AMACPTCMSHCPCSProcedureCodes.html\">Current Procedural Terminology (CPT) -  Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes - Procedure Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.modifier\">modifier</a><a name=\"ExplanationOfBenefit.item.modifier\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Product or service billing modifiers</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-AMACPTCMSHCPCSModifiers.html\">Current Procedural Terminology (CPT) -  Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes - Procedure Modifier Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck112.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.serviced[x]\">serviced[x]</a><a name=\"ExplanationOfBenefit.item.serviced_x_\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Date or dates of service or product delivery</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by type:$this</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.servicedDate\">servicedDate</a><a name=\"ExplanationOfBenefit.item.servicedDate\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Date or dates of service or product delivery</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.quantity\">quantity</a><a name=\"ExplanationOfBenefit.item.quantity\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#SimpleQuantity\" title=\"Quantity\">SimpleQuantity</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Count of products or services</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication\">adjudication</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic\" title=\"This element must be supported\">S</span><span style=\"padding-left: 3px; padding-right: 3px; color: black; null; font-style: italic\" title=\"This element has or is affected by some invariants (adjudication-has-amount-type-slice)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Adjudication details</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Closed by pattern:category</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">adjudication-has-amount-type-slice: </span><span style=\"font-style: italic\">If Adjudication is present, it must have at least one adjudicationamounttype slice</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1033.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> adjudication:All Slices<a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudicationCategoryDiscriminator.html\">C4BB Adjudication Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">adjudication:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.item.adjudication.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Monetary amount</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason\" title=\"Slice denialreason\">adjudication:denialreason</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10351.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck103501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1035000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">denialreason</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:denialreason.reason\">reason</a><a name=\"ExplanationOfBenefit.item.adjudication.reason\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of adjudication outcome</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes.html\">X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits\" title=\"Slice allowedunits\">adjudication:allowedunits</a><a name=\"ExplanationOfBenefit.item.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication details</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits.category\">category</a><a name=\"ExplanationOfBenefit.item.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck102501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1025000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">allowedunits</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.item.adjudication:allowedunits.value\">value</a><a name=\"ExplanationOfBenefit.item.adjudication.value\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#decimal\">decimal</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Non-monitary value</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication\">adjudication</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic\" title=\"This element must be supported\">S</span><span style=\"padding-left: 3px; padding-right: 3px; color: black; null; font-style: italic\" title=\"This element has or is affected by some invariants (adjudication-has-amount-type-slice)\">I</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">0</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Header-level adjudication</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Closed by pattern:category</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">adjudication-has-amount-type-slice: </span><span style=\"font-style: italic\">If Adjudication is present, it must have at least one adjudicationamounttype slice</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck133.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> adjudication:All Slices<a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudicationCategoryDiscriminator.html\">C4BB Adjudication Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">adjudication:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Header-level adjudication</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.adjudication.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Monetary amount</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason\" title=\"Slice denialreason\">adjudication:denialreason</a><a name=\"ExplanationOfBenefit.adjudication\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Header-level adjudication</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1251.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason.category\">category</a><a name=\"ExplanationOfBenefit.adjudication.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Required Pattern: </span><span style=\"color: darkgreen\">At least the following</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12501.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#CodeableConcept.coding\">coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#Coding\">Coding</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Code defined by a terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">(complex)</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.system\">system</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#uri\">uri</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Identity of the terminology system<br/><span style=\"font-weight: bold\">Fixed Value: </span><a style=\"color: darkgreen\" href=\"CodeSystem-C4BBAdjudicationDiscriminator.html\">http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_fixed.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Fixed Value\" class=\"hierarchy\"/> <a href=\"http://hl7.org/fhir/R4/datatypes-definitions.html#Coding.code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/datatypes.html#code\">code</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symbol in syntax defined by the system<br/><span style=\"font-weight: bold\">Fixed Value: </span><span style=\"color: darkgreen\">denialreason</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.adjudication:denialreason.reason\">reason</a><a name=\"ExplanationOfBenefit.adjudication.reason\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..<span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Explanation of adjudication outcome</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes.html\">X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Definition\" class=\"hierarchy\"/> <a style=\"font-style: italic\" href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total\">total</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"font-style: italic\"/><span style=\"opacity: 0.5; font-style: italic\">1</span><span style=\"opacity: 0.5; font-style: italic\">..</span><span style=\"opacity: 0.5; font-style: italic\">*</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"font-style: italic\" href=\"http://hl7.org/fhir/R4/profiling.html#slicing\">(Slice Definition)</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5; font-style: italic\">Adjudication totals</span><br style=\"font-style: italic\"/><span style=\"font-weight:bold; font-style: italic\">Slice: </span><span style=\"font-style: italic\">Unordered, Open by pattern:category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck133.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> total:All Slices<a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Content/Rules for all slices</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1330.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBTotalCategoryDiscriminator.html\">C4BB Total Category Discriminator</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#extensible\" title=\"To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.\">extensible</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1320.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total.amount\">amount</a><a name=\"ExplanationOfBenefit.total.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Financial total for the category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck135.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype\" title=\"Slice adjudicationamounttype\">total:adjudicationamounttype</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication totals</span><br/></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1350.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBAdjudication.html\">C4BB Adjudication</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1340.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:adjudicationamounttype.amount\">amount</a><a name=\"ExplanationOfBenefit.total.amount\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#Money\">Money</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Financial total for the category</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slicer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_slice_item.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Slice Item\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:inoutnetwork\" title=\"Slice inoutnetwork\">total:inoutnetwork</a><a name=\"ExplanationOfBenefit.total\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#BackboneElement\">BackboneElement</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Adjudication totals</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end_slice.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.total:inoutnetwork.category\">category</a><a name=\"ExplanationOfBenefit.total.category\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">1</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#CodeableConcept\">CodeableConcept</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Type of adjudication information</span><br/><span style=\"font-weight:bold\">Binding: </span><a href=\"ValueSet-C4BBPayerBenefitPaymentStatus.html\">C4BB Payer Benefit Payment Status</a> (<a href=\"http://hl7.org/fhir/R4/terminologies.html#required\" title=\"To be conformant, the concept in this element SHALL be from the specified value set.\">required</a>)</td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.payment\">payment</a><a name=\"ExplanationOfBenefit.payment\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.payment.date\">date</a><a name=\"ExplanationOfBenefit.payment.date\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#date\">date</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Expected date of payment</span></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.processNote\">processNote</a><a name=\"ExplanationOfBenefit.processNote\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-definitions.html#ExplanationOfBenefit.processNote.text\">text</a><a name=\"ExplanationOfBenefit.processNote.text\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">0</span><span style=\"opacity: 0.5\">..</span><span style=\"opacity: 0.5\">1</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a style=\"opacity: 0.5\" href=\"http://hl7.org/fhir/R4/datatypes.html#string\">string</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"opacity: 0.5\">Note explanatory text</span></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
+    },
+    "extension": [
+        {
+            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-category",
+            "valueString": "Financial.General"
+        },
+        {
+            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category",
+            "valueCode": "patient"
+        }
+    ],
+    "url": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional",
+    "version": "1.0.0",
+    "name": "C4BBExplanationOfBenefitOutpatientInstitutional",
+    "title": "C4BB ExplanationOfBenefit Outpatient Institutional",
+    "status": "active",
+    "date": "2020-11-23T16:49:10+00:00",
+    "publisher": "HL7 Financial Management Working Group",
+    "contact": [
+        {
+            "name": "HL7 Financial Management Working Group",
+            "telecom": [
+                {
+                    "system": "url",
+                    "value": "http://www.hl7.org/Special/committees/fm/index.cfm"
+                },
+                {
+                    "system": "email",
+                    "value": "fm@lists.HL7.org"
+                }
+            ]
+        }
+    ],
+    "description": "This profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for outpatient services, which may include including the use of equipment and supplies, laboratory services, radiology services and other charges. Outpatient claims are submitted for services rendered at an institution that are not part of an overnight stay. \nThe claims data is based on the institutional claim form UB-04, submission standards adopted by the Department of Health and Human Services.",
+    "jurisdiction": [
+        {
+            "coding": [
+                {
+                    "system": "urn:iso:std:iso:3166",
+                    "code": "US"
+                }
+            ]
+        }
+    ],
+    "fhirVersion": "4.0.1",
+    "mapping": [
+        {
+            "identity": "workflow",
+            "uri": "http://hl7.org/fhir/workflow",
+            "name": "Workflow Pattern"
+        },
+        {
+            "identity": "w5",
+            "uri": "http://hl7.org/fhir/fivews",
+            "name": "FiveWs Pattern Mapping"
+        },
+        {
+            "identity": "v2",
+            "uri": "http://hl7.org/v2",
+            "name": "HL7 v2 Mapping"
+        },
+        {
+            "identity": "rim",
+            "uri": "http://hl7.org/v3",
+            "name": "RIM Mapping"
+        }
+    ],
+    "kind": "resource",
+    "abstract": false,
+    "type": "ExplanationOfBenefit",
+    "baseDefinition": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit",
+    "derivation": "constraint",
+    "snapshot": {
+        "element": [
+            {
+                "id": "ExplanationOfBenefit",
+                "path": "ExplanationOfBenefit",
+                "short": "Explanation of Benefit resource",
+                "definition": "This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.",
+                "alias": [
+                    "EOB"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit",
+                    "min": 0,
+                    "max": "*"
+                },
+                "constraint": [
+                    {
+                        "key": "dom-2",
+                        "severity": "error",
+                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
+                        "expression": "contained.contained.empty()",
+                        "xpath": "not(parent::f:contained and f:contained)",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-3",
+                        "severity": "error",
+                        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
+                        "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
+                        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-4",
+                        "severity": "error",
+                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
+                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
+                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-5",
+                        "severity": "error",
+                        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
+                        "expression": "contained.meta.security.empty()",
+                        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                                "valueBoolean": true
+                            },
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
+                                "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
+                            }
+                        ],
+                        "key": "dom-6",
+                        "severity": "warning",
+                        "human": "A resource should have narrative for robust management",
+                        "expression": "text.`div`.exists()",
+                        "xpath": "exists(f:text/h:div)",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "EOB-institutional-item-or-header-adjudication",
+                        "severity": "error",
+                        "human": "Institutional EOB:  Should have adjudication at the item or header level, but not both",
+                        "expression": "(adjudication.exists() != item.adjudication.exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    },
+                    {
+                        "key": "adjudication-has-amount-type-slice",
+                        "severity": "error",
+                        "human": "If Adjudication is present, it must have at least one adjudicationamounttype slice",
+                        "expression": "adjudication.exists() implies (adjudication.where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "Entity. Role, or Act"
+                    },
+                    {
+                        "identity": "workflow",
+                        "map": "Event"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.id",
+                "path": "ExplanationOfBenefit.id",
+                "short": "Logical id of this artifact",
+                "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
+                "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Resource.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta",
+                "path": "ExplanationOfBenefit.meta",
+                "short": "Metadata about the resource",
+                "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "Resource.meta",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Meta"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.id",
+                "path": "ExplanationOfBenefit.meta.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.extension",
+                "path": "ExplanationOfBenefit.meta.extension",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "value",
+                            "path": "url"
+                        }
+                    ],
+                    "description": "Extensions are always sliced by (at least) url",
+                    "rules": "open"
+                },
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.versionId",
+                "path": "ExplanationOfBenefit.meta.versionId",
+                "short": "Version specific identifier",
+                "definition": "The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.",
+                "comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Meta.versionId",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "id"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.lastUpdated",
+                "path": "ExplanationOfBenefit.meta.lastUpdated",
+                "short": "When the resource version last changed",
+                "definition": "When the resource last changed - e.g. when the version changed.",
+                "comment": "Defines the date the Resource was created or updated, whichever comes last (163). Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "Meta.lastUpdated",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "instant"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.source",
+                "path": "ExplanationOfBenefit.meta.source",
+                "short": "Identifies where the resource comes from",
+                "definition": "A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.",
+                "comment": "In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. \n\nThis element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Meta.source",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "uri"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.profile",
+                "path": "ExplanationOfBenefit.meta.profile",
+                "short": "Profiles this resource claims to conform to",
+                "definition": "A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).",
+                "comment": "CPCDS data element (190)",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "Meta.profile",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "canonical",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/StructureDefinition"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.security",
+                "path": "ExplanationOfBenefit.meta.security",
+                "short": "Security Labels applied to this resource",
+                "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
+                "comment": "The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Meta.security",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "SecurityLabels"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "extensible",
+                    "description": "Security Labels from the Healthcare Privacy and Security Classification System.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/security-labels"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.meta.tag",
+                "path": "ExplanationOfBenefit.meta.tag",
+                "short": "Tags applied to this resource",
+                "definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
+                "comment": "The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Meta.tag",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Tags"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\".",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/common-tags"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.implicitRules",
+                "path": "ExplanationOfBenefit.implicitRules",
+                "short": "A set of rules under which this content was created",
+                "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
+                "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Resource.implicitRules",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "uri"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.language",
+                "path": "ExplanationOfBenefit.language",
+                "short": "Language of the resource content",
+                "definition": "The base language in which the resource is written.",
+                "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Resource.language",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+                            "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Language"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "preferred",
+                    "description": "A human language.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.text",
+                "path": "ExplanationOfBenefit.text",
+                "short": "Text summary of the resource, for human interpretation",
+                "definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
+                "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
+                "alias": [
+                    "narrative",
+                    "html",
+                    "xhtml",
+                    "display"
+                ],
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "DomainResource.text",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Narrative"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "Act.text?"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.contained",
+                "path": "ExplanationOfBenefit.contained",
+                "short": "Contained, inline Resources",
+                "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
+                "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
+                "alias": [
+                    "inline resources",
+                    "anonymous resources",
+                    "contained resources"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "DomainResource.contained",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Resource"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.extension",
+                "path": "ExplanationOfBenefit.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "DomainResource.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.modifierExtension",
+                "path": "ExplanationOfBenefit.modifierExtension",
+                "short": "Extensions that cannot be ignored",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "DomainResource.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier",
+                "path": "ExplanationOfBenefit.identifier",
+                "short": "Business Identifier for the resource",
+                "definition": "A unique identifier assigned to this explanation of benefit.",
+                "comment": "Identifier assigned by a payer for a claim received from a provider or subscriber. It is not the same identifier as that assigned by a provider. (35)",
+                "requirements": "Allows EOBs to be distinguished and referenced.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.identifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Identifier"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.identifier"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.identifier"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.id",
+                "path": "ExplanationOfBenefit.identifier.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.extension",
+                "path": "ExplanationOfBenefit.identifier.extension",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "value",
+                            "path": "url"
+                        }
+                    ],
+                    "description": "Extensions are always sliced by (at least) url",
+                    "rules": "open"
+                },
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.use",
+                "path": "ExplanationOfBenefit.identifier.use",
+                "short": "usual | official | temp | secondary | old (If known)",
+                "definition": "The purpose of this identifier.",
+                "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
+                "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.use",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "IdentifierUse"
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "Identifies the purpose for this identifier, if known .",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
+                },
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "N/A"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "Role.code or implied by context"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.type",
+                "path": "ExplanationOfBenefit.identifier.type",
+                "short": "Description of identifier",
+                "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
+                "comment": "Indicates that the claim identifier is that assigned by a payer for a claim received from a provider or subscriber. (183)",
+                "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimIdentifierType"
+                },
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.5"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "Role.code or implied by context"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.system",
+                "path": "ExplanationOfBenefit.identifier.system",
+                "short": "The namespace for the identifier value",
+                "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
+                "comment": "Identifier.system is always case sensitive.",
+                "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.system",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "uri"
+                    }
+                ],
+                "example": [
+                    {
+                        "label": "General",
+                        "valueUri": "http://www.acme.com/identifiers/patient"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.4 / EI-2-4"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "II.root or Role.id.root"
+                    },
+                    {
+                        "identity": "servd",
+                        "map": "./IdentifierType"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.value",
+                "path": "ExplanationOfBenefit.identifier.value",
+                "short": "The value that is unique",
+                "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
+                "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "example": [
+                    {
+                        "label": "General",
+                        "valueString": "123456"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.1 / EI.1"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
+                    },
+                    {
+                        "identity": "servd",
+                        "map": "./Value"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.period",
+                "path": "ExplanationOfBenefit.identifier.period",
+                "short": "Time period when id is/was valid for use",
+                "definition": "Time period during which identifier is/was valid for use.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.period",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.7 + CX.8"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "Role.effectiveTime or implied by context"
+                    },
+                    {
+                        "identity": "servd",
+                        "map": "./StartDate and ./EndDate"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.identifier.assigner",
+                "path": "ExplanationOfBenefit.identifier.assigner",
+                "short": "Organization that issued id (may be just text)",
+                "definition": "Organization that issued/manages the identifier.",
+                "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Identifier.assigner",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Organization"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "CX.4 / (CX.4,CX.9,CX.10)"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
+                    },
+                    {
+                        "identity": "servd",
+                        "map": "./IdentifierIssuingAuthority"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.status",
+                "path": "ExplanationOfBenefit.status",
+                "short": "active | cancelled | draft | entered-in-error",
+                "definition": "The status of the resource instance.",
+                "comment": "Claim processing status code (140).  Expected values are active or cancelled.  To comply with the CMS rule, draft EOBs are not required",
+                "requirements": "Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.status",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": true,
+                "isModifierReason": "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ExplanationOfBenefitStatus"
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "A code specifying the state of the resource instance.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/explanationofbenefit-status|4.0.1"
+                },
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.status"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.status"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.type",
+                "path": "ExplanationOfBenefit.type",
+                "short": "Category or discipline",
+                "definition": "The category of claim, e.g. oral, pharmacy, vision, institutional, professional.",
+                "comment": "Specifies the type of claim. (e.g., inpatient insitutional, outpatient institutional, physician, etc.) (16).  Defines the Claims profiles.  Values from Claim Type Codes are required; a data absent reason is not allowed",
+                "requirements": "Claim type determine the general sets of business rules applied for information requirements and adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.type",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://terminology.hl7.org/CodeSystem/claim-type",
+                            "code": "institutional"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-type"
+                },
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.code"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.class"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.subType",
+                "path": "ExplanationOfBenefit.subType",
+                "short": "More granular claim type",
+                "definition": "A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Some jurisdictions need a finer grained claim type for routing and adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.subType",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ClaimSubType"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "A more granular claim typecode.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-subtype"
+                },
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.class"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.use",
+                "path": "ExplanationOfBenefit.use",
+                "short": "claim | preauthorization | predetermination",
+                "definition": "A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.",
+                "comment": "Expected value is claim. The CMS rule applies to adjudicated claims; it does not require preauthorizations or predeterminations",
+                "requirements": "This element is required to understand the nature of the request for adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.use",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "patternCode": "claim",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Use"
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "Complete, proposed, exploratory, other.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-use|4.0.1"
+                },
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.class"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.patient",
+                "path": "ExplanationOfBenefit.patient",
+                "short": "The recipient of the products and services",
+                "definition": "The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought.",
+                "comment": "Identifier for a member assigned by the Payer.  If members receive ID cards, that is the identifier that should be provided. (1). The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction. Additional required path:EOB.insurance.coverage(Coverage).beneficiary(Patient).identifier",
+                "requirements": "The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.patient",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.subject"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.subject[x]"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.subject"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod",
+                "path": "ExplanationOfBenefit.billablePeriod",
+                "short": "Relevant time frame for the claim",
+                "definition": "The period for which charges are being submitted.",
+                "comment": "Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and prodeterminations. Typically line item dates of service should fall within the billing period if one is specified.",
+                "requirements": "A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.billablePeriod",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.done[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.id",
+                "path": "ExplanationOfBenefit.billablePeriod.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.extension",
+                "path": "ExplanationOfBenefit.billablePeriod.extension",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "value",
+                            "path": "url"
+                        }
+                    ],
+                    "description": "Extensions are always sliced by (at least) url",
+                    "rules": "open"
+                },
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.start",
+                "path": "ExplanationOfBenefit.billablePeriod.start",
+                "short": "Starting time with inclusive boundary",
+                "definition": "The start of the period. The boundary is inclusive.",
+                "comment": "The first day on the billing statement covering services rendered to the beneficiary (i.e. 'Statement Covers From Date’). (177)",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Period.start",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "dateTime"
+                    }
+                ],
+                "condition": [
+                    "per-1"
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "DR.1"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "./low"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.billablePeriod.end",
+                "path": "ExplanationOfBenefit.billablePeriod.end",
+                "short": "End time with inclusive boundary, if not ongoing",
+                "definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
+                "comment": "The last day on the billing statement covering services rendered to the beneficiary (i.e. 'Statement Covers Thru Date’). (178)",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Period.end",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "dateTime"
+                    }
+                ],
+                "meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
+                "condition": [
+                    "per-1"
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "DR.2"
+                    },
+                    {
+                        "identity": "rim",
+                        "map": "./high"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.created",
+                "path": "ExplanationOfBenefit.created",
+                "short": "Response creation date",
+                "definition": "The date this resource was created.",
+                "comment": "Date the claim was adjudicated (179)",
+                "requirements": "Need to record a timestamp for use by both the recipient and the issuer.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.created",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "dateTime"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.occurrence[x]"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.recorded"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.enterer",
+                "path": "ExplanationOfBenefit.enterer",
+                "short": "Author of the claim",
+                "definition": "Individual who created the claim, predetermination or preauthorization.",
+                "requirements": "Some jurisdictions require the contact information for personnel completing claims.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.enterer",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
+                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.performer.agent"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.author"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurer",
+                "path": "ExplanationOfBenefit.insurer",
+                "short": "Party responsible for reimbursement",
+                "definition": "The party responsible for authorization, adjudication and reimbursement.",
+                "comment": "Code of the payer responsible for the claim (2, 5).  Same as insurance.coverage.organization.  Party responsible for reimbursing the provider",
+                "requirements": "To be a valid claim, preauthorization or predetermination there must be a party who is responsible for adjudicating the contents against a policy which provides benefits for the patient.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurer",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.performer.agent"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.author"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.provider",
+                "path": "ExplanationOfBenefit.provider",
+                "short": "Party responsible for the claim",
+                "definition": "The provider which is responsible for the claim, predetermination or preauthorization.",
+                "comment": "The identifier assigned to the Billing Provider. (94)",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.provider",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.source"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.priority",
+                "path": "ExplanationOfBenefit.priority",
+                "short": "Desired processing urgency",
+                "definition": "The provider-required urgency of processing the request. Typical values include: stat, routine deferred.",
+                "comment": "If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request.",
+                "requirements": "The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.priority",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/process-priority"
+                },
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "Request.priority"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.fundsReserveRequested",
+                "path": "ExplanationOfBenefit.fundsReserveRequested",
+                "short": "For whom to reserve funds",
+                "definition": "A code to indicate whether and for whom funds are to be reserved for future claims.",
+                "comment": "This field is only used for preauthorizations.",
+                "requirements": "In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested.",
+                "alias": [
+                    "Fund pre-allocation"
+                ],
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.fundsReserveRequested",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "FundsReserve"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "For whom funds are to be reserved: (Patient, Provider, None).",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/fundsreserve"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.fundsReserve",
+                "path": "ExplanationOfBenefit.fundsReserve",
+                "short": "Funds reserved status",
+                "definition": "A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.",
+                "comment": "Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none.",
+                "requirements": "Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.fundsReserve",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "FundsReserve"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "For whom funds are to be reserved: (Patient, Provider, None).",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/fundsreserve"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.related",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "RelatedClaim"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.related",
+                "short": "Prior or corollary claims",
+                "definition": "Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.",
+                "comment": "If the current claim represents a claim that has been adjusted and was given a prior claim number, this field represents the prior claim number. If the current claim has been adjusted; i.e., replaced by or merged to another claim number, this data element represents that new number.(111, 112)",
+                "requirements": "For workplace or other accidents it is common to relate separate claims arising from the same event.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.related",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.related.id",
+                "path": "ExplanationOfBenefit.related.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.related.extension",
+                "path": "ExplanationOfBenefit.related.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.related.modifierExtension",
+                "path": "ExplanationOfBenefit.related.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.related.claim",
+                "path": "ExplanationOfBenefit.related.claim",
+                "short": "Reference to the related claim",
+                "definition": "Reference to a related claim.",
+                "requirements": "For workplace or other accidents it is common to relate separate claims arising from the same event.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.related.claim",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Claim"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.related.relationship",
+                "path": "ExplanationOfBenefit.related.relationship",
+                "short": "How the reference claim is related",
+                "definition": "A code to convey how the claims are related.",
+                "comment": "For example, prior claim or umbrella.",
+                "requirements": "Some insurers need a declaration of the type of relationship.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.related.relationship",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBRelatedClaimRelationshipCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.related.reference",
+                "path": "ExplanationOfBenefit.related.reference",
+                "short": "File or case reference",
+                "definition": "An alternate organizational reference to the case or file to which this particular claim pertains.",
+                "comment": "For example, Property/Casualty insurer claim number or Workers Compensation case number.",
+                "requirements": "In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.related.reference",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Identifier"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.prescription",
+                "path": "ExplanationOfBenefit.prescription",
+                "short": "Prescription authorizing services or products",
+                "definition": "Prescription to support the dispensing of pharmacy, device or vision products.",
+                "requirements": "Required to authorize the dispensing of controlled substances and devices.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.prescription",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
+                            "http://hl7.org/fhir/StructureDefinition/VisionPrescription"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.originalPrescription",
+                "path": "ExplanationOfBenefit.originalPrescription",
+                "short": "Original prescription if superceded by fulfiller",
+                "definition": "Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.",
+                "comment": "For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.",
+                "requirements": "Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.originalPrescription",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payee",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Payee"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.payee",
+                "short": "Recipient of benefits payable",
+                "definition": "The party to be reimbursed for cost of the products and services according to the terms of the policy.",
+                "comment": "Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and may choose to pay the subscriber instead.",
+                "requirements": "The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payee",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.id",
+                "path": "ExplanationOfBenefit.payee.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.extension",
+                "path": "ExplanationOfBenefit.payee.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.modifierExtension",
+                "path": "ExplanationOfBenefit.payee.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.type",
+                "path": "ExplanationOfBenefit.payee.type",
+                "short": "Category of recipient",
+                "definition": "Type of Party to be reimbursed: Subscriber, provider, other.",
+                "comment": "Identifies the type of recipient of the adjudication amount; i.e., provider, subscriber, beneficiary or another recipient. (120)",
+                "requirements": "Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payee.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayeeType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.payee.party",
+                "path": "ExplanationOfBenefit.payee.party",
+                "short": "Recipient reference",
+                "definition": "Reference to the individual or organization to whom any payment will be made.",
+                "comment": "Recipient reference (121)",
+                "requirements": "Need to provide demographics if the payee is not 'subscriber' nor 'provider'.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payee.party",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization",
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Patient",
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.referral",
+                "path": "ExplanationOfBenefit.referral",
+                "short": "Treatment Referral",
+                "definition": "A reference to a referral resource.",
+                "comment": "The referral resource which lists the date, practitioner, reason and other supporting information.",
+                "requirements": "Some insurers require proof of referral to pay for services or to pay specialist rates for services.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.referral",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.cause"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.facility",
+                "path": "ExplanationOfBenefit.facility",
+                "short": "Servicing Facility",
+                "definition": "Facility where the services were provided.",
+                "requirements": "Insurance adjudication can be dependant on where services were delivered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.facility",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Location"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "workflow",
+                        "map": "Event.performer.location"
+                    },
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.where[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.claim",
+                "path": "ExplanationOfBenefit.claim",
+                "short": "Claim reference",
+                "definition": "The business identifier for the instance of the adjudication request: claim predetermination or preauthorization.",
+                "requirements": "To provide a link to the original adjudication request.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.claim",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Claim"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.why[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.claimResponse",
+                "path": "ExplanationOfBenefit.claimResponse",
+                "short": "Claim response reference",
+                "definition": "The business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response.",
+                "requirements": "To provide a link to the original adjudication response.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.claimResponse",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/ClaimResponse"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.outcome",
+                "path": "ExplanationOfBenefit.outcome",
+                "short": "queued | complete | error | partial",
+                "definition": "The outcome of the claim, predetermination, or preauthorization processing.",
+                "comment": "Expected value is complete",
+                "requirements": "To advise the requestor of an overall processing outcome.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.outcome",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "RemittanceOutcome"
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "The result of the claim processing.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.disposition",
+                "path": "ExplanationOfBenefit.disposition",
+                "short": "Disposition Message",
+                "definition": "A human readable description of the status of the adjudication.",
+                "requirements": "Provided for user display.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.disposition",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.preAuthRef",
+                "path": "ExplanationOfBenefit.preAuthRef",
+                "short": "Preauthorization reference",
+                "definition": "Reference from the Insurer which is used in later communications which refers to this adjudication.",
+                "comment": "This value is only present on preauthorization adjudications.",
+                "requirements": "On subsequent claims, the insurer may require the provider to quote this value.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.preAuthRef",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.preAuthRefPeriod",
+                "path": "ExplanationOfBenefit.preAuthRefPeriod",
+                "short": "Preauthorization in-effect period",
+                "definition": "The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.",
+                "comment": "This value is only present on preauthorization adjudications.",
+                "requirements": "On subsequent claims, the insurer may require the provider to quote this value.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.preAuthRefPeriod",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "CareTeam"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.careTeam",
+                "short": "Care Team members",
+                "definition": "The members of the team who provided the products and services.",
+                "requirements": "Common to identify the responsible and supporting practitioners.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "EOB-inst-careTeam-practitioner",
+                        "severity": "error",
+                        "human": "Institutional EOB: Careteam roles refer to a practitioner",
+                        "expression": "(\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists() implies\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists().provider.all(resolve() is Practitioner)\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    },
+                    {
+                        "key": "EOB-inst-careTeam-organization",
+                        "severity": "error",
+                        "human": "Institutional EOB:  Careteam roles refer to an organization",
+                        "expression": "(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().provider.all(resolve() is Organization)\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    },
+                    {
+                        "key": "EOB-careteam-qualification",
+                        "severity": "error",
+                        "human": "Care Team Performing physician's qualifications are from US-Core-Provider-Specialty Value Set",
+                        "expression": "(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().qualification.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty')\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.id",
+                "path": "ExplanationOfBenefit.careTeam.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.extension",
+                "path": "ExplanationOfBenefit.careTeam.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.modifierExtension",
+                "path": "ExplanationOfBenefit.careTeam.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.sequence",
+                "path": "ExplanationOfBenefit.careTeam.sequence",
+                "short": "Order of care team",
+                "definition": "A number to uniquely identify care team entries.",
+                "comment": "careTeam.sequence values uniquely identify careTeam members.  They do not necessarily indiate any order in which the patient was seen by the careTeam or identify any level of significance of the careTeam to the patient, etc.  Client app implementations should not assign any significance to the sequence values",
+                "requirements": "Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.provider",
+                "path": "ExplanationOfBenefit.careTeam.provider",
+                "short": "Practitioner or organization",
+                "definition": "Member of the team who provided the product or service.",
+                "comment": "The identifier assigned to the care team. (varies depending on the profile)",
+                "requirements": "Often a regulatory requirement to specify the responsible provider.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.provider",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization",
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.actor"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.responsible",
+                "path": "ExplanationOfBenefit.careTeam.responsible",
+                "short": "Indicator of the lead practitioner",
+                "definition": "The party who is billing and/or responsible for the claimed products or services.",
+                "comment": "Responsible might not be required when there is only a single provider listed.",
+                "requirements": "When multiple parties are present it is required to distinguish the lead or responsible individual.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.responsible",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.role",
+                "path": "ExplanationOfBenefit.careTeam.role",
+                "short": "Function within the team",
+                "definition": "The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.",
+                "comment": "The functional role of a provider on a claim. (165)",
+                "requirements": "When multiple parties are present it is required to distinguish the roles performed by each member.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.role",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInstitutionalCareTeamRole"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.qualification",
+                "path": "ExplanationOfBenefit.careTeam.qualification",
+                "short": "Practitioner credential or specialization",
+                "definition": "The qualification of the practitioner which is applicable for this service.",
+                "requirements": "Need to specify which qualification a provider is delivering the product or service under.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.careTeam.qualification",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on $this pattern",
+                    "ordered": false,
+                    "rules": "open"
+                },
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Defines data elements not available in the base EOB resource",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "InformationCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The valuset used for additional information codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-exception"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "billingnetworkcontractingstatus",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Indicates that the Billing Provider has a contract with the Plan (regardless of the network) as of the effective date of service or admission. (101)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "billingnetworkcontractingstatus"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderContractingStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "clmrecvddate",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "The date the claim was received by the payer (88)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "clmrecvddate"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "InformationCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The valuset used for additional information codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-exception"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "typeofbill",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of institution, the second digit classifies the type of care being billed, and the third digit  identifies the frequency of the bill for a specific course of treatment or inpatient confinement. (17)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "typeofbill"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCTypeOfBill"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "pointoforigin",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Identifies the place where the patient was identified as needing admission to an institution. This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15). (13)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "pointoforigin"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPointOfOriginForAdmissionOrVisit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "admtype",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled. (14)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "admtype"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPriorityTypeOfAdmissionOrVisit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SupportingInformation"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "discharge-status",
+                "short": "Supporting information",
+                "definition": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
+                "comment": "Patient’s status as of the discharge date for a facility stay. Information located on UB04. (Form Locator 17). (117)",
+                "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.id",
+                "path": "ExplanationOfBenefit.supportingInfo.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.extension",
+                "path": "ExplanationOfBenefit.supportingInfo.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.modifierExtension",
+                "path": "ExplanationOfBenefit.supportingInfo.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.sequence",
+                "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                "short": "Information instance identifier",
+                "definition": "A number to uniquely identify supporting information entries.",
+                "comment": "Client app implementations should look-up supportingInfo elements based on category values instead of sequence values",
+                "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "short": "Classification of the supplied information",
+                "definition": "The general class of the information supplied: information; exception; accident, employment; onset, etc.",
+                "comment": "This may contain a category for the local bill type codes.",
+                "requirements": "Required to group or associate information items with common characteristics. For example: admission information or prior treatments.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "discharge-status"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "short": "Type of information",
+                "definition": "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient  for which care is sought.",
+                "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
+                "requirements": "Required to identify the kind of additional information.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.code",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPatientDischargeStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "short": "When it occurred",
+                "definition": "The date when or period to which this information refers.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.value[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                "short": "Data to be provided",
+                "definition": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
+                "comment": "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident.",
+                "requirements": "To convey the data content to be provided when the information is more than a simple code or period.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.value[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Quantity"
+                    },
+                    {
+                        "code": "Attachment"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Resource"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.reason",
+                "path": "ExplanationOfBenefit.supportingInfo.reason",
+                "short": "Explanation for the information",
+                "definition": "Provides the reason in the situation where a reason code is required in addition to the content.",
+                "comment": "For example: the reason for the additional stay, or why a tooth is  missing.",
+                "requirements": "Needed when the supporting information has both a date and amount/value and requires explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.supportingInfo.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Coding"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "MissingReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Reason codes for the missing teeth.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/missing-tooth-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Diagnosis"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.diagnosis",
+                "short": "Pertinent diagnosis information",
+                "definition": "Information about diagnoses relevant to the claim items.",
+                "comment": "Diagnosis codes describe an individual's disease or medical condition. (6, 7, 8, 21, 22, 23, 30)",
+                "requirements": "Required for the adjudication by provided context for the services and product listed.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.id",
+                "path": "ExplanationOfBenefit.diagnosis.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.extension",
+                "path": "ExplanationOfBenefit.diagnosis.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.modifierExtension",
+                "path": "ExplanationOfBenefit.diagnosis.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.sequence",
+                "path": "ExplanationOfBenefit.diagnosis.sequence",
+                "short": "Diagnosis instance identifier",
+                "definition": "A number to uniquely identify diagnosis entries.",
+                "comment": "Diagnosis.sequence values do not necessarily indiate any order in which the diagnosis was reported or identified.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of diagnosis.type to identify primary, secondary, etc.",
+                "requirements": "Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                "path": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                "short": "Nature of illness or problem",
+                "definition": "The nature of illness or problem in a coded form or as a reference to an external defined Condition.",
+                "requirements": "Provides health context for the evaluation of the products and/or services.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/CDCICD910CMDiagnosisCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.type",
+                "path": "ExplanationOfBenefit.diagnosis.type",
+                "short": "Timing or nature of the diagnosis",
+                "definition": "When the condition was observed or the relative ranking.",
+                "comment": "Indicates if the outpatient institutional diagnosis is principal, other, an external cause of injury or a patient reason for visit. (21, 22, 23)",
+                "requirements": "Often required to capture a particular diagnosis, for example: primary or discharge.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.type",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimOutpatientInstitutionalDiagnosisType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.onAdmission",
+                "path": "ExplanationOfBenefit.diagnosis.onAdmission",
+                "short": "Present on admission",
+                "definition": "Indication of whether the diagnosis was present on admission to a facility.",
+                "requirements": "Many systems need to understand for adjudication if the diagnosis was present a time of admission.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.onAdmission",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "DiagnosisOnAdmission"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Present on admission.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.packageCode",
+                "path": "ExplanationOfBenefit.diagnosis.packageCode",
+                "short": "Package billing code",
+                "definition": "A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.",
+                "comment": "For example, DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardio-infarction and a DRG for HeartAttack would assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.",
+                "requirements": "Required to relate the current  diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.diagnosis.packageCode",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "DiagnosisRelatedGroup"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The DRG codes associated with the diagnosis.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Procedure"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.procedure",
+                "short": "Clinical procedures performed",
+                "definition": "Procedures performed on the patient relevant to the billing items with the claim.",
+                "requirements": "The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.id",
+                "path": "ExplanationOfBenefit.procedure.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.extension",
+                "path": "ExplanationOfBenefit.procedure.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.modifierExtension",
+                "path": "ExplanationOfBenefit.procedure.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.sequence",
+                "path": "ExplanationOfBenefit.procedure.sequence",
+                "short": "Procedure instance identifier",
+                "definition": "A number to uniquely identify procedure entries.",
+                "requirements": "Necessary to provide a mechanism to link to claim details.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.type",
+                "path": "ExplanationOfBenefit.procedure.type",
+                "short": "Category of Procedure",
+                "definition": "When the condition was observed or the relative ranking.",
+                "requirements": "Often required to capture a particular diagnosis, for example: primary or discharge.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.type",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProcedureType"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Example procedure type codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-procedure-type"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.date",
+                "path": "ExplanationOfBenefit.procedure.date",
+                "short": "When the procedure was performed",
+                "definition": "Date and optionally time the procedure was performed.",
+                "requirements": "Required for auditing purposes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.date",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "dateTime"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.procedure[x]",
+                "path": "ExplanationOfBenefit.procedure.procedure[x]",
+                "short": "Specific clinical procedure",
+                "definition": "The code or reference to a Procedure resource which identifies the clinical intervention performed.",
+                "requirements": "This identifies the actual clinical procedure.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.procedure[x]",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Procedure"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ICD10_Procedures"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "ICD10 Procedure codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/icd-10-procedures"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.procedure.udi",
+                "path": "ExplanationOfBenefit.procedure.udi",
+                "short": "Unique device identifier",
+                "definition": "Unique Device Identifiers associated with this line item.",
+                "requirements": "The UDI code allows the insurer to obtain device level information on the product supplied.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.procedure.udi",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Device"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.precedence",
+                "path": "ExplanationOfBenefit.precedence",
+                "short": "Precedence (primary, secondary, etc.)",
+                "definition": "This indicates the relative order of a series of EOBs related to different coverages for the same suite of services.",
+                "requirements": "Needed to coordinate between multiple EOBs for the same suite of services.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.precedence",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Insurance"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.insurance",
+                "short": "Patient insurance information",
+                "definition": "Financial instruments for reimbursement for the health care products and services specified on the claim.",
+                "comment": "Identity of the payers responsible for the claim. (2, 141).  All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. An invariant is defined to enforce the following rule:  Will have multiple occurrences on secondary / tertiary, etc. claims.  Up to one occurrence, that of the ExplanationOfBenefit.insurer, will have a boolean value = 'True'",
+                "requirements": "At least one insurer is required for a claim to be a claim.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurance",
+                    "min": 1,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "EOB-insurance-focal",
+                        "severity": "error",
+                        "human": "EOB.insurance:  at most one with focal = true",
+                        "expression": "insurance.select (focal = true).count() < 2",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "v2",
+                        "map": "Coverage"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.id",
+                "path": "ExplanationOfBenefit.insurance.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.extension",
+                "path": "ExplanationOfBenefit.insurance.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.modifierExtension",
+                "path": "ExplanationOfBenefit.insurance.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.focal",
+                "path": "ExplanationOfBenefit.insurance.focal",
+                "short": "Coverage to be used for adjudication",
+                "definition": "A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.",
+                "comment": "A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example, a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies. An invariant is defined to enforce the following rule:  Will have multiple occurrences on secondary / tertiary, etc. claims.  Up to one occurrence, that of the ExplanationOfBenefit.insurer, will have a boolean value = 'True'",
+                "requirements": "To identify which coverage in the list is being used to adjudicate this claim.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurance.focal",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.coverage",
+                "path": "ExplanationOfBenefit.insurance.coverage",
+                "short": "Insurance information",
+                "definition": "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.",
+                "comment": "Same as insurance.coverage.organization.  Party responsible for reimbursing the provider. When focal = true, Coverage.payer--> Organization.identifier.  When focal = false, EOB.insurance.coverage.display = [name of other carrier]",
+                "requirements": "Required to allow the adjudicator to locate the correct policy and history within their information system.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurance.coverage",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.insurance.preAuthRef",
+                "path": "ExplanationOfBenefit.insurance.preAuthRef",
+                "short": "Prior authorization reference number",
+                "definition": "Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.",
+                "comment": "This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.",
+                "requirements": "Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.insurance.preAuthRef",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.accident",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Accident"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.accident",
+                "short": "Details of the event",
+                "definition": "Details of a accident which resulted in injuries which required the products and services listed in the claim.",
+                "requirements": "When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.accident",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.id",
+                "path": "ExplanationOfBenefit.accident.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.extension",
+                "path": "ExplanationOfBenefit.accident.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.modifierExtension",
+                "path": "ExplanationOfBenefit.accident.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.date",
+                "path": "ExplanationOfBenefit.accident.date",
+                "short": "When the incident occurred",
+                "definition": "Date of an accident event  related to the products and services contained in the claim.",
+                "comment": "The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.",
+                "requirements": "Required for audit purposes and adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.accident.date",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.type",
+                "path": "ExplanationOfBenefit.accident.type",
+                "short": "The nature of the accident",
+                "definition": "The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.",
+                "requirements": "Coverage may be dependant on the type of accident.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.accident.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AccidentType"
+                        }
+                    ],
+                    "strength": "extensible",
+                    "description": "Type of accident: work place, auto, etc.",
+                    "valueSet": "http://terminology.hl7.org/ValueSet/v3-ActIncidentCode"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.accident.location[x]",
+                "path": "ExplanationOfBenefit.accident.location[x]",
+                "short": "Where the event occurred",
+                "definition": "The physical location of the accident event.",
+                "requirements": "Required for audit purposes and determination of applicable insurance liability.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.accident.location[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Address"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Location"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Item"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item",
+                "short": "Product or service provided",
+                "definition": "A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.",
+                "comment": "Put the comment here for item",
+                "requirements": "The items to be processed for adjudication.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "adjudication-has-amount-type-slice",
+                        "severity": "error",
+                        "human": "If Adjudication is present, it must have at least one adjudicationamounttype slice",
+                        "expression": "adjudication.exists() implies (adjudication.where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.id",
+                "path": "ExplanationOfBenefit.item.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.extension",
+                "path": "ExplanationOfBenefit.item.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.modifierExtension",
+                "path": "ExplanationOfBenefit.item.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.sequence",
+                "path": "ExplanationOfBenefit.item.sequence",
+                "short": "Item instance identifier",
+                "definition": "A number to uniquely identify item entries.",
+                "comment": "Line identification number that represents the number assigned in a source system for identification and processing. (36)",
+                "requirements": "Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.careTeamSequence",
+                "path": "ExplanationOfBenefit.item.careTeamSequence",
+                "short": "Applicable care team members",
+                "definition": "Care team members related to this service or product.",
+                "requirements": "Need to identify the individuals and their roles in the provision of the product or service.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.careTeamSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.diagnosisSequence",
+                "path": "ExplanationOfBenefit.item.diagnosisSequence",
+                "short": "Applicable diagnoses",
+                "definition": "Diagnoses applicable for this service or product.",
+                "requirements": "Need to related the product or service to the associated diagnoses.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.diagnosisSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.procedureSequence",
+                "path": "ExplanationOfBenefit.item.procedureSequence",
+                "short": "Applicable procedures",
+                "definition": "Procedures applicable for this service or product.",
+                "requirements": "Need to provide any listed specific procedures to support the product or service being claimed.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.procedureSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.informationSequence",
+                "path": "ExplanationOfBenefit.item.informationSequence",
+                "short": "Applicable exception and supporting information",
+                "definition": "Exceptions, special conditions and supporting information applicable for this service or product.",
+                "requirements": "Need to reference the supporting information items that relate directly to this product or service.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.informationSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.revenue",
+                "path": "ExplanationOfBenefit.item.revenue",
+                "short": "Revenue or cost center code",
+                "definition": "The type of revenue or cost center providing the product and/or service.",
+                "comment": "Code used on the UB-04 (Form Locator 42) to identify a specific accommodation, ancillary service, or billing calculation related to the service being billed (86)",
+                "requirements": "Needed in the processing of institutional claims.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.revenue",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCRevenueCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.category",
+                "path": "ExplanationOfBenefit.item.category",
+                "short": "Benefit classification",
+                "definition": "Code to identify the general type of benefits under which products and services are provided.",
+                "comment": "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
+                "requirements": "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.category",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitCategory"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Benefit categories such as: oral, medical, vision, oral-basic etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.productOrService",
+                "path": "ExplanationOfBenefit.item.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "Medical procedure a patient received from a health care provider. Current coding methods include: CPT-4 and HCFA Common Procedure Coding System Level II - (HCPCSII). (40)",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSProcedureCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.modifier",
+                "path": "ExplanationOfBenefit.item.modifier",
+                "short": "Product or service billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "Modifier(s) for the procedure represented on this line. Identifies special circumstances related to the performance of the service. (41)",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.programCode",
+                "path": "ExplanationOfBenefit.item.programCode",
+                "short": "Program the product or service is provided under",
+                "definition": "Identifies the program under which this may be recovered.",
+                "comment": "For example: Neonatal program, child dental program or drug users recovery program.",
+                "requirements": "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.programCode",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProgramCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Program specific reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.serviced[x]",
+                "path": "ExplanationOfBenefit.item.serviced[x]",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "type",
+                            "path": "$this"
+                        }
+                    ],
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "short": "Date or dates of service or product delivery",
+                "definition": "The date or dates when the service or product was supplied, performed or completed.",
+                "requirements": "Needed to determine whether the  service or product was provided during the term of the insurance coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.serviced[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.done[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.serviced[x]:servicedDate",
+                "path": "ExplanationOfBenefit.item.serviced[x]",
+                "sliceName": "servicedDate",
+                "short": "Date or dates of service or product delivery",
+                "definition": "The date or dates when the service or product was supplied, performed or completed.",
+                "requirements": "Needed to determine whether the  service or product was provided during the term of the insurance coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.serviced[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.done[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.location[x]",
+                "path": "ExplanationOfBenefit.item.location[x]",
+                "short": "Place of service or where product was supplied",
+                "definition": "Where the product or service was provided.",
+                "requirements": "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.location[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    },
+                    {
+                        "code": "Address"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Location"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServicePlace"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Place where the service is rendered.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-place"
+                },
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.where[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.quantity",
+                "path": "ExplanationOfBenefit.item.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "comment": "The quantity of units, times, days, visits, services, or treatments for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (42)",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.unitPrice",
+                "path": "ExplanationOfBenefit.item.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.factor",
+                "path": "ExplanationOfBenefit.item.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.net",
+                "path": "ExplanationOfBenefit.item.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.udi",
+                "path": "ExplanationOfBenefit.item.udi",
+                "short": "Unique device identifier",
+                "definition": "Unique Device Identifiers associated with this line item.",
+                "requirements": "The UDI code allows the insurer to obtain device level information on the product supplied.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.udi",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Device"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.bodySite",
+                "path": "ExplanationOfBenefit.item.bodySite",
+                "short": "Anatomical location",
+                "definition": "Physical service site on the patient (limb, tooth, etc.).",
+                "comment": "For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.",
+                "requirements": "Allows insurer to validate specific procedures.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.bodySite",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "OralSites"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The code for the teeth, quadrant, sextant and arch.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/tooth"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.subSite",
+                "path": "ExplanationOfBenefit.item.subSite",
+                "short": "Anatomical sub-location",
+                "definition": "A region or surface of the bodySite, e.g. limb region or tooth surface(s).",
+                "requirements": "Allows insurer to validate specific procedures.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.subSite",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Surface"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The code for the tooth surface and surface combinations.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/surface"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.encounter",
+                "path": "ExplanationOfBenefit.item.encounter",
+                "short": "Encounters related to this billed item",
+                "definition": "A billed item may include goods or services provided in multiple encounters.",
+                "requirements": "Used in some jurisdictions to link clinical events to claim items.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.encounter",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Encounter"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.noteNumber",
+                "path": "ExplanationOfBenefit.item.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "comment": "References number of the associated processNote entered",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Adjudication"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "short": "Adjudication details",
+                "definition": "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
+                "requirements": "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.id",
+                "path": "ExplanationOfBenefit.item.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.extension",
+                "path": "ExplanationOfBenefit.item.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "path": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Adjudication"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "adjudicationamounttype",
+                "short": "Adjudication details",
+                "definition": "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "requirements": "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.id",
+                "path": "ExplanationOfBenefit.item.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.extension",
+                "path": "ExplanationOfBenefit.item.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.modifierExtension",
+                "path": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Adjudication"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "denialreason",
+                "short": "Adjudication details",
+                "definition": "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "requirements": "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.id",
+                "path": "ExplanationOfBenefit.item.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.extension",
+                "path": "ExplanationOfBenefit.item.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.modifierExtension",
+                "path": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "denialreason"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Adjudication"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The adjudication codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Adjudication"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "allowedunits",
+                "short": "Adjudication details",
+                "definition": "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.",
+                "comment": "The quantity of units, times, days, visits, services, or treatments allowed for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (149)",
+                "requirements": "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.id",
+                "path": "ExplanationOfBenefit.item.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.extension",
+                "path": "ExplanationOfBenefit.item.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.modifierExtension",
+                "path": "ExplanationOfBenefit.item.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "allowedunits"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Adjudication"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The adjudication codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Detail"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.detail",
+                "short": "Additional items",
+                "definition": "Second-tier of goods and services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.id",
+                "path": "ExplanationOfBenefit.item.detail.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.extension",
+                "path": "ExplanationOfBenefit.item.detail.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.modifierExtension",
+                "path": "ExplanationOfBenefit.item.detail.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.sequence",
+                "path": "ExplanationOfBenefit.item.detail.sequence",
+                "short": "Product or service provided",
+                "definition": "A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.",
+                "requirements": "The items to be processed for adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.revenue",
+                "path": "ExplanationOfBenefit.item.detail.revenue",
+                "short": "Revenue or cost center code",
+                "definition": "The type of revenue or cost center providing the product and/or service.",
+                "requirements": "Needed in the processing of institutional claims.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.revenue",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "RevenueCenter"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Codes for the revenue or cost centers supplying the service and/or products.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-revenue-center"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.category",
+                "path": "ExplanationOfBenefit.item.detail.category",
+                "short": "Benefit classification",
+                "definition": "Code to identify the general type of benefits under which products and services are provided.",
+                "comment": "Examples include: Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
+                "requirements": "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.category",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitCategory"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Benefit categories such as: oral, medical, vision, oral-basic etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.productOrService",
+                "path": "ExplanationOfBenefit.item.detail.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.modifier",
+                "path": "ExplanationOfBenefit.item.detail.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.programCode",
+                "path": "ExplanationOfBenefit.item.detail.programCode",
+                "short": "Program the product or service is provided under",
+                "definition": "Identifies the program under which this may be recovered.",
+                "comment": "For example: Neonatal program, child dental program or drug users recovery program.",
+                "requirements": "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.programCode",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProgramCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Program specific reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.quantity",
+                "path": "ExplanationOfBenefit.item.detail.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.unitPrice",
+                "path": "ExplanationOfBenefit.item.detail.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.factor",
+                "path": "ExplanationOfBenefit.item.detail.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.net",
+                "path": "ExplanationOfBenefit.item.detail.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.udi",
+                "path": "ExplanationOfBenefit.item.detail.udi",
+                "short": "Unique device identifier",
+                "definition": "Unique Device Identifiers associated with this line item.",
+                "requirements": "The UDI code allows the insurer to obtain device level information on the product supplied.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.udi",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Device"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.noteNumber",
+                "path": "ExplanationOfBenefit.item.detail.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.adjudication",
+                "path": "ExplanationOfBenefit.item.detail.adjudication",
+                "short": "Detail level adjudication details",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "SubDetail"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.item.detail.subDetail",
+                "short": "Additional items",
+                "definition": "Third-tier of goods and services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.id",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.extension",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.modifierExtension",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.sequence",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.sequence",
+                "short": "Product or service provided",
+                "definition": "A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.",
+                "requirements": "The items to be processed for adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.sequence",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.revenue",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.revenue",
+                "short": "Revenue or cost center code",
+                "definition": "The type of revenue or cost center providing the product and/or service.",
+                "requirements": "Needed in the processing of institutional claims.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.revenue",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "RevenueCenter"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Codes for the revenue or cost centers supplying the service and/or products.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-revenue-center"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.category",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.category",
+                "short": "Benefit classification",
+                "definition": "Code to identify the general type of benefits under which products and services are provided.",
+                "comment": "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
+                "requirements": "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.category",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitCategory"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Benefit categories such as: oral, medical, vision, oral-basic etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.productOrService",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.modifier",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.programCode",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.programCode",
+                "short": "Program the product or service is provided under",
+                "definition": "Identifies the program under which this may be recovered.",
+                "comment": "For example: Neonatal program, child dental program or drug users recovery program.",
+                "requirements": "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.programCode",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProgramCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Program specific reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.quantity",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.unitPrice",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.factor",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.net",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.udi",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.udi",
+                "short": "Unique device identifier",
+                "definition": "Unique Device Identifiers associated with this line item.",
+                "requirements": "The UDI code allows the insurer to obtain device level information on the product supplied.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.udi",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Device"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.noteNumber",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.item.detail.subDetail.adjudication",
+                "path": "ExplanationOfBenefit.item.detail.subDetail.adjudication",
+                "short": "Subdetail level adjudication details",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.detail.subDetail.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "740;600"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "AddedItem"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.addItem",
+                "short": "Insurer added line items",
+                "definition": "The first-tier service adjudications for payor added product or service lines.",
+                "requirements": "Insurers may redefine the provided product or service or may package and/or decompose groups of products and services. The addItems allows the insurer to provide their line item list with linkage to the submitted items/details/sub-details. In a preauthorization the insurer may use the addItem structure to provide additional information on authorized products and services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.id",
+                "path": "ExplanationOfBenefit.addItem.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.extension",
+                "path": "ExplanationOfBenefit.addItem.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.modifierExtension",
+                "path": "ExplanationOfBenefit.addItem.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.itemSequence",
+                "path": "ExplanationOfBenefit.addItem.itemSequence",
+                "short": "Item sequence number",
+                "definition": "Claim items which this service line is intended to replace.",
+                "requirements": "Provides references to the claim items.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.itemSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detailSequence",
+                "path": "ExplanationOfBenefit.addItem.detailSequence",
+                "short": "Detail sequence number",
+                "definition": "The sequence number of the details within the claim item which this line is intended to replace.",
+                "requirements": "Provides references to the claim details within the claim item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detailSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.subDetailSequence",
+                "path": "ExplanationOfBenefit.addItem.subDetailSequence",
+                "short": "Subdetail sequence number",
+                "definition": "The sequence number of the sub-details woithin the details within the claim item which this line is intended to replace.",
+                "requirements": "Provides references to the claim sub-details within the claim detail.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.subDetailSequence",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.provider",
+                "path": "ExplanationOfBenefit.addItem.provider",
+                "short": "Authorized providers",
+                "definition": "The providers who are authorized for the services rendered to the patient.",
+                "requirements": "Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.provider",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
+                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
+                            "http://hl7.org/fhir/StructureDefinition/Organization"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.source"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.productOrService",
+                "path": "ExplanationOfBenefit.addItem.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.modifier",
+                "path": "ExplanationOfBenefit.addItem.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.programCode",
+                "path": "ExplanationOfBenefit.addItem.programCode",
+                "short": "Program the product or service is provided under",
+                "definition": "Identifies the program under which this may be recovered.",
+                "comment": "For example: Neonatal program, child dental program or drug users recovery program.",
+                "requirements": "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.programCode",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ProgramCode"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Program specific reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.serviced[x]",
+                "path": "ExplanationOfBenefit.addItem.serviced[x]",
+                "short": "Date or dates of service or product delivery",
+                "definition": "The date or dates when the service or product was supplied, performed or completed.",
+                "requirements": "Needed to determine whether the  service or product was provided during the term of the insurance coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.serviced[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    },
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.done[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.location[x]",
+                "path": "ExplanationOfBenefit.addItem.location[x]",
+                "short": "Place of service or where product was supplied",
+                "definition": "Where the product or service was provided.",
+                "requirements": "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.location[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    },
+                    {
+                        "code": "Address"
+                    },
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/StructureDefinition/Location"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServicePlace"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Place where the service is rendered.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-place"
+                },
+                "mapping": [
+                    {
+                        "identity": "w5",
+                        "map": "FiveWs.where[x]"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.quantity",
+                "path": "ExplanationOfBenefit.addItem.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.unitPrice",
+                "path": "ExplanationOfBenefit.addItem.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.factor",
+                "path": "ExplanationOfBenefit.addItem.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.net",
+                "path": "ExplanationOfBenefit.addItem.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.bodySite",
+                "path": "ExplanationOfBenefit.addItem.bodySite",
+                "short": "Anatomical location",
+                "definition": "Physical service site on the patient (limb, tooth, etc.).",
+                "comment": "For example, providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed.",
+                "requirements": "Allows insurer to validate specific procedures.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.bodySite",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "OralSites"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The code for the teeth, quadrant, sextant and arch.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/tooth"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.subSite",
+                "path": "ExplanationOfBenefit.addItem.subSite",
+                "short": "Anatomical sub-location",
+                "definition": "A region or surface of the bodySite, e.g. limb region or tooth surface(s).",
+                "requirements": "Allows insurer to validate specific procedures.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.subSite",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Surface"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The code for the tooth surface and surface combinations.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/surface"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.noteNumber",
+                "path": "ExplanationOfBenefit.addItem.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.adjudication",
+                "path": "ExplanationOfBenefit.addItem.adjudication",
+                "short": "Added items adjudication",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "740;600"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "AddedItemDetail"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.addItem.detail",
+                "short": "Insurer added line items",
+                "definition": "The second-tier service adjudications for payor added services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.id",
+                "path": "ExplanationOfBenefit.addItem.detail.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.extension",
+                "path": "ExplanationOfBenefit.addItem.detail.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.modifierExtension",
+                "path": "ExplanationOfBenefit.addItem.detail.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.productOrService",
+                "path": "ExplanationOfBenefit.addItem.detail.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.modifier",
+                "path": "ExplanationOfBenefit.addItem.detail.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.quantity",
+                "path": "ExplanationOfBenefit.addItem.detail.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.unitPrice",
+                "path": "ExplanationOfBenefit.addItem.detail.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.factor",
+                "path": "ExplanationOfBenefit.addItem.detail.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.net",
+                "path": "ExplanationOfBenefit.addItem.detail.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.noteNumber",
+                "path": "ExplanationOfBenefit.addItem.detail.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.adjudication",
+                "path": "ExplanationOfBenefit.addItem.detail.adjudication",
+                "short": "Added items adjudication",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "740;600"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "AddedItemDetailSubDetail"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail",
+                "short": "Insurer added line items",
+                "definition": "The third-tier service adjudications for payor added services.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.id",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.extension",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.productOrService",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.productOrService",
+                "short": "Billing, service, product, or drug code",
+                "definition": "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.",
+                "comment": "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.",
+                "requirements": "Necessary to state what was provided or done.",
+                "alias": [
+                    "Drug Code",
+                    "Bill Code",
+                    "Service Code"
+                ],
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.productOrService",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "ServiceProduct"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Allowable service and product codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.modifier",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.modifier",
+                "short": "Service/Product billing modifiers",
+                "definition": "Item typification or modifiers codes to convey additional context for the product or service.",
+                "comment": "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
+                "requirements": "To support inclusion of the item for adjudication or to charge an elevated fee.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.modifier",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Modifiers"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.quantity",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.quantity",
+                "short": "Count of products or services",
+                "definition": "The number of repetitions of a service or product.",
+                "requirements": "Required when the product or service code does not convey the quantity provided.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.quantity",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Quantity",
+                        "profile": [
+                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+                        ]
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice",
+                "short": "Fee, charge or cost per item",
+                "definition": "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.",
+                "requirements": "The amount charged to the patient by the provider for a single unit.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.factor",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.factor",
+                "short": "Price scaling factor",
+                "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
+                "comment": "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).",
+                "requirements": "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.factor",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.net",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.net",
+                "short": "Total item cost",
+                "definition": "The quantity times the unit price for an additional service or product or charge.",
+                "comment": "For example, the formula: quantity * unitPrice * factor  = net. Quantity and factor are assumed to be 1 if not supplied.",
+                "requirements": "Provides the total amount claimed  for the group (if a grouper) or the line item.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.net",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber",
+                "short": "Applicable note numbers",
+                "definition": "The numbers associated with notes below which apply to the adjudication of this item.",
+                "requirements": "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.addItem.detail.subDetail.adjudication",
+                "path": "ExplanationOfBenefit.addItem.detail.subDetail.adjudication",
+                "short": "Added items adjudication",
+                "definition": "The adjudication results.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.addItem.detail.subDetail.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "contentReference": "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit#ExplanationOfBenefit.item.adjudication",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication",
+                "path": "ExplanationOfBenefit.adjudication",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "short": "Header-level adjudication",
+                "definition": "The adjudication results which are presented at the header level rather than at the line-item or add-item levels.",
+                "requirements": "Some insurers will receive line-items but provide the adjudication only at a summary or header-level.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.id",
+                "path": "ExplanationOfBenefit.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.extension",
+                "path": "ExplanationOfBenefit.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.modifierExtension",
+                "path": "ExplanationOfBenefit.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.reason",
+                "path": "ExplanationOfBenefit.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.amount",
+                "path": "ExplanationOfBenefit.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.value",
+                "path": "ExplanationOfBenefit.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype",
+                "path": "ExplanationOfBenefit.adjudication",
+                "sliceName": "adjudicationamounttype",
+                "short": "Header-level adjudication",
+                "definition": "The adjudication results which are presented at the header level rather than at the line-item or add-item levels.",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "requirements": "Some insurers will receive line-items but provide the adjudication only at a summary or header-level.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.id",
+                "path": "ExplanationOfBenefit.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.extension",
+                "path": "ExplanationOfBenefit.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.modifierExtension",
+                "path": "ExplanationOfBenefit.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.reason",
+                "path": "ExplanationOfBenefit.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "For example, may indicate that the funds for this benefit type have been exhausted.",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "AdjudicationReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Adjudication reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.value",
+                "path": "ExplanationOfBenefit.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason",
+                "path": "ExplanationOfBenefit.adjudication",
+                "sliceName": "denialreason",
+                "short": "Header-level adjudication",
+                "definition": "The adjudication results which are presented at the header level rather than at the line-item or add-item levels.",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "requirements": "Some insurers will receive line-items but provide the adjudication only at a summary or header-level.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.adjudication",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.id",
+                "path": "ExplanationOfBenefit.adjudication.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.extension",
+                "path": "ExplanationOfBenefit.adjudication.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.modifierExtension",
+                "path": "ExplanationOfBenefit.adjudication.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to enable understanding of the context of the other information in the adjudication.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "denialreason"
+                        }
+                    ]
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Adjudication"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The adjudication codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/adjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.reason",
+                "path": "ExplanationOfBenefit.adjudication.reason",
+                "short": "Explanation of adjudication outcome",
+                "definition": "A code supporting the understanding of the adjudication result and explaining variance from expected amount.",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "requirements": "To support understanding of variance from adjudication expectations.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.reason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.amount",
+                "path": "ExplanationOfBenefit.adjudication.amount",
+                "short": "Monetary amount",
+                "definition": "Monetary amount associated with the category.",
+                "comment": "For example, amount submitted, eligible amount, co-payment, and benefit payable.",
+                "requirements": "Most adjuciation categories convey a monetary amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.value",
+                "path": "ExplanationOfBenefit.adjudication.value",
+                "short": "Non-monitary value",
+                "definition": "A non-monetary value associated with the category. Mutually exclusive to the amount element above.",
+                "comment": "For example: eligible percentage or co-payment percentage.",
+                "requirements": "Some adjudication categories convey a percentage or a fixed value.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.item.adjudication.value",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "decimal"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.total",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "'360;620"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Total"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.total",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "open"
+                },
+                "short": "Adjudication totals",
+                "definition": "Categorized monetary totals for the adjudication.",
+                "comment": "Totals for amounts submitted, co-pays, benefits payable etc.",
+                "requirements": "To provide the requestor with financial totals by category for the adjudication.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.total",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total.id",
+                "path": "ExplanationOfBenefit.total.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total.extension",
+                "path": "ExplanationOfBenefit.total.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total.modifierExtension",
+                "path": "ExplanationOfBenefit.total.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to convey the type of total provided.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBTotalCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "short": "Financial total for the category",
+                "definition": "Monetary total amount associated with the category.",
+                "comment": "Total amount for each category (i.e., submitted, allowed, etc.) (148)",
+                "requirements": "Needed to convey the total monetary amount.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.amount",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "'360;620"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Total"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.total",
+                "sliceName": "adjudicationamounttype",
+                "short": "Adjudication totals",
+                "definition": "Categorized monetary totals for the adjudication.",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "requirements": "To provide the requestor with financial totals by category for the adjudication.",
+                "min": 1,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.total",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.id",
+                "path": "ExplanationOfBenefit.total.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.extension",
+                "path": "ExplanationOfBenefit.total.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.modifierExtension",
+                "path": "ExplanationOfBenefit.total.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to convey the type of total provided.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "short": "Financial total for the category",
+                "definition": "Monetary total amount associated with the category.",
+                "requirements": "Needed to convey the total monetary amount.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.amount",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "'360;620"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Total"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.total",
+                "sliceName": "inoutnetwork",
+                "short": "Adjudication totals",
+                "definition": "Categorized monetary totals for the adjudication.",
+                "comment": "Indicates the in network or out of network payment status of the claim. (142)",
+                "requirements": "To provide the requestor with financial totals by category for the adjudication.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.id",
+                "path": "ExplanationOfBenefit.total.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.extension",
+                "path": "ExplanationOfBenefit.total.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.modifierExtension",
+                "path": "ExplanationOfBenefit.total.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "short": "Type of adjudication information",
+                "definition": "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.",
+                "comment": "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
+                "requirements": "Needed to convey the type of total provided.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "short": "Financial total for the category",
+                "definition": "Monetary total amount associated with the category.",
+                "requirements": "Needed to convey the total monetary amount.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.total.amount",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": true
+            },
+            {
+                "id": "ExplanationOfBenefit.payment",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
+                        "valueString": "360;650"
+                    },
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Payment"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.payment",
+                "short": "Payment Details",
+                "definition": "Payment details for the adjudication of the claim.",
+                "requirements": "Needed to convey references to the financial instrument that has been used if payment has been made.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.id",
+                "path": "ExplanationOfBenefit.payment.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.extension",
+                "path": "ExplanationOfBenefit.payment.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.modifierExtension",
+                "path": "ExplanationOfBenefit.payment.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.type",
+                "path": "ExplanationOfBenefit.payment.type",
+                "short": "Partial or complete payment",
+                "definition": "Whether this represents partial or complete payment of the benefits payable.",
+                "comment": "Indicates whether the claim was paid or denied. (91)",
+                "requirements": "To advise the requestor when the insurer believes all payments to have been completed.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerClaimPaymentStatusCode"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.adjustment",
+                "path": "ExplanationOfBenefit.payment.adjustment",
+                "short": "Payment adjustment for non-claim issues",
+                "definition": "Total amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication.",
+                "comment": "Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider.",
+                "requirements": "To advise the requestor of adjustments applied to the payment.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.adjustment",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.adjustmentReason",
+                "path": "ExplanationOfBenefit.payment.adjustmentReason",
+                "short": "Explanation for the variance",
+                "definition": "Reason for the payment adjustment.",
+                "requirements": "Needed to clarify the monetary adjustment.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.adjustmentReason",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "PaymentAdjustmentReason"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Payment Adjustment reason codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/payment-adjustment-reason"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.date",
+                "path": "ExplanationOfBenefit.payment.date",
+                "short": "Expected date of payment",
+                "definition": "Estimated date the payment will be issued or the actual issue date of payment.",
+                "comment": "The date the claim was paid. (107)",
+                "requirements": "To advise the payee when payment can be expected.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.date",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.amount",
+                "path": "ExplanationOfBenefit.payment.amount",
+                "short": "Payable amount after adjustment",
+                "definition": "Benefits payable less any payment adjustment.",
+                "requirements": "Needed to provide the actual payment amount.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.amount",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.identifier",
+                "path": "ExplanationOfBenefit.payment.identifier",
+                "short": "Business identifier for the payment",
+                "definition": "Issuer's unique identifier for the payment instrument.",
+                "comment": "For example: EFT number or check number.",
+                "requirements": "Enable the receiver to reconcile when payment received.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.payment.identifier",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Identifier"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.formCode",
+                "path": "ExplanationOfBenefit.formCode",
+                "short": "Printed form identifier",
+                "definition": "A code for the form to be used for printing the content.",
+                "comment": "May be needed to identify specific jurisdictional forms.",
+                "requirements": "Needed to specify the specific form used for producing output for this response.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.formCode",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Forms"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "The forms codes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/forms"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.form",
+                "path": "ExplanationOfBenefit.form",
+                "short": "Printed reference or actual form",
+                "definition": "The actual form, by reference or inclusion, for printing the content or an EOB.",
+                "comment": "Needed to permit insurers to include the actual form.",
+                "requirements": "Needed to include the specific form used for producing output for this response.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.form",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Attachment"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Note"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.processNote",
+                "short": "Note concerning adjudication",
+                "definition": "A note that describes or explains adjudication results in a human readable form.",
+                "requirements": "Provides the insurer specific textual explanations associated with the processing.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.id",
+                "path": "ExplanationOfBenefit.processNote.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.extension",
+                "path": "ExplanationOfBenefit.processNote.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.modifierExtension",
+                "path": "ExplanationOfBenefit.processNote.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.number",
+                "path": "ExplanationOfBenefit.processNote.number",
+                "short": "Note instance identifier",
+                "definition": "A number to uniquely identify a note entry.",
+                "requirements": "Necessary to provide a mechanism to link from adjudications.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote.number",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "positiveInt"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.type",
+                "path": "ExplanationOfBenefit.processNote.type",
+                "short": "display | print | printoper",
+                "definition": "The business purpose of the note text.",
+                "requirements": "To convey the expectation for when the text is used.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote.type",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "code"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "NoteType"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "required",
+                    "description": "The presentation types of notes.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/note-type|4.0.1"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.text",
+                "path": "ExplanationOfBenefit.processNote.text",
+                "short": "Note explanatory text",
+                "definition": "The explanation or description associated with the processing.",
+                "comment": "Payment denial explanation to a member, typically goes on the EOB when the payment is denied or disallowed (181)",
+                "requirements": "Required to provide human readable explanation.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote.text",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true,
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.language",
+                "path": "ExplanationOfBenefit.processNote.language",
+                "short": "Language of the text",
+                "definition": "A code to define the language used in the text of the note.",
+                "comment": "Only required if the language is different from the resource language.",
+                "requirements": "Note text may vary from the resource defined language.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.processNote.language",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+                            "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "Language"
+                        },
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+                            "valueBoolean": true
+                        }
+                    ],
+                    "strength": "preferred",
+                    "description": "A human language.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitPeriod",
+                "path": "ExplanationOfBenefit.benefitPeriod",
+                "short": "When the benefits are applicable",
+                "definition": "The term of the benefits documented in this response.",
+                "comment": "Not applicable when use=claim.",
+                "requirements": "Needed as coverages may be multi-year while benefits tend to be annual therefore a separate expression of the benefit period is needed.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitPeriod",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "Period"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "BenefitBalance"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.benefitBalance",
+                "short": "Balance by Benefit Category",
+                "definition": "Balance by Benefit Category.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.id",
+                "path": "ExplanationOfBenefit.benefitBalance.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.extension",
+                "path": "ExplanationOfBenefit.benefitBalance.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.modifierExtension",
+                "path": "ExplanationOfBenefit.benefitBalance.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.category",
+                "path": "ExplanationOfBenefit.benefitBalance.category",
+                "short": "Benefit classification",
+                "definition": "Code to identify the general type of benefits under which products and services are provided.",
+                "comment": "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
+                "requirements": "Needed to convey the category of service or product for which eligibility is sought.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.category",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitCategory"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Benefit categories such as: oral, medical, vision, oral-basic etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/ex-benefitcategory"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.excluded",
+                "path": "ExplanationOfBenefit.benefitBalance.excluded",
+                "short": "Excluded from the plan",
+                "definition": "True if the indicated class of service is excluded from the plan, missing or False indicates the product or service is included in the coverage.",
+                "requirements": "Needed to identify items that are specifically excluded from the coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.excluded",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "boolean"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.name",
+                "path": "ExplanationOfBenefit.benefitBalance.name",
+                "short": "Short name for the benefit",
+                "definition": "A short name or tag for the benefit.",
+                "comment": "For example: MED01, or DENT2.",
+                "requirements": "Required to align with other plan names.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.name",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.description",
+                "path": "ExplanationOfBenefit.benefitBalance.description",
+                "short": "Description of the benefit or services covered",
+                "definition": "A richer description of the benefit or services covered.",
+                "comment": "For example, 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'.",
+                "requirements": "Needed for human readable reference.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.description",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "string"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.network",
+                "path": "ExplanationOfBenefit.benefitBalance.network",
+                "short": "In or out of network",
+                "definition": "Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers.",
+                "requirements": "Needed as in or out of network providers are treated differently under the coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.network",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitNetwork"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Code to classify in or out of network services.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/benefit-network"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.unit",
+                "path": "ExplanationOfBenefit.benefitBalance.unit",
+                "short": "Individual or family",
+                "definition": "Indicates if the benefits apply to an individual or to the family.",
+                "requirements": "Needed for the understanding of the benefits.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.unit",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitUnit"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Unit covered/serviced - individual or family.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/benefit-unit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.term",
+                "path": "ExplanationOfBenefit.benefitBalance.term",
+                "short": "Annual or lifetime",
+                "definition": "The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.",
+                "requirements": "Needed for the understanding of the benefits.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.term",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitTerm"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Coverage unit - annual, lifetime.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/benefit-term"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial",
+                "extension": [
+                    {
+                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+                        "valueString": "Benefit"
+                    }
+                ],
+                "path": "ExplanationOfBenefit.benefitBalance.financial",
+                "short": "Benefit Summary",
+                "definition": "Benefits Used to date.",
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.financial",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.id",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.id",
+                "representation": [
+                    "xmlAttr"
+                ],
+                "short": "Unique id for inter-element referencing",
+                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "Element.id",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
+                                "valueUrl": "string"
+                            }
+                        ],
+                        "code": "http://hl7.org/fhirpath/System.String"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.extension",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.extension",
+                "short": "Additional content defined by implementations",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "alias": [
+                    "extensions",
+                    "user content"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "Element.extension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "n/a"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.modifierExtension",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.modifierExtension",
+                "short": "Extensions that cannot be ignored even if unrecognized",
+                "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
+                "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+                "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
+                "alias": [
+                    "extensions",
+                    "user content",
+                    "modifiers"
+                ],
+                "min": 0,
+                "max": "*",
+                "base": {
+                    "path": "BackboneElement.modifierExtension",
+                    "min": 0,
+                    "max": "*"
+                },
+                "type": [
+                    {
+                        "code": "Extension"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "ext-1",
+                        "severity": "error",
+                        "human": "Must have either extensions or value[x], not both",
+                        "expression": "extension.exists() != value.exists()",
+                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
+                    }
+                ],
+                "isModifier": true,
+                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
+                "isSummary": true,
+                "mapping": [
+                    {
+                        "identity": "rim",
+                        "map": "N/A"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.type",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.type",
+                "short": "Benefit classification",
+                "definition": "Classification of benefit being provided.",
+                "comment": "For example: deductible, visits, benefit amount.",
+                "requirements": "Needed to convey the nature of the benefit.",
+                "min": 1,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.financial.type",
+                    "min": 1,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false,
+                "binding": {
+                    "extension": [
+                        {
+                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+                            "valueString": "BenefitType"
+                        }
+                    ],
+                    "strength": "example",
+                    "description": "Deductable, visits, co-pay, etc.",
+                    "valueSet": "http://hl7.org/fhir/ValueSet/benefit-type"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.allowed[x]",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.allowed[x]",
+                "short": "Benefits allowed",
+                "definition": "The quantity of the benefit which is permitted under the coverage.",
+                "requirements": "Needed to convey the benefits offered under the coverage.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.financial.allowed[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "unsignedInt"
+                    },
+                    {
+                        "code": "string"
+                    },
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            },
+            {
+                "id": "ExplanationOfBenefit.benefitBalance.financial.used[x]",
+                "path": "ExplanationOfBenefit.benefitBalance.financial.used[x]",
+                "short": "Benefits used",
+                "definition": "The quantity of the benefit which have been consumed to date.",
+                "requirements": "Needed to convey the benefits consumed to date.",
+                "min": 0,
+                "max": "1",
+                "base": {
+                    "path": "ExplanationOfBenefit.benefitBalance.financial.used[x]",
+                    "min": 0,
+                    "max": "1"
+                },
+                "type": [
+                    {
+                        "code": "unsignedInt"
+                    },
+                    {
+                        "code": "Money"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "isModifier": false,
+                "isSummary": false
+            }
+        ]
+    },
+    "differential": {
+        "element": [
+            {
+                "id": "ExplanationOfBenefit",
+                "path": "ExplanationOfBenefit",
+                "constraint": [
+                    {
+                        "key": "dom-2",
+                        "severity": "error",
+                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
+                        "expression": "contained.contained.empty()",
+                        "xpath": "not(parent::f:contained and f:contained)",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-3",
+                        "severity": "error",
+                        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
+                        "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
+                        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-4",
+                        "severity": "error",
+                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
+                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
+                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "dom-5",
+                        "severity": "error",
+                        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
+                        "expression": "contained.meta.security.empty()",
+                        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "extension": [
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                                "valueBoolean": true
+                            },
+                            {
+                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
+                                "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
+                            }
+                        ],
+                        "key": "dom-6",
+                        "severity": "warning",
+                        "human": "A resource should have narrative for robust management",
+                        "expression": "text.`div`.exists()",
+                        "xpath": "exists(f:text/h:div)",
+                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
+                    },
+                    {
+                        "key": "EOB-institutional-item-or-header-adjudication",
+                        "severity": "error",
+                        "human": "Institutional EOB:  Should have adjudication at the item or header level, but not both",
+                        "expression": "(adjudication.exists() != item.adjudication.exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    },
+                    {
+                        "key": "adjudication-has-amount-type-slice",
+                        "severity": "error",
+                        "human": "If Adjudication is present, it must have at least one adjudicationamounttype slice",
+                        "expression": "adjudication.exists() implies (adjudication.where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.type",
+                "path": "ExplanationOfBenefit.type",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://terminology.hl7.org/CodeSystem/claim-type",
+                            "code": "institutional"
+                        }
+                    ]
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.created",
+                "path": "ExplanationOfBenefit.created",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.provider",
+                "path": "ExplanationOfBenefit.provider",
+                "type": [
+                    {
+                        "code": "Reference",
+                        "targetProfile": [
+                            "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"
+                        ]
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam",
+                "path": "ExplanationOfBenefit.careTeam",
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    },
+                    {
+                        "key": "EOB-inst-careTeam-practitioner",
+                        "severity": "error",
+                        "human": "Institutional EOB: Careteam roles refer to a practitioner",
+                        "expression": "(\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists() implies\nrole.where(coding.where(code in ('attending' | 'primary' | 'referring' | 'supervising')).exists()).exists().provider.all(resolve() is Practitioner)\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    },
+                    {
+                        "key": "EOB-inst-careTeam-organization",
+                        "severity": "error",
+                        "human": "Institutional EOB:  Careteam roles refer to an organization",
+                        "expression": "(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().provider.all(resolve() is Organization)\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    },
+                    {
+                        "key": "EOB-careteam-qualification",
+                        "severity": "error",
+                        "human": "Care Team Performing physician's qualifications are from US-Core-Provider-Specialty Value Set",
+                        "expression": "(\nrole.where(coding.where(code in ('performing' )).exists()).exists() implies\nrole.where(coding.where(code in ('performing' )).exists()).exists().qualification.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty')\n)",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.role",
+                "path": "ExplanationOfBenefit.careTeam.role",
+                "min": 1,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimInstitutionalCareTeamRole"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.careTeam.qualification",
+                "path": "ExplanationOfBenefit.careTeam.qualification",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on $this pattern",
+                    "ordered": false,
+                    "rules": "open"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "billingnetworkcontractingstatus",
+                "comment": "Indicates that the Billing Provider has a contract with the Plan (regardless of the network) as of the effective date of service or admission. (101)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "billingnetworkcontractingstatus"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:billingnetworkcontractingstatus.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderContractingStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "clmrecvddate",
+                "comment": "The date the claim was received by the payer (88)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "clmrecvddate"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:clmrecvddate.timing[x]",
+                "path": "ExplanationOfBenefit.supportingInfo.timing[x]",
+                "min": 1,
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ],
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "typeofbill",
+                "comment": "UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of institution, the second digit classifies the type of care being billed, and the third digit  identifies the frequency of the bill for a specific course of treatment or inpatient confinement. (17)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "typeofbill"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:typeofbill.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCTypeOfBill"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "pointoforigin",
+                "comment": "Identifies the place where the patient was identified as needing admission to an institution. This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15). (13)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "pointoforigin"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:pointoforigin.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPointOfOriginForAdmissionOrVisit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "admtype",
+                "comment": "Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled. (14)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "admtype"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:admtype.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPriorityTypeOfAdmissionOrVisit"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status",
+                "path": "ExplanationOfBenefit.supportingInfo",
+                "sliceName": "discharge-status",
+                "comment": "Patient’s status as of the discharge date for a facility stay. Information located on UB04. (Form Locator 17). (117)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.category",
+                "path": "ExplanationOfBenefit.supportingInfo.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                            "code": "discharge-status"
+                        }
+                    ]
+                },
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.supportingInfo:discharge-status.code",
+                "path": "ExplanationOfBenefit.supportingInfo.code",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCPatientDischargeStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis",
+                "path": "ExplanationOfBenefit.diagnosis",
+                "comment": "Diagnosis codes describe an individual's disease or medical condition. (6, 7, 8, 21, 22, 23, 30)",
+                "min": 1
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.sequence",
+                "path": "ExplanationOfBenefit.diagnosis.sequence",
+                "comment": "Diagnosis.sequence values do not necessarily indiate any order in which the diagnosis was reported or identified.  client app implementations should not assign any significance to the sequence values.  client app implementations should use the values of diagnosis.type to identify primary, secondary, etc."
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                "path": "ExplanationOfBenefit.diagnosis.diagnosis[x]",
+                "type": [
+                    {
+                        "code": "CodeableConcept"
+                    }
+                ],
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/CDCICD910CMDiagnosisCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.diagnosis.type",
+                "path": "ExplanationOfBenefit.diagnosis.type",
+                "comment": "Indicates if the outpatient institutional diagnosis is principal, other, an external cause of injury or a patient reason for visit. (21, 22, 23)",
+                "min": 1,
+                "max": "1",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBClaimOutpatientInstitutionalDiagnosisType"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item",
+                "path": "ExplanationOfBenefit.item",
+                "comment": "Put the comment here for item",
+                "constraint": [
+                    {
+                        "key": "adjudication-has-amount-type-slice",
+                        "severity": "error",
+                        "human": "If Adjudication is present, it must have at least one adjudicationamounttype slice",
+                        "expression": "adjudication.exists() implies (adjudication.where(category.memberOf('http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication')).exists())",
+                        "source": "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.revenue",
+                "path": "ExplanationOfBenefit.item.revenue",
+                "comment": "Code used on the UB-04 (Form Locator 42) to identify a specific accommodation, ancillary service, or billing calculation related to the service being billed (86)",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AHANUBCRevenueCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.productOrService",
+                "path": "ExplanationOfBenefit.item.productOrService",
+                "comment": "Medical procedure a patient received from a health care provider. Current coding methods include: CPT-4 and HCFA Common Procedure Coding System Level II - (HCPCSII). (40)",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSProcedureCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.modifier",
+                "path": "ExplanationOfBenefit.item.modifier",
+                "comment": "Modifier(s) for the procedure represented on this line. Identifies special circumstances related to the performance of the service. (41)",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.serviced[x]",
+                "path": "ExplanationOfBenefit.item.serviced[x]",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "type",
+                            "path": "$this"
+                        }
+                    ],
+                    "ordered": false,
+                    "rules": "open"
+                },
+                "type": [
+                    {
+                        "code": "date"
+                    }
+                ]
+            },
+            {
+                "id": "ExplanationOfBenefit.item.servicedDate",
+                "path": "ExplanationOfBenefit.item.servicedDate",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.quantity",
+                "path": "ExplanationOfBenefit.item.quantity",
+                "comment": "The quantity of units, times, days, visits, services, or treatments for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (42)",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication",
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype",
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "adjudicationamounttype",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "min": 0,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.item.adjudication.amount",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason",
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "denialreason",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "min": 0,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "denialreason"
+                        }
+                    ]
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:denialreason.reason",
+                "path": "ExplanationOfBenefit.item.adjudication.reason",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits",
+                "path": "ExplanationOfBenefit.item.adjudication",
+                "sliceName": "allowedunits",
+                "comment": "The quantity of units, times, days, visits, services, or treatments allowed for the service described by the HCPCS code, revenue code or procedure code, submitted by the provider. (149)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.category",
+                "path": "ExplanationOfBenefit.item.adjudication.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "allowedunits"
+                        }
+                    ]
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.item.adjudication:allowedunits.value",
+                "path": "ExplanationOfBenefit.item.adjudication.value",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication",
+                "path": "ExplanationOfBenefit.adjudication",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "closed"
+                },
+                "type": [
+                    {
+                        "code": "BackboneElement"
+                    }
+                ],
+                "constraint": [
+                    {
+                        "key": "ele-1",
+                        "severity": "error",
+                        "human": "All FHIR elements must have a @value or children",
+                        "expression": "hasValue() or (children().count() > id.count())",
+                        "xpath": "@value|f:*|h:div",
+                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
+                    }
+                ],
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudicationCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype",
+                "path": "ExplanationOfBenefit.adjudication",
+                "sliceName": "adjudicationamounttype",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "min": 0,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.adjudication.amount",
+                "min": 1,
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason",
+                "path": "ExplanationOfBenefit.adjudication",
+                "sliceName": "denialreason",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "min": 0,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.category",
+                "path": "ExplanationOfBenefit.adjudication.category",
+                "patternCodeableConcept": {
+                    "coding": [
+                        {
+                            "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator",
+                            "code": "denialreason"
+                        }
+                    ]
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.adjudication:denialreason.reason",
+                "path": "ExplanationOfBenefit.adjudication.reason",
+                "comment": "Reason codes used to interpret the Non-Covered Amount that are provided to the Provider. (92)",
+                "min": 1,
+                "mustSupport": true,
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total",
+                "path": "ExplanationOfBenefit.total",
+                "slicing": {
+                    "discriminator": [
+                        {
+                            "type": "pattern",
+                            "path": "category"
+                        }
+                    ],
+                    "description": "Slice based on value pattern",
+                    "ordered": false,
+                    "rules": "open"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "mustSupport": true,
+                "binding": {
+                    "strength": "extensible",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBTotalCategoryDiscriminator"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "comment": "Total amount for each category (i.e., submitted, allowed, etc.) (148)"
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype",
+                "path": "ExplanationOfBenefit.total",
+                "sliceName": "adjudicationamounttype",
+                "comment": "Describes the various amount fields used when payers receive and adjudicate a claim. (187)",
+                "min": 1,
+                "max": "*",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.total:adjudicationamounttype.amount",
+                "path": "ExplanationOfBenefit.total.amount",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork",
+                "path": "ExplanationOfBenefit.total",
+                "sliceName": "inoutnetwork",
+                "comment": "Indicates the in network or out of network payment status of the claim. (142)",
+                "min": 0,
+                "max": "1",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.total:inoutnetwork.category",
+                "path": "ExplanationOfBenefit.total.category",
+                "binding": {
+                    "strength": "required",
+                    "valueSet": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus"
+                }
+            },
+            {
+                "id": "ExplanationOfBenefit.payment.date",
+                "path": "ExplanationOfBenefit.payment.date",
+                "mustSupport": true
+            },
+            {
+                "id": "ExplanationOfBenefit.processNote.text",
+                "path": "ExplanationOfBenefit.processNote.text",
+                "mustSupport": true
+            }
+        ]
+    }
+}
\ No newline at end of file
diff --git a/conformance/fhir-ig-carin-bb/src/test/java/com/ibm/fhir/ig/carin/bb/test/ExplanationOfBenefitTest.java b/conformance/fhir-ig-carin-bb/src/test/java/com/ibm/fhir/ig/carin/bb/test/ExplanationOfBenefitTest.java
new file mode 100644
index 00000000000..7aeb49294d0
--- /dev/null
+++ b/conformance/fhir-ig-carin-bb/src/test/java/com/ibm/fhir/ig/carin/bb/test/ExplanationOfBenefitTest.java
@@ -0,0 +1,57 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.ig.carin.bb.test;
+
+import java.util.ArrayList;
+import java.util.List;
+
+import org.testng.Assert;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.model.resource.ExplanationOfBenefit;
+import com.ibm.fhir.model.resource.ExplanationOfBenefit.Item;
+import com.ibm.fhir.model.resource.ExplanationOfBenefit.Item.Adjudication;
+import com.ibm.fhir.model.resource.OperationOutcome.Issue;
+import com.ibm.fhir.model.test.TestUtil;
+import com.ibm.fhir.model.type.Code;
+import com.ibm.fhir.model.type.CodeableConcept;
+import com.ibm.fhir.model.type.Coding;
+import com.ibm.fhir.model.type.Decimal;
+import com.ibm.fhir.model.type.Uri;
+import com.ibm.fhir.validation.FHIRValidator;
+import com.ibm.fhir.validation.util.FHIRValidationUtil;
+
+public class ExplanationOfBenefitTest {
+    @Test
+    public void testExplanationOfBenefit() throws Exception {
+        ExplanationOfBenefit explanationOfBenefit = TestUtil.readExampleResource("json/profiles/fhir-ig-carin-bb/ExplanationOfBenefit-InpatientEOBExample1.json");
+        List<Issue> issues = FHIRValidator.validator().validate(explanationOfBenefit);
+        Assert.assertFalse(FHIRValidationUtil.hasErrors(issues));
+
+        // add an 'allowedunits' adjudication slice to the first item
+        List<Item> items = new ArrayList<>(explanationOfBenefit.getItem());
+        Item item = items.get(0);
+        item = item.toBuilder()
+                .adjudication(Adjudication.builder()
+                    .category(CodeableConcept.builder()
+                        .coding(Coding.builder()
+                            .system(Uri.of("http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator"))
+                            .code(Code.of("allowedunits"))
+                            .build())
+                        .build())
+                    .value(Decimal.of(1))
+                    .build())
+                .build();
+        items.set(0, item);
+        explanationOfBenefit = explanationOfBenefit
+            .toBuilder()
+            .item(items)
+            .build();
+        issues = FHIRValidator.validator().validate(explanationOfBenefit);
+        Assert.assertFalse(FHIRValidationUtil.hasErrors(issues));
+    }
+}
diff --git a/conformance/fhir-ig-davinci-hrex/pom.xml b/conformance/fhir-ig-davinci-hrex/pom.xml
index 6cbbcda425d..8be74f0b33c 100644
--- a/conformance/fhir-ig-davinci-hrex/pom.xml
+++ b/conformance/fhir-ig-davinci-hrex/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-ig-davinci-hrex</artifactId>
diff --git a/conformance/fhir-ig-davinci-pdex-formulary/pom.xml b/conformance/fhir-ig-davinci-pdex-formulary/pom.xml
index 9354bd00b6f..ad19e07195c 100644
--- a/conformance/fhir-ig-davinci-pdex-formulary/pom.xml
+++ b/conformance/fhir-ig-davinci-pdex-formulary/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-ig-davinci-pdex-formulary</artifactId>
diff --git a/conformance/fhir-ig-davinci-pdex-formulary/src/test/java/com/ibm/fhir/ig/davinci/pdex/formulary/tool/ResourceProcessor.java b/conformance/fhir-ig-davinci-pdex-formulary/src/test/java/com/ibm/fhir/ig/davinci/pdex/formulary/tool/ResourceProcessor.java
index e41d6a4d3b1..c0c3d40303f 100644
--- a/conformance/fhir-ig-davinci-pdex-formulary/src/test/java/com/ibm/fhir/ig/davinci/pdex/formulary/tool/ResourceProcessor.java
+++ b/conformance/fhir-ig-davinci-pdex-formulary/src/test/java/com/ibm/fhir/ig/davinci/pdex/formulary/tool/ResourceProcessor.java
@@ -11,14 +11,14 @@
 import java.io.FileReader;
 import java.io.FileWriter;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonWriter;
-import javax.json.JsonWriterFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonWriter;
+import jakarta.json.JsonWriterFactory;
 
 /**
  * This class fixes the following issues with the packaged DaVinci PDEX Formulary artifacts:
diff --git a/conformance/fhir-ig-davinci-pdex-plan-net/pom.xml b/conformance/fhir-ig-davinci-pdex-plan-net/pom.xml
index d3631cbac67..64228e78c88 100644
--- a/conformance/fhir-ig-davinci-pdex-plan-net/pom.xml
+++ b/conformance/fhir-ig-davinci-pdex-plan-net/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-ig-davinci-pdex-plan-net</artifactId>
diff --git a/conformance/fhir-ig-davinci-pdex-plan-net/src/test/java/com/ibm/fhir/ig/davinci/plannet/tool/ResourceProcessor.java b/conformance/fhir-ig-davinci-pdex-plan-net/src/test/java/com/ibm/fhir/ig/davinci/plannet/tool/ResourceProcessor.java
index 6a19239d575..881336b0260 100644
--- a/conformance/fhir-ig-davinci-pdex-plan-net/src/test/java/com/ibm/fhir/ig/davinci/plannet/tool/ResourceProcessor.java
+++ b/conformance/fhir-ig-davinci-pdex-plan-net/src/test/java/com/ibm/fhir/ig/davinci/plannet/tool/ResourceProcessor.java
@@ -10,14 +10,14 @@
 import java.io.FileReader;
 import java.io.FileWriter;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonWriter;
-import javax.json.JsonWriterFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonWriter;
+import jakarta.json.JsonWriterFactory;
 
 /**
  * This class fixes the following issues with the packaged DaVinci PDEX Plan Net artifacts:
diff --git a/conformance/fhir-ig-davinci-pdex/pom.xml b/conformance/fhir-ig-davinci-pdex/pom.xml
index 4e3c3f57ebf..71ff5059813 100644
--- a/conformance/fhir-ig-davinci-pdex/pom.xml
+++ b/conformance/fhir-ig-davinci-pdex/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-ig-davinci-pdex</artifactId>
diff --git a/conformance/fhir-ig-davinci-pdex/src/test/java/com/ibm/fhir/ig/davinci/pdex/tool/SearchParameterAugmenter.java b/conformance/fhir-ig-davinci-pdex/src/test/java/com/ibm/fhir/ig/davinci/pdex/tool/SearchParameterAugmenter.java
index 95380d243f5..24ac088aa3c 100644
--- a/conformance/fhir-ig-davinci-pdex/src/test/java/com/ibm/fhir/ig/davinci/pdex/tool/SearchParameterAugmenter.java
+++ b/conformance/fhir-ig-davinci-pdex/src/test/java/com/ibm/fhir/ig/davinci/pdex/tool/SearchParameterAugmenter.java
@@ -15,6 +15,7 @@
 import java.util.Set;
 import java.util.stream.Collectors;
 
+import com.ibm.fhir.core.FHIRConstants;
 import com.ibm.fhir.model.format.Format;
 import com.ibm.fhir.model.generator.FHIRGenerator;
 import com.ibm.fhir.model.resource.SearchParameter;
@@ -35,7 +36,7 @@
  * to search parameters which always reference code values with a particular system
  */
 public class SearchParameterAugmenter {
-    private static final String IMPLICIT_SYSTEM_EXT_URL = "http://ibm.com/fhir/extension/implicit-system";
+    private static final String IMPLICIT_SYSTEM_EXT_URL = FHIRConstants.EXT_BASE + "implicit-system";
     private static final FHIRGenerator generator = FHIRGenerator.generator(Format.JSON, false);
 
     public static void main(String[] args) throws Exception {
diff --git a/conformance/fhir-ig-mcode/pom.xml b/conformance/fhir-ig-mcode/pom.xml
index 5ad7237f447..9e24e14c83b 100644
--- a/conformance/fhir-ig-mcode/pom.xml
+++ b/conformance/fhir-ig-mcode/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-ig-mcode</artifactId>
diff --git a/conformance/fhir-ig-spl/pom.xml b/conformance/fhir-ig-spl/pom.xml
index 92e8234a767..61b6f3a4498 100644
--- a/conformance/fhir-ig-spl/pom.xml
+++ b/conformance/fhir-ig-spl/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
 
diff --git a/conformance/fhir-ig-us-core/pom.xml b/conformance/fhir-ig-us-core/pom.xml
index c7f9f721d27..bf894044afd 100644
--- a/conformance/fhir-ig-us-core/pom.xml
+++ b/conformance/fhir-ig-us-core/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-ig-us-core</artifactId>
diff --git a/conformance/fhir-ig-us-core/src/test/java/com/ibm/fhir/ig/us/core/tool/ResourceProcessor.java b/conformance/fhir-ig-us-core/src/test/java/com/ibm/fhir/ig/us/core/tool/ResourceProcessor.java
index d636e57db21..1d28173a008 100644
--- a/conformance/fhir-ig-us-core/src/test/java/com/ibm/fhir/ig/us/core/tool/ResourceProcessor.java
+++ b/conformance/fhir-ig-us-core/src/test/java/com/ibm/fhir/ig/us/core/tool/ResourceProcessor.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2020
+ * (C) Copyright IBM Corp. 2020, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -11,14 +11,14 @@
 import java.io.FileReader;
 import java.io.FileWriter;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonWriter;
-import javax.json.JsonWriterFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonWriter;
+import jakarta.json.JsonWriterFactory;
 
 /**
  * This class fixes two issues with the packaged US Core artifacts:
diff --git a/conformance/fhir-ig-us-core/src/test/java/com/ibm/fhir/ig/us/core/tool/SearchParameterAugmenter.java b/conformance/fhir-ig-us-core/src/test/java/com/ibm/fhir/ig/us/core/tool/SearchParameterAugmenter.java
index be5debb539a..bcb42e1ce45 100644
--- a/conformance/fhir-ig-us-core/src/test/java/com/ibm/fhir/ig/us/core/tool/SearchParameterAugmenter.java
+++ b/conformance/fhir-ig-us-core/src/test/java/com/ibm/fhir/ig/us/core/tool/SearchParameterAugmenter.java
@@ -15,6 +15,7 @@
 import java.util.Set;
 import java.util.stream.Collectors;
 
+import com.ibm.fhir.core.FHIRConstants;
 import com.ibm.fhir.model.format.Format;
 import com.ibm.fhir.model.generator.FHIRGenerator;
 import com.ibm.fhir.model.resource.SearchParameter;
@@ -35,7 +36,7 @@
  * to search parameters which always reference code values with a particular system
  */
 public class SearchParameterAugmenter {
-    private static final String IMPLICIT_SYSTEM_EXT_URL = "http://ibm.com/fhir/extension/implicit-system";
+    private static final String IMPLICIT_SYSTEM_EXT_URL = FHIRConstants.EXT_BASE + "implicit-system";
     private static final FHIRGenerator generator = FHIRGenerator.generator(Format.JSON, false);
 
     public static void main(String[] args) throws Exception {
diff --git a/demo/.gitignore b/demo/.gitignore
index 97eefa6cf1f..65ca5bc0fd2 100644
--- a/demo/.gitignore
+++ b/demo/.gitignore
@@ -1 +1,3 @@
 /postgres/db/data/
+/bulkdata/out/*
+!/bulkdata/out/.empty
diff --git a/demo/bulkdata/in/Patient_1.ndjson b/demo/bulkdata/in/Patient_1.ndjson
new file mode 100644
index 00000000000..2d732157cdd
--- /dev/null
+++ b/demo/bulkdata/in/Patient_1.ndjson
@@ -0,0 +1 @@
+{"resourceType":"Patient","id":"Patient1","meta":{"versionId":"1","lastUpdated":"2021-06-04T05:18:29.570489Z","tag":[{"code":"test"},{"code":"test2"}]},"language":"en","identifier":[{"use":"usual"}],"active":true}
diff --git a/fhir-cli/src/test/java/.empty b/demo/bulkdata/out/.empty
similarity index 100%
rename from fhir-cli/src/test/java/.empty
rename to demo/bulkdata/out/.empty
diff --git a/demo/docker-compose.yml b/demo/docker-compose.yml
index 1752eba90cc..7764e0c0a6f 100644
--- a/demo/docker-compose.yml
+++ b/demo/docker-compose.yml
@@ -54,6 +54,9 @@ services:
         source: ./fhir/openapi.json
         target: /opt/ol/wlp/usr/servers/defaultServer/apps/expanded/fhir-openapi.war/META-INF/openapi.json
         read_only: true
+      - type: bind
+        source: ./bulkdata
+        target: /output/bulkdata
     command: bash -c "
       java -jar /opt/ibm-fhir-server/tools/fhir-persistence-schema-*-cli.jar
         --db-type postgresql --prop db.host=postgres --prop db.port=5432 --prop db.database=fhirdb --prop user=fhiradmin --prop password=change-password
diff --git a/demo/fhir/config/default/fhir-server-config.json b/demo/fhir/config/default/fhir-server-config.json
index 498bb0208fb..59cbd55992e 100644
--- a/demo/fhir/config/default/fhir-server-config.json
+++ b/demo/fhir/config/default/fhir-server-config.json
@@ -178,32 +178,19 @@
           "truststorePassword": "change-password",
           "trustAll": true
         },
-        "cos" : {
-          "partUploadTriggerSizeMB": 10,
-          "objectSizeThresholdMB": 200,
-          "objectResourceCountThreshold": 200000,
-          "useServerTruststore": true
-        },
-        "pageSize": 100,
-        "batchIdEncryptionKey": "change-password",
-        "maxPartitions": 3,
-        "maxInputs": 5
+        "defaultImportProvider": "in",
+        "defaultExportProvider": "out"
       },
       "storageProviders": {
-        "default" : {
-          "type": "ibm-cos",
-          "bucketName": "${COS_BUCKET}",
-          "location": "${COS_LOCATION}",
-          "endpointInternal": "${COS_ENDPOINT_INTERNAL}",
-          "endpointExternal": "${COS_ENDPOINT_EXTERNAL}",
-          "auth" : {
-            "type": "hmac",
-            "accessKeyId": "${COS_ACCESS_KEY}",
-            "secretAccessKey": "${COS_SECRET_KEY}"
-          },
-          "__exportPublic": false,
-          "__disableOperationOutcomes": true,
-          "presigned": true
+        "in" : {
+            "type": "file",
+            "fileBase": "/output/bulkdata/in",
+            "duplicationCheck": false,
+            "validateResources": false
+        },
+        "out" : {
+            "type": "file",
+            "fileBase": "/output/bulkdata/out"
         }
       }
     }
diff --git a/demo/fhir/configDropins/overrides/datasource.xml b/demo/fhir/configDropins/overrides/datasources.xml
similarity index 53%
rename from demo/fhir/configDropins/overrides/datasource.xml
rename to demo/fhir/configDropins/overrides/datasources.xml
index 576cfbf48a5..9fbb31d6402 100644
--- a/demo/fhir/configDropins/overrides/datasource.xml
+++ b/demo/fhir/configDropins/overrides/datasources.xml
@@ -14,4 +14,18 @@
          />
         <connectionManager maxPoolSize="200" minPoolSize="40"/>
     </dataSource>
+
+    <!-- The default bulkdata.xml config includes a batchPersistence element that
+    references a databaseStore that references a dataSource with id=fhirbatchDS, meaning
+    that this dataSource will be automatically picked up and used for bulkdata jobs. -->
+    <dataSource id="fhirbatchDS" jndiName="jdbc/fhirbatchDB" type="javax.sql.XADataSource" statementCacheSize="200" syncQueryTimeoutWithTransactionTimeout="true">
+        <jdbcDriver javax.sql.XADataSource="org.postgresql.xa.PGXADataSource" libraryRef="sharedLibPostgres"/>
+        <properties.postgresql
+            serverName="postgres"
+            portNumber="5432"
+            databaseName="fhirdb"
+            user="fhiradmin"
+            password="change-password"
+          />
+    </dataSource>
 </server>
diff --git a/demo/fhir/userlib/fhir-ig-us-core-4.7.1.jar b/demo/fhir/userlib/fhir-ig-us-core-4.7.1.jar
deleted file mode 100644
index ff18566fd08..00000000000
Binary files a/demo/fhir/userlib/fhir-ig-us-core-4.7.1.jar and /dev/null differ
diff --git a/demo/postgres/resources/docker-entrypoint.sh b/demo/postgres/resources/docker-entrypoint.sh
index eeeb5b8bae4..73e0af642a2 100644
--- a/demo/postgres/resources/docker-entrypoint.sh
+++ b/demo/postgres/resources/docker-entrypoint.sh
@@ -20,9 +20,9 @@ then
     sed -ri "s!^#?(listen_addresses)\s*=\s*\S+.*!\1 = '*'!" /db/data/postgresql.conf
 
     # Configuration
-    sed -i -e "s/^max_connections = 100.*$/max_connections = 100/" \
-           -e "s/^max_prepared_transactions = 100.*$/max_prepared_transactions = 100/" \
-           -e "s/^max_locks_per_transaction = .*$/max_locks_per_transaction = 128/" \
+    sed -i -e "s/^max_connections = .*$/max_connections = 100/" \
+           -e "s/^#max_prepared_transactions = .*$/max_prepared_transactions = 100/" \
+           -e "s/^#max_locks_per_transaction = .*$/max_locks_per_transaction = 128/" \
            -e "s/^shared_buffers =.*$/shared_buffers = 4GB/" \
            -e "s/^#effective_cache_size = 128MB.*$/effective_cache_size = 2GB/" \
            -e "s/^#work_mem = 1MB.*$/work_mem = 1MB/" \
diff --git a/docs/src/pages/Conformance.md b/docs/src/pages/Conformance.md
index a12fac10db4..3b0a69c7d80 100644
--- a/docs/src/pages/Conformance.md
+++ b/docs/src/pages/Conformance.md
@@ -2,7 +2,7 @@
 layout: post
 title:  Conformance
 description: Notes on the Conformance of the IBM FHIR Server
-date:   2021-05-19
+date:   2021-05-26
 permalink: /conformance/
 ---
 
@@ -12,7 +12,7 @@ The IBM FHIR Server aims to be a conformant implementation of the HL7 FHIR speci
 ## Capability statement
 The HL7 FHIR specification defines [an interaction](https://www.hl7.org/fhir/R4/http.html#capabilities) for retrieving a machine-readable description of the server's capabilities via the `[base]/metadata` endpoint. The IBM FHIR Server implements this interaction and generates a `CapabilityStatement` resource based on the current server configuration. While the `CapabilityStatement` resource is ideal for certain uses, this markdown document provides a human-readable summary of important details, with a special focus on limitations of the current implementation and deviations from the specification.
 
-The IBM FHIR Server supports only version 4.0.1 of the specification and ignores the optional MIME-type parameter `fhirVersion`.
+The IBM FHIR Server supports only version 4.0.1 of the specification.
 
 ## FHIR HTTP API
 The HL7 FHIR specification is more than just a data format. It defines an [HTTP API](https://www.hl7.org/fhir/R4/http.html) for creating, reading, updating, deleting, and searching over FHIR resources. The IBM FHIR Server implements the full API for every resource defined in the specification, with the following exceptions:
@@ -213,7 +213,7 @@ To ensure consistency of search results, clients are recommended to include the
 
 Finally, the server extends the specified capabilities with support for "exact match" semantics on fractional seconds.
 
-Query parameter values without fractional seconds are handled as an implicit range. For example, a search like `Observatoin?date=2019-01-01T12:00:00Z` would return resources with the following effectiveDateTime values:
+Query parameter values without fractional seconds are handled as an implicit range. For example, a search like `Observation?date=2019-01-01T12:00:00Z` would return resources with the following effectiveDateTime values:
 * 2019-01-01T12:00:00Z
 * 2019-01-01T12:00:00.1Z
 * 2019-01-01T12:00:00.999999Z
diff --git a/docs/src/pages/blog/raspberrypi4howto.mdx b/docs/src/pages/blog/raspberrypi4howto.mdx
index 2d3b4e73653..aadf0fd86d9 100644
--- a/docs/src/pages/blog/raspberrypi4howto.mdx
+++ b/docs/src/pages/blog/raspberrypi4howto.mdx
@@ -2,7 +2,7 @@
 layout: post
 title:  IBM FHIR Server on the Raspberry Pi 4
 description: IBM FHIR Server on the Raspberry Pi 4
-date:   2019-10-08 09:59:05 -0400
+date:   2021-06-07
 ---
 
 ![IBM FHIR Server on Raspberry Pi 4](https://ibm.github.io/FHIR/images/piOnFhir30.jpg)
@@ -130,7 +130,6 @@ Some exceptions from negative tests may appear in the build log. As long as the
 [INFO] fhir-operation-document ............................ SUCCESS [  1.074 s]
 [INFO] fhir-operation-healthcheck ......................... SUCCESS [  0.547 s]
 [INFO] fhir-client ........................................ SUCCESS [ 12.460 s]
-[INFO] fhir-cli ........................................... SUCCESS [ 12.682 s]
 [INFO] fhir-notification .................................. SUCCESS [  0.971 s]
 [INFO] fhir-notification-kafka ............................ SUCCESS [  0.769 s]
 [INFO] fhir-notification-websocket ........................ SUCCESS [  0.931 s]
diff --git a/docs/src/pages/guides/BringYourOwnPersistence.md b/docs/src/pages/guides/BringYourOwnPersistence.md
index 3d496eac2c5..11ca0bff940 100644
--- a/docs/src/pages/guides/BringYourOwnPersistence.md
+++ b/docs/src/pages/guides/BringYourOwnPersistence.md
@@ -2,73 +2,81 @@
 layout: post
 title: Bring your own Persistence Layer
 description: Learn how to build and test a persistence layer for the IBM FHIR Server
-date:   2020-08-31 14:55:00 -0400
+date:   2021-06-01
 permalink: /BringYourOwnPersistence/
 ---
 
 ## Overview
-The IBM FHIR Server ships with a JDBC persistence layer that works with IBM Db2, PostgreSQL and Apache Derby.
-However, based on the modular design, its possible to add support for other relational databases and/or
-plug in any other persistence layer.
+The IBM FHIR Server is a modular Java implementation of the HL7 FHIR specification with a focus on performance and configurability. The IBM FHIR Server ships with a JDBC persistence layer that works with IBM Db2, PostgreSQL and Apache Derby. With this modular design, it's possible to add support for other relational databases and/or plug in any other persistence layer.
+
+This document outlines the interfaces that need to be implemented and the behaviors required for the related methods to work with the IBM FHIR Server.
 
 ### Interfaces
-Persistence layer interfaces are defined in the `fhir-persistence` project.
+Persistence layer interfaces are defined in the `fhir-persistence` module.
+
 * [FHIRPersistence](https://github.com/IBM/FHIR/blob/main/fhir-persistence/src/main/java/com/ibm/fhir/persistence/FHIRPersistence.java) defines the contract between the REST layer and the persistence layer.
 * [FHIRPersistenceFactory](https://github.com/IBM/FHIR/blob/main/fhir-persistence/src/main/java/com/ibm/fhir/persistence/FHIRPersistenceFactory.java) is the interface for providing instances of FHIRPersistence to the server.
 
-### Config
-Which persistence layer is used by the server is determined by the `/fhirServer/persistence/factoryClassname` property in `fhir-server-config.json`.
+### Configuration
+Which persistence layer is used by the server is determined by the `/fhirServer/persistence/factoryClassname` property in `fhir-server-config.json`. There is more detail on the configuration in the [IBM FHIR Server's User Guide](https://ibm.github.io/FHIR/guides/FHIRServerUsersGuide#33-persistence-layer-configuration)
 
-When the default `com.ibm.fhir.persistence.jdbc.FHIRPersistenceJDBCFactory` is used, the returned FHIRPersistenceJDBCImpl instance will look up a corresponding datasource, by JNDI name, using the combination of the tenant id and datastore id from the request context. Specifically, the connection strategy will use the `fhirServer/persistence/<datastore_id>/jndiName` property in the tenant config, or--if the property is omitted--it will construct the name via the following pattern:
-```
-jdbc/fhir_<tenant_id>_<datastore_id>[_ro]
+When the default `com.ibm.fhir.persistence.jdbc.FHIRPersistenceJDBCFactory` is used, the returned FHIRPersistenceJDBCImpl instance will look up a corresponding datasource, by JNDI name, using the combination of the tenant id and datastore id from the request context. Specifically, the connection strategy will use the `fhirServer/persistence/<datasourceId>/jndiName` property in the tenant config, or -- if the property is omitted --it will construct the name via the following pattern:
+
+``` md
+jdbc/fhir_<tenantId>_<datasourceId>[_ro]
 ```
 
+Note, the `_ro` postfix means the datasource is 'Read Only'.
+
 ## Adding support for another relational database
 Adding a new relational database type is not for the faint of heart, but the IBM FHIR Server team is here to help!
-To add support for an alternative relational database, there are multiple projects to consider:
+To add support for an alternative relational database, there are multiple modules to consider:
 
 1. `fhir-database-utils`
 2. `fhir-persistence-schema`
 3. `fhir-persistence-jdbc`
 
-The `fhir-database-utils` project provides generic utilities for defining a PhysicalDataModel and applying it to a target database via the IDatabaseAdapter and IVersionHistoryService interfaces. Check out the `com.ibm.fhir.database.utils.db2` and `com.ibm.fhir.database.utils.derby` packages to understand how you might extend the framework with support for a new database type.
+The `fhir-database-utils` module provides generic utilities for defining a PhysicalDataModel and applying it to a target database via the IDatabaseAdapter and IVersionHistoryService interfaces. Check out the `com.ibm.fhir.database.utils.db2`, `com.ibm.fhir.database.utils.postgres` and `com.ibm.fhir.database.utils.derby` packages to understand how you might extend the framework with support for a new database type.
+
+The `fhir-persistence-schema` module is used to programmatically construct DDL statements and execute them against a target database. This module uses the generic utilities in `fhir-database-utils` to deploy both an admin schema (used for tenant provisioning and schema versioning) and an application schema for the FHIR data.
+
+Presently, the `fhir-persistence-schema` and `fhir-persistence-jdbc` modules work with Postgres, Derby and Db2 databases, but it should be possible to either:
 
-The `fhir-persistence-schema` project is used to programmatically construct DDL statements and execute them against a target database. This project uses the generic utilities in `fhir-persistence-utils` to deploy both an admin schema (used for tenant provisioning and schema versioning) and an application schema for the FHIR data.
-Presently, this project is written for use with a Db2 database, but it should be possible to either:
+1. Print the DDL and manually tweak it for your desired database; or
+2. Add configuration to control which IDatabaseAdapter and IDatabaseTranslator are used.
 
-A. Print the DDL and manually tweak it for your desired database; or
-B. Add some kind of configuration to control which IDatabaseAdapter and IDatabaseTranslator are used.
+Note, the Db2 implementation uses stored procedures, the Postgres implementation uses Functions, and the Derby implementation is JDBC.
 
-Note that the Db2 implementation makes use of stored procedures whereas the derby implementation is pure JDBC.
+Finally, the `fhir-persistence-jdbc` module provides the default implementation of the `FHIRPersistence` interface.
 
-Finally, the `fhir-persistence-jdbc` project provides the default implementation of the `FHIRPersistence` interface.
-The project makes heavy use of Data Access Objects (DAO) and Data Transfer Objects (DTO) to abstract the details of the database. Most of the code is common across database types, but there is a branch in `ResourceDAOImpl.insert` which corresponds to the differences between the IBM Db2 (stored procedure) and Apache Derby (pure JDBC) implementations.
+The module makes heavy use of Data Access Objects (DAO) and Data Transfer Objects (DTO) to abstract the details of the database. Most of the code is common across database types, but there is a branch in `ResourceDAOImpl.insert` which corresponds to the differences between the IBM Db2/Postgres flavors and Apache Derby (pure JDBC) flavor of implementation.
 
 ## Building your own persistence layer
 Most FHIR projects are interoperability projects--the data already exists in some datastore.
-Due to performance considerations and the complexities of the FHIR API (especially search), we generally recommend converting that data to FHIR and storing it in the FHIR server's database. However, in some cases, it might be better to configure the FHIR server to work directly with an existing datastore or APIs.
 
-If you are using Maven, add the following dependencies to your persistence layer project (replacing the version variables with your desired version):
-```
-        <dependency>
-            <groupId>com.ibm.fhir</groupId>
-            <artifactId>fhir-persistence</artifactId>
-            <version>${fhir.persistence.version}</version>
-        </dependency>
-        <dependency>
-            <groupId>com.ibm.fhir</groupId>
-            <artifactId>fhir-persistence</artifactId>
-            <version>${fhir.persistence.version}</version>
-            <type>test-jar</type>
-            <scope>test</scope>
-        </dependency>
-        <dependency>
-            <groupId>com.ibm.fhir</groupId>
-            <artifactId>fhir-examples</artifactId>
-            <version>${fhir.examples.version}</version>
-            <scope>test</scope>
-        </dependency>
+Due to performance considerations and the complexities of the FHIR API (especially search), we generally recommend converting that data to FHIR and storing the binary representation in the IBM FHIR Server's database. However, in some cases, it might be better to configure the IBM FHIR Server to work directly with an existing datastore or APIs.
+
+If you are using Maven, add the following dependencies to your persistence layer module (replacing the version variables with your desired version):
+
+``` xml
+<dependency>
+    <groupId>com.ibm.fhir</groupId>
+    <artifactId>fhir-persistence</artifactId>
+    <version>${fhir.persistence.version}</version>
+</dependency>
+<dependency>
+    <groupId>com.ibm.fhir</groupId>
+    <artifactId>fhir-persistence</artifactId>
+    <version>${fhir.persistence.version}</version>
+    <type>test-jar</type>
+    <scope>test</scope>
+</dependency>
+<dependency>
+    <groupId>com.ibm.fhir</groupId>
+    <artifactId>fhir-examples</artifactId>
+    <version>${fhir.examples.version}</version>
+    <scope>test</scope>
+</dependency>
 ```
 
 You might also want to set up `fhir-persistence-jdbc` to use an example.
@@ -89,6 +97,8 @@ If `SingleResourceResult.success` is set to true, the `SingleResourceResult.reso
 
 If `SingleResourceResult.success` is set to false, the `SingleResourceResult.outcome` should be an OperationOutcome with a list of one or more issues that prevented the success of the operation.
 
+Note that a `generateResourceId` implementation is required to generate server-assigned resource ids. For performance reasons, recommend the use of `TimestampPrefixedUUID`.
+
 #### Read
 Read requests include a FHIRPersistenceContext, a Class object for the resource type being read, and the logical id of the resource to read.
 Implementations should check the FHIRSearchContext of the FHIRPersistenceContext to determine whether the caller would like the full resource back, the resource text or data, or just a summary (see `FHIRSearchContext.getSummaryParameter()`).
@@ -107,11 +117,11 @@ Note: we plan to deprecate these exceptions and use only `SingleResourceResult`
 Version read requests work just like read requests except that the caller passes a version identifier and the persistence implementation must return that specific version of the resource.
 
 #### Update
-Update requests include a FHIRPersistenceContext, a resource logical id, and an updated version of the resource to save. FHIRPersistence implementations must set the `Resource.meta.lastUpdate` and `Resource.meta.versionId` elements before storing it. Typically, implementations will set the version of the updated resource based on the previous version of the resource which can be found in the FHIRPersistenceEvent (`FHIRPersistenceEvent.getPrevFhirResource()`) of the FHIRPersistenceContext.
+Update requests include a FHIRPersistenceContext, a resource logical id, and an updated version of the resource to save. FHIRPersistence implementations must set the `Resource.meta.lastUpdate` and `Resource.meta.versionId` elements before storing it. Typically, implementations set the version of the updated resource based on the previous version of the resource which can be found in the FHIRPersistenceEvent (`FHIRPersistenceEvent.getPrevFhirResource()`) of the FHIRPersistenceContext.
 
 Note: at the REST layer, an update request will first invoke read and then invoke update. Similarly, PATCH requests are converted to normal updates before reaching the persistence layer's update implementation.
 
-FHIRPersistence implementations SHOULD use the value of the `fhirServer/persistence/common/updateCreateEnabled` property to determine whether they should allow an update to a resource that doesn't exist yet.
+FHIRPersistence implementations SHOULD use the value of the [`fhirServer/persistence/common/updateCreateEnabled`](https://ibm.github.io/FHIR/guides/FHIRServerUsersGuide#45-updatecreate-feature) property to determine whether they should allow an update to a resource that doesn't exist yet.
 
 #### Delete
 Delete requests include a FHIRPersistenceContext, a Class object for the resource type being deleted, and the logical id of the resource to delete.
@@ -127,6 +137,8 @@ Similarly, FHIRPersistence implementations should check and honor the the `since
 
 In addition to setting the MultiResourceResult success indicator and the resource version instances for the requested page, FHIRPersistence implementations must set the total number of versions for the requested resource (`FHIRPagingContext.setTotalCount(int)`) and a map of deleted resource versions (`FHIRHistoryContext.setDeletedResources()`) for the REST layer to properly construct the response bundle and accurately reflect which versions are deletes (rather than updates).
 
+The FHIRPersistence also supports whole system `_history`. If supported, `isChangesSupported` must return true, and `changes` must be implemented to return a list of ResourceChangeLogRecord DTOs.
+
 #### Search
 The [FHIR Search specification](https://www.hl7.org/fhir/R4/search.html) is sprawling and difficult to implement in its entirety. At the persistence layer, search requests will include a FHIRPersistenceContext with an embedded FHIRSearchContext and a Class object to indicate the resource type(s) to search on.
 A Class of `com.ibm.fhir.model.type.Resource` is passed for searches performed at the "whole-system" level.
@@ -143,12 +155,23 @@ On success, set `MultiResourceResult.success` to true and set `MultiResourceResu
 
 On failure, set `MultiResourceResult.success` to false and set `MultiResourceResult.outcome` to an OperationOutcome with one or more issues which indicate the failure.
 
+#### Extended Operations
+
+The IBM FHIR Server supports [extended operations](https://www.hl7.org/fhir/operations.html). The IBM FHIR Server has some operations which use custom persistence interactions: 
+
+| Operation Name | Interfaces to implement |
+|----------------|-------------------------|
+| `$healthcheck` | `getHealth` must be implemented to indicate if the persistence layer is in a healthy state and can access the data store |
+| `$erase`  | `erase` must be implemented so that ResourceEraseRecord is returned for each Erase operation.  If not implemented it throws an exception|
+| `$export` | `fetchResourcePayloads` must be implemented so that the ResourcePayload is returned as a BinaryStream |
+| `$reindex`| `isReindexSupported` must be true and, if true, `reindex` must be implemented so that users can apply the latest search configuration to a resource after it is already ingested|
+
 ## Testing your persistence layer
-In addition to defining the interfaces, the `fhir-persistence` project includes a set of tests that you can extend to test your implementation.
+In addition to defining the interfaces, the `fhir-persistence` module includes a set of tests that you can extend to test your implementation.
 
-Most of the tests defined in this project relate to search, but they also exercise the create, update, and delete interactions in the process.
-The tests in the `com.ibm.fhir.persistence.search.test` package are organized by search parameter type and they utilize tenant-specific search parameter definitions from the `fhir-persistence/src/test/resources/config` directory and search for fields on the generated example resources at `fhir-examples/src/main/resources/json/ibm/basic`.
+Most of the tests defined in this module relate to search, but they also exercise the create, update, and delete interactions in the process.
+The tests in the `com.ibm.fhir.persistence.search.test` package are organized by search parameter type and they utilize tenant-specific search parameter definitions from the `fhir-persistence/src/test/resources/config` directory and search for fields on the generated example resources at `fhir-examples/src/main/resources/json/ibm/basic`. The `fhir-examples` module is available on Maven Central [link](https://repo1.maven.org/maven2/com/ibm/fhir/fhir-examples/).
 
 For an example of how to extend these tests, see the `com.ibm.fhir.persistence.jdbc.search.test` package under `fhir-persistence-jdbc/src/test/java`.
 
-Finally, the IBM FHIR Server contains a number of end-to-end (e2e) integration tests under the `fhir-server-test` project. These tests can be executed against a running server that is configured with your persistence layer to provide further confidence in your implementation.
+Finally, the IBM FHIR Server contains a number of end-to-end (e2e) integration tests under the [`fhir-server-test`](https://github.com/IBM/FHIR/tree/main/fhir-server-test) module. These tests can be executed against a running server that is configured with your persistence layer to provide further confidence in your implementation.
diff --git a/docs/src/pages/guides/DB2OnCloudSetup.md b/docs/src/pages/guides/DB2OnCloudSetup.md
index 5e368b7bc41..09f3db2fb47 100644
--- a/docs/src/pages/guides/DB2OnCloudSetup.md
+++ b/docs/src/pages/guides/DB2OnCloudSetup.md
@@ -2,7 +2,7 @@
 layout: post
 title:  Setup for IBM Db2 on Cloud
 description: Setup for IBM Db2 on Cloud
-date:   2020-04-03 09:59:05 -0400
+date:   2021-06-01
 permalink: /FHIR/guides/DB2OnCloudSetup
 ---
 
@@ -18,8 +18,8 @@ This document guides a developer or administrator through the steps necessary to
 
 1. Choose [Db2](https://cloud.ibm.com/catalog/services/db2).
 
-1. Select the Pricing Plan
-    - The IBM FHIR Server does not support using the *Lite* plan.
+1. Select the Pricing Plan - `Standard` or `Enterprise`
+    - Note, the IBM FHIR Server does not support using the *Lite* plan.
 
 1. Create `Create`
 
@@ -35,8 +35,6 @@ Note:
 
 ### **Create the administrator credential**
 
-The administrator is `BLUADMIN` but you need to create a credential.
-
 1. Navigate to the Db2 instance you created.
 
 1. Click on the `Service credentials` panel.
@@ -47,35 +45,76 @@ The administrator is `BLUADMIN` but you need to create a credential.
 
 1. Access the credential, select View Credentials. The entry you just created looks like the following block of JSON(the secrets are blanked out here):
 
-    ``` json
-    {
-        "hostname": "dashdb-txn-***-***********.services.dal.bluemix.net",
-        "password": "bluadmin-password-very-secret",
-        "https_url": "https://dashdb-txn-***-************.services.dal.bluemix.net:8443",
-        "port": 50000,
-        "ssldsn": "DATABASE=BLUDB;HOSTNAME=dashdb-txn-***-************.services.dal.bluemix.net;PORT=50001;PROTOCOL=TCPIP;UID=bluadmin;PWD=bluadmin-password-very-secret;Security=SSL;",
-        "host": "dashdb-txn-***-************.services.dal.bluemix.net",
-        "jdbcurl": "jdbc:db2://dashdb-txn-***-************.services.dal.bluemix.net:50000/BLUDB",
-        "uri": "db2://bluadmin:bluadmin-password-very-secret@dashdb-txn-***-************.services.dal.bluemix.net:50000/BLUDB",
-        "db": "BLUDB",
-        "dsn": "DATABASE=BLUDB;HOSTNAME=dashdb-txn-***-************.services.dal.bluemix.net;PORT=50000;PROTOCOL=TCPIP;UID=bluadmin;PWD=bluadmin-password-very-secret;",
-        "username": "bluadmin",
-        "ssljdbcurl": "jdbc:db2://dashdb-txn-***-************.services.dal.bluemix.net:50001/BLUDB:sslConnection=true;"
+``` json
+{
+  "apikey": "******",
+  "connection": {
+    ...
+    "db2": {
+      "authentication": {
+        "method": "direct",
+        "password": "P1234",
+        "username": "username1"
+      },
+      "certificate": {
+        "certificate_base64": "secret=",
+        "name": "9e529eec-97df-4574-8839-12345"
+      },
+      "composed": [
+        "db2://username1:P1234@1-2-3-4.databases.appdomain.cloud:31366/bludb?authSource=admin&replicaSet=replset"
+      ],
+      "database": "bludb",
+      "host_ros": [
+        "1-2-3-4.databases.appdomain.cloud:32116"
+      ],
+      "hosts": [
+        {
+          "hostname": "1-2-3-4.databases.appdomain.cloud",
+          "port": 31366
+        }
+      ],
+      "jdbc_url": [
+        "jdbc:db2://1-2-3-4.databases.appdomain.cloud:31366/bludb:user=<userid>;password=<your_password>;sslConnection=true;"
+      ],
+      "path": "/bludb",
+      "query_options": {
+        "authSource": "admin",
+        "replicaSet": "replset"
+      },
+      "replica_set": "replset",
+      "scheme": "db2",
+      "type": "uri"
     }
-    ```
+  },
+  "iam_apikey_description": "Auto-generated for key username1-fc89-48e1-a1ce-569ca6c6e3d5",
+  "iam_apikey_name": "Service credentials-1",
+  "iam_role_crn": "crn:v1:bluemix:public:iam::::serviceRole:Manager",
+  "iam_serviceid_crn": "secret",
+  "instance_administration_api": {
+    "deployment_id": "crn:v1:bluemix:public:dashdb-for-transactions:us-east:a/secret:",
+    "instance_id": "crn:v1:bluemix:public:dashdb-for-transactions:us-east:a/secret::",
+    "root": "https://api.us-east.db2.cloud.ibm.com/v4/ibm"
+  }
+}
+```
 
 4. Save these details for later, as these properties are needed to deploy and manage the IBM FHIR Server schema.
 
-For improved security, the **BLUADMIN** user should only be used to deploy the schema objects (tables, indexes, stored procedures etc) and administer the database, NOT for connecting from the fhir-server application.
+For improved security, the **admin** user should only be used to deploy the schema objects (tables, indexes, stored procedures etc) and administer the database, NOT for connecting from the IBM FHIR Server application.
 
-### **Add the FHIRSERVER user and API key**
+### **Adding the FHIRSERVER user**
 
-Following the least-privilege principle, the IBM FHIR server itself does not use **BLUADMIN**. The IBM FHIR server uses an API Key associated with an [IAM Service Id](https://cloud.ibm.com/iam/serviceids). The IAM Service Id is mapped to a Db2 user which is granted explicit privileges to the tables and stored procedures.
+Following the least-privilege principle, the IBM FHIR server itself recommends running as db user, not db administrator.
+
+#### Using IAM apiKey
+The IBM FHIR Server uses an API Key associated with an [IAM Service Id](https://cloud.ibm.com/iam/serviceids). The IAM Service Id is mapped to a Db2 user which is granted explicit privileges to the tables and stored procedures.
 
 The IBM FHIR Server uses the access flow:
 
 1. Read API Key and the tenant key from the fhir-server-config.json
+
 2. Connect to Db2 to access authenticated data using IAM
+
 3. Confirm tenant-key to access authorized data
 
 The steps to create the API key are:
@@ -116,9 +155,9 @@ Before the API key can be used, you need to create a Db2 user and associate it w
 
 1. Click on Open Console.
 
-1. Click `SETTINGS` > `Manage Users`.
+1. Click Administration > User Management
 
-    - Note: If you do not see `Manage Users`, you are probably using a [non-IAM instance](https://www.ibm.com/support/knowledgecenter/SS6NHC/com.ibm.swg.im.dashdb.security.doc/doc/iam.html). To confirm:
+    - To confirm the IAM instance:
         1. Click Run Sql
         1. Enter the SQL
             ``` sql
@@ -142,10 +181,23 @@ Before the API key can be used, you need to create a Db2 user and associate it w
 
 You are now able to connect to the database as the FHIRSERVER user using only the API key created above.
 
+#### Using Db2 Auth
+
+1. On the Db2 Resource, click `Manage`
+
+2. Click `Open Console`
+
+3. Click Administration > User Management
+
+4. Click Add User, and enter the user details with a sufficiently complex password. Set the `User Privilege` as `User`. 
+
+5. Save these details for the datasource.xml.
+
 ### **Testing the connection**
 
 The [Db2 driver](https://repo1.maven.org/maven2/com/ibm/db2/jcc/11.5.0.0/jcc-11.5.0.0.jar) is able to execute a connectivity test to check the configuration of the combo of API-key/Service-Id/Db2-User-Id.
 
+#### Test IAM Access
 1. Copy the command to your code editor
 
     ``` bash
@@ -164,9 +216,31 @@ The [Db2 driver](https://repo1.maven.org/maven2/com/ibm/db2/jcc/11.5.0.0/jcc-11.
 
 1. Run in your favorite terminal, and you should see no errors in the output. You should see output like:
 
-```
-[jcc][10516][13709]Test Connection Successful.
-```
+    ```
+    [jcc][10516][13709]Test Connection Successful.
+    ```
+
+#### Test Db2 Auth Access
+1. Copy the command to your code editor
+
+    ``` bash
+    java -cp /path/to/db2jcc4.jar com.ibm.db2.jcc.DB2Jcc  -url "jdbc:db2://<DB2-HOSTNAME>:50001/bludb:user=<userid>;password=<your_password>;sslConnection=true;sslTrustStoreLocation=/path/to/truststore.jks;sslTrustStorePassword=<TRUSTSTORE-PASSWORD>;"
+    ```
+
+    - Note: Don't forget the trailing `;` in the URL. Some of the documented examples don't include it, but it is required in order for the connection to work, although this may be fixed in a future driver release. This only affects this test URL, not the actual FHIR server configuration.
+
+1. Replace the following values with your service details:
+    - `/path/to/db2jcc4.jar` : replace with the path to your driver jar.
+    - `<DB-HOSTNAME>`: the hostname of your Db2 service from the Service Credentials page
+    - `<userid>`: The userid to acecss the db
+    - `<your_password>`: The password to access the db with
+    - `<TRUSTSTORE-PASSWORD>`: the password for your truststore
+
+1. Run in your favorite terminal, and you should see no errors in the output. You should see output like:
+
+    ``` bash
+    [jcc][10516][13709]Test Connection Successful.
+    ```
 
 ### **Deploy the IBM FHIR Server schema**
 
@@ -174,67 +248,110 @@ Now that you've created the database and credentials, use the `fhir-persistence-
 
 1. download the `fhir-persistence-schema` cli jar from the corresponding project release: https://github.com/IBM/FHIR/releases
 
-2. create a properties file named db2.properties with the db2 connection info from IBM Cloud; for example:
-    ```
-    db.host=dashdb-txn-***-***********.services.dal.bluemix.net
+2. create a properties file named db2.properties with the Db2 Admin connection info from IBM Cloud; for example:
+
+    ``` sh
+    db.host=1-2-3-4.databases.appdomain.cloud
     db.port=50001
-    db.database=BLUDB
-    user=bluadmin
-    password=bluadmin-password-very-secret
+    db.database=bludb
+    user=myuser
+    password=mypassword
     sslConnection=true
     ```
 
 3. execute the following commands:
-    ```sh
+
+    ``` sh
     java -jar schema/fhir-persistence-schema-*-cli.jar \
       --prop-file db2.properties --schema-name FHIRDATA --create-schemas
     java -jar schema/fhir-persistence-schema-*-cli.jar \
-      --prop-file db2.properties --schema-name FHIRDATA --update-schema --pool-size 2
+      --prop-file db2.properties --schema-name FHIRDATA --update-schema
     java -jar schema/fhir-persistence-schema-*-cli.jar \
-      --prop-file db2.properties --schema-name FHIRDATA --grant-to FHIRSERVER --pool-size 2
+      --prop-file db2.properties --schema-name FHIRDATA --grant-to FHIRSERVER
     java -jar schema/fhir-persistence-schema-*-cli.jar \
-      --prop-file db2.properties --schema-name FHIRDATA --allocate-tenant default --pool-size 2
+      --prop-file db2.properties --schema-name FHIRDATA --allocate-tenant default
     ```
 
-4. note the tenantKey from the allocate-tenant step above; this will be needed to configure the IBM FHIR Server datasource in the next step
+4. save the tenantKey from the `allocate-tenant` step above; this is needed to configure the IBM FHIR Server datasource in the next step
 
 For more information on using the fhir-persistence-schema cli jar, see https://github.com/IBM/FHIR/tree/main/fhir-persistence-schema/README.md.
 
 ### **Configuring an IBM FHIR Server datasource**
 
-The IBM FHIR Server uses a proxy datasource mechanism, allowing new datasources to be added at runtime without requiring a (Liberty Profile) server restart. To configure a FHIR tenant datasource using an API-KEY, use the following template:
+The IBM FHIR Server uses the native Open Liberty datasources. To configure a FHIR tenant datasource for a tenantKey, use the following template in the fhir-server-config.json:
 
 ``` json
         "persistence": {
             "datasources": {
                 "default": {
-                    "tenantKey": "",
+                    "tenantKey": "myTenantKey",
+                    "currentSchema": "${DB_SCHEMA}",
                     "hints" : {
                         "search.reopt": "ONCE"
                     },
                     "type": "db2",
-                    "connectionProperties": {
-                        "serverName": "dashdb-txn-***-************.services.dal.bluemix.net",
-                        "portNumber": 50001,
-                        "databaseName": "BLUDB",
-                        "apiKey": "<API-KEY>",
-                        "securityMechanism": 15,
-                        "pluginName": "IBMIAMauth",
-                        "currentSchema": "FHIRDATA",
-                        "driverType": 4,
-                        "sslConnection": true,
-                        "sslTrustStoreLocation": "resources/security/dbTruststore.jks",
-                        "sslTrustStorePassword": "change-password"
-                    }
                 }
             }
         }
 ```
 
-The persistence configuration is stored in the `fhir-server-config.json` in the tenant and default configuration folders.
-
 Since release 4.3.2 you can use the `search.reopt` query optimizer hint (shown above) to improve the performance of certain search queries involving multiple search parameters. This optimization is currently only available for Db2. Valid values are "ALWAYS" and "ONCE". See Db2 documentation for `REOPT` for more details.
 
+To configure the datasource.xml for db2 create a datasource.xml for the configDropins folder.
+
+#### For IAM User
+
+Create a file as the following
+
+``` xml
+<server>
+    <!-- ============================================================== -->
+    <!-- TENANT: default; DSID: default; TYPE: read-write               -->
+    <!-- ============================================================== -->
+    <dataSource id="fhirDefaultDefault" jndiName="jdbc/fhir_default_default" type="javax.sql.XADataSource" statementCacheSize="200" syncQueryTimeoutWithTransactionTimeout="true" validationTimeout="30s" isolationLevel="TRANSACTION_READ_COMMITTED">
+        <jdbcDriver javax.sql.XADataSource="com.ibm.db2.jcc.DB2XADataSource" libraryRef="sharedLibDb2"/>
+        <properties.db2.jcc
+            apiKey="${DB_APIKEY}"
+            serverName="${DB_HOSTNAME}"
+            currentSchema="${DB_SCHEMA}"
+            databaseName="${DB_NAME}"
+            driverType="4"
+            pluginName="IBMIAMauth"
+            portNumber="${DB_PORT}"
+            securityMechanism="15"
+            sslConnection="true" />
+    </dataSource>
+```
+
+#### For Db2 Auth user
+
+Create a file as the following: 
+
+``` xml
+<server>
+    <!-- ============================================================== -->
+    <!-- TENANT: default; DSID: default; TYPE: read-write               -->
+    <!-- ============================================================== -->
+    <dataSource id="fhirDefaultDefault" jndiName="jdbc/fhir_default_default" type="javax.sql.XADataSource" statementCacheSize="200" syncQueryTimeoutWithTransactionTimeout="true" validationTimeout="30s" isolationLevel="TRANSACTION_READ_COMMITTED">
+        <jdbcDriver javax.sql.XADataSource="com.ibm.db2.jcc.DB2XADataSource" libraryRef="sharedLibDb2"/>
+        <properties.db2.jcc
+            erverName="${DB_HOSTNAME}"
+            currentSchema="${DB_SCHEMA}"
+            databaseName="${DB_NAME}"
+            driverType="4"
+            portNumber="${DB_PORT}"
+            sslConnection="true" 
+            user="fhirserver"
+            password="mypassword"
+         />
+        <connectionManager maxPoolSize="200" minPoolSize="40"/>
+    </dataSource>
+</server>
+```
+
+Each tenant datastore must have a corresponding dataSource definition and these dataSources must either follow the default jndiName pattern (`jndi/fhir_[tenantid]_[dsid]`) or the name must be explicitly configured in the corresponding section of `fhir-server-config.json`.
+
+
 #### Mapping from IBM Db2 on Cloud endpoint credentials
 
 This section explains how to populate the FHIR datasource from IBM Db2 on Cloud configuration details from an example configuration:
@@ -247,9 +364,11 @@ Use the following table to populate your datasource.
 | portNumber | from the credential object select  `port` |
 | databaseName | from the credential object select  `db`, generally always `BLUDB` |
 | apiKey | from the created user in the assigned to the `fhiruser` group. Reference Section **FHIRSERVER User and API Key** |
-| securityMechanism | `15` generally set to 15 to trigger the `apiKey` use with IBM Cloud |
-| pluginName | `IBMIAMauth` fixed for use with the IBM Cloud|
+| securityMechanism | If using IAM, set to `15` to trigger the use of IAM-based `apiKey` authentication|
+| pluginName | If using IAM, set to `IBMIAMauth`|
 | currentSchema | the schema name of your deployed tenant Schema, for instance `FHIRDATA` |
+| user| the userid |
+| password | the password for the user|
 | driverType | `4`, always JDBC Type-4|
 | sslConnection | `true`, if you are using IBM Cloud |
 | sslTrustStoreLocation | Local server path to the truststore, `resources/security/dbTruststore.jks` |
@@ -267,27 +386,11 @@ The IBM FHIR Server Bulk Data modules utilize Java Batch (JSR-352) from the Libe
 
 1. Associate it with a ServiceId (no need to create an Administration user, a simple user has sufficient privileges) using the same procedure you followed for the fhir-server ServiceId user.
 
-1. Using a valid API-KEY for the given ServiceId, configure a new datasource and the Java Batch persistence layer as follows:
-
-``` xml
-    <dataSource id="fhirbatchDS" jndiName="jdbc/fhirbatchDB">
-        <jdbcDriver libraryRef="sharedLibDb2"/>
-        <properties.db2.jcc
-            serverName="dashdb-txn-***-************.services.dal.bluemix.net"
-            portNumber="50001"
-            apiKey="<API-KEY>"
-            securityMechanism="15"
-            pluginName="IBMIAMauth"
-            databaseName="BLUDB"
-            currentSchema="JBATCH"
-            driverType="4" sslConnection="true" sslTrustStoreLocation="resources/security/dbTruststore.jks" sslTrustStorePassword="<TRUSTSTORE-PASSWORD>"/>
-    </dataSource>
-
-    <batchPersistence jobStoreRef="BatchDatabaseStore" />
-    <databaseStore id="BatchDatabaseStore" dataSourceRef="fhirbatchDS" schema="JBATCH" tablePrefix="" />
-```
+1. Create the datasource
+    1. Db2 with IAM https://github.com/IBM/FHIR/blob/main/fhir-server/liberty-config/configDropins/disabled/db2-cloud/bulkdata.xml
+    1. Db2 with Db2Auth https://github.com/IBM/FHIR/blob/main/fhir-server/liberty-config/configDropins/disabled/db2/bulkdata.xml
 
-- Note: The Java Batch is configured in `batchDs.xml` and included from the IBM FHIR Server's `server.xml` which is installed to `{wlp}/usr/server/fhir-server`.
+- Note: The Java Batch is configured in `bulkdata.xml` and included from the IBM FHIR Server's `server.xml` which is installed to `{wlp}/usr/server/defaultServer`. (fhir-server is installed locally)
 - Note: While this feature is not required, it's best to configure this datasource while configuring the main datasource.
 
 ### **SSL Certificate**
@@ -302,7 +405,6 @@ All passwords including apiKey values should be encrypted using the Liberty Prof
 
 The Lite plan is not supported for development and evaluation.
 - The schema size is larger than the available space.
-- Concurrent Connections: The Lite plan has a limit of 5 concurrent connections, and the IBM FHIR Server `fhirProxyDataSource` needs to be updated to avoid failures. One should update the server.xml connectionManager with maxPoolSize - `<connectionManager maxPoolSize="5"/>`.  
 - The instance is not enabled with IAM, and you may use the `Service Credentials` that are created to connect to configure the datasource.
 
 # **References**
diff --git a/docs/src/pages/guides/FHIRPerformanceGuide.md b/docs/src/pages/guides/FHIRPerformanceGuide.md
index bcd92c321c0..cb6944b8b73 100644
--- a/docs/src/pages/guides/FHIRPerformanceGuide.md
+++ b/docs/src/pages/guides/FHIRPerformanceGuide.md
@@ -3,7 +3,7 @@ layout: post
 title:  IBM FHIR Server Performance Guide
 description: IBM FHIR Server Performance Guide
 Copyright: years 2020, 2021
-lastupdated: "2020-03-31"
+lastupdated: "2020-06-01"
 permalink: /FHIRServerPerformanceGuide/
 ---
 
@@ -21,6 +21,8 @@ permalink: /FHIRServerPerformanceGuide/
     - [3.3 Session Affinity](#33-session-affinity)
     - [3.4 Value-Id Caches](#34-value-id-caches)
     - [3.5 Compartment Search Optimization](#35-compartment-search-optimization)
+    - [3.6 Usage of Server Resource Provider](#36-usage-of-server-resource-provider)
+    - [3.7 Usage of the extension-search-parameters.json file](#37-usage-of-the-extension-search-parameters.json-file)
 - [4 Database Tuning](#4-database-tuning)
     - [4.1 PostgreSQL](#41-postgresql)
         - [4.1.1 Fillfactor](#411-fillfactor)
@@ -285,6 +287,34 @@ To enable this optimization, set the `fhirServer/search/useStoredCompartmentPara
 
 Enabling this optimization is recommended. See the IBM FHIR Server release notes for more details.
 
+## 3.6. Usage of Server Resource Provider
+
+The IBM FHIR Server has a dynamic registry of conformance resources. The built-in "ServerRegistryResourceProvider" can be used to bridge conformance resources from the tenant data store (uploaded through the REST API) to the registry.
+When enabled, this means that each call to the registry (e.g. for extension StructureDefinition lookups during resource creation) can result in a round trip to the database.
+
+For optimal performance, the IBM FHIR Server team recommends to disable this resource provider via the following setting:
+
+| Configuration | Recommended value |
+|------|-------|
+| `fhirServer/core/serverRegistryResourceProviderEnabled` | false |
+
+This configuration setting avoids an extra Search during ingestion.
+
+## 3.7. Usage of the extension-search-parameters.json file
+
+The IBM FHIR Server supports multi-tenant SearchParameter extensions described in the extension-search-parameters.json file. When the `extension-search-parameters.json` is missing, the SearchParameter value extraction tries to open the file for every resource. This is a file-system operation which results in a context switch and impacts performance.
+
+The IBM FHIR Server team recommends each tenant include an `extension-search-parameters.json` file, even if it is empty.
+
+An example of the empty search parameters file is: 
+
+``` json
+{
+  "resourceType": "Bundle",
+  "type": "collection",
+  "entry": []
+}
+```
 
 # 4. Database Tuning
 
@@ -633,23 +663,6 @@ The above query requires a join of around 13 tables which is too many for the da
 /ExplanationOfBenefit?_pretty=true&patient:Patient.birthdate=le1915&claim.priority=normal,stat,deferred&_include=ExplanationOfBenefit:claim&_include=ExplanationOfBenefit:patient
 ```
 
-**Include Code System**
-
-Token-based searches should include a code-system when possible. The same code value might exist in multiple code-systems, Unless the code-system is included in the search query, the database join may need to consider multiple matches in order to find all the associated resources. This multiplies the amount of work the database must do to execute the query. This also impacts cardinality estimation by the optimizer. If both the code-system and code value are provided, this matches a unique index in the schema allowing the optimizer to infer the SQL fragment will produce a single row.
-
-Don't do this:
-```
-Patient/175517d8bea-32d33eec-d98f-4c99-a3cf-06a113ddcf08/CareTeam?status=active
-```
-
-Instead, do this:
-```
-Patient/175517d8bea-32d33eec-d98f-4c99-a3cf-06a113ddcf08/CareTeam?status=http://hl7.org/fhir/care-team-status|active
-```
-
-Explicitly providing the code is always preferred. If no system is provided, in some cases the IBM FHIR Server can determine the correct code-system to use automatically, which helps query performance.
-
-
 ## 6.5. Search Examples
 
 The section contains search examples and performance considerations for various types of search parameters.
@@ -663,7 +676,14 @@ HL7 FHIR supports a few variants of token search:
 * `[parameter]=[system]|[code]`
 * `[parameter]=|[code]`
 
-For optimal performance, users should prefer the `[system]|[code]` variant.
+Token-based searches should include a code-system when possible. The same code value might exist in multiple code-systems and so, unless the code-system is included in the search query, the database join may need to consider multiple matches in order to find all the associated resources. This multiplies the amount of work the database must do to execute the query. This also impacts cardinality estimation by the optimizer. If both the code-system and code value are provided, this matches a unique index in the schema allowing the optimizer to infer the SQL fragment will produce a single row.
+
+For optimal performance, users should prefer the `[system]|[code]` variant. Explicitly providing the code is always preferred. If no system is provided, in some cases the IBM FHIR Server can determine the correct code-system to use automatically, which helps query performance.
+
+Don't do this:
+`Patient/175517d8bea-32d33eec-d98f-4c99-a3cf-06a113ddcf08/CareTeam?status=active`
+
+Instead, do this: `Patient/175517d8bea-32d33eec-d98f-4c99-a3cf-06a113ddcf08/CareTeam?status=http://hl7.org/fhir/care-team-status|active`
 
 This is especially important for code values that are common across systems (e.g short strings like "active").
 However, the IBM FHIR Server supports a SearchParameter extension which allows the server to add an implicit `[system]|` prefix for certain token parameter searches that come in with just a `[code]`.
diff --git a/docs/src/pages/guides/FHIRSearchConfiguration.md b/docs/src/pages/guides/FHIRSearchConfiguration.md
index 3d6e7b2717a..9a956bbedd7 100644
--- a/docs/src/pages/guides/FHIRSearchConfiguration.md
+++ b/docs/src/pages/guides/FHIRSearchConfiguration.md
@@ -1,7 +1,7 @@
 ---
 layout: default
 title: Search Configuration Overview
-date:   2020-01-15 08:37:05 -0400
+date:   2021-06-10
 permalink: /FHIRSearchConfiguration/
 markdown: kramdown
 ---
@@ -263,12 +263,56 @@ In order to avoid this issue, inclusion criteria search parameters should not be
 ##  2 Re-index
 Reindexing is implemented as a custom operation that tells the IBM FHIR Server to read a set of resources and replace the existing search parameters with those newly extracted from the resource body.
 
-The `$reindex` operation can be invoked via an HTTP(s) POST to `[base]/$reindex`. By default, the operation will select 10 resources and re-extract their search parameters values based on the current configuration of the server. The operation supports the following parameters to control the behavior:
+The `$reindex` operation can be invoked via an HTTP(s) POST to `[base]/$reindex`, `[base]/[type]/$reindex`, or `[base]/[type]/[instance]/$reindex`. By default, the operation at the System-level or Type-level selects 10 resources and re-extract their search parameters values based on the current configuration of the server. The operation supports the following parameters to control the behavior:
 
 |name|type|description|
 |----|----|-----------|
 |`tstamp`|string|Reindex any resource not previously reindexed before this timestamp. Format as a date YYYY-MM-DD or time YYYY-MM-DDTHH:MM:DDZ.|
 |`resourceCount`|integer|The maximum number of resources to reindex in this call. If this number is too large, the processing time might exceed the transaction timeout and fail.|
+|`resourceLogicalId`|string|The ResourceType or the ResourceType/Logical id for targetted reindexing, only valid at System-level|
+
+An example request is:
+
+``` sh
+curl --location --request POST 'https://localhost:9443/fhir-server/api/v4/$reindex' \
+--header 'X-FHIR-TENANT-ID: default' \
+--header 'Content-Type: application/fhir+json' \
+-u 'fhiruser:change-password' \
+--data-raw '{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "resourceCount",
+      "valueInteger": 100
+    },
+    {
+      "name": "tstamp",
+      "valueString": "2021-01-01"
+    }
+  ]
+}'
+```
+
+An example response when processing in a loop: 
+
+``` json
+{
+    "resourceType": "OperationOutcome",
+    "issue": [
+        {
+            "severity": "information",
+            "code": "informational",
+            "diagnostics": "Processed Patient/1795df2b501-04f88a35-9f2f-4871-a05e-ba8090fa18f5"
+        }
+    ]
+}
+```
+
+An example response when processing is complete: 
+
+``` json 
+{"resourceType":"OperationOutcome","issue":[{"severity":"information","code":"informational","diagnostics":"Reindex complete"}]}
+```
 
 The IBM FHIR Server tracks when a resource was last reindexed and only resources with a reindex_tstamp value less than the given tstamp parameter will be processed. When a resource is reindexed, its reindex_tstamp is set to the given tstamp value. In most cases, using the current date (for example "2020-10-27") is the best option for this value.
 
diff --git a/docs/src/pages/guides/FHIRServerUsersGuide.md b/docs/src/pages/guides/FHIRServerUsersGuide.md
index 13221891e86..4e5aff84bd6 100644
--- a/docs/src/pages/guides/FHIRServerUsersGuide.md
+++ b/docs/src/pages/guides/FHIRServerUsersGuide.md
@@ -3,7 +3,7 @@ layout: post
 title:  IBM FHIR Server User's Guide
 description: IBM FHIR Server User's Guide
 Copyright: years 2017, 2021
-lastupdated: "2021-05-19"
+lastupdated: "2021-06-07"
 permalink: /FHIRServerUsersGuide/
 ---
 
@@ -16,14 +16,15 @@ permalink: /FHIRServerUsersGuide/
   * [3.1 Liberty server configuration](#31-liberty-server-configuration)
   * [3.2 FHIR server configuration](#32-fhir-server-configuration)
   * [3.3 Persistence layer configuration](#33-persistence-layer-configuration)
+  * [3.4 "Update/Create" feature](#34-updatecreate-feature)
 - [4 Customization](#4-customization)
   * [4.1 Extended operations](#41-extended-operations)
   * [4.2 Notification Service](#42-notification-service)
   * [4.3 Persistence interceptors](#43-persistence-interceptors)
-  * [4.4 Resource validation](#44-resource-validation)
-  * [4.5 "Update/Create" feature](#45-updatecreate-feature)
-  * [4.6 FHIR client API](#46-fhir-client-api)
-  * [4.7 FHIR command-line interface (fhir-cli)](#47-fhir-command-line-interface-fhir-cli)
+  * [4.4 Registry resources](#44-registry-resources)
+  * [4.5 Resource validation](#45-resource-validation)
+  * [4.6 Extending search](#46-extending-search)
+  * [4.7 FHIR client API](#47-fhir-client-api)
   * [4.8 Using local references within request bundles](#48-using-local-references-within-request-bundles)
   * [4.9 Multi-tenancy](#49-multi-tenancy)
   * [4.10 Bulk data operations](#410-bulk-data-operations)
@@ -153,7 +154,8 @@ By default, we include:
 In the examples within the following sections, you'll see the default password `change-password`. In order to secure your server, these values should be changed.
 
 Optionally, the values can be encoded via the Liberty `securityUtility` command. For example, to encode a string value with the default `{xor}` encoding, run the following command:
-```
+
+``` sh
 <WLP_HOME>/bin/securityUtility encode stringToEncode
 ```
 
@@ -202,6 +204,7 @@ The IBM FHIR Server supports the ability to compute and store compartment member
         }
     }
 ```
+
 Note that this parameter only enables or disables the compartment search query optimization feature. The compartment membership values are always computed and stored during ingestion or reindexing, regardless of the setting of this value. After the reindex operation is complete, it is recommended to set `useStoredCompartmentParam` to true. No reindex is required if this value is subsequently set to false.
 
 ## 3.3 Persistence layer configuration
@@ -211,10 +214,11 @@ Before you can configure the server to use the JDBC persistence layer implementa
 
 The IBM FHIR Server is delivered with a default configuration that is already configured to use the JDBC persistence layer implementation with an Embedded Derby database. This provides the easiest out-of-the-box experience since it requires very little setup.
 
-The IBM FHIR Server persistence configuration is split between `fhir-server-config.json` and the Liberty `server.xml + configDropins`.
+The IBM FHIR Server persistence configuration is split between `fhir-server-config.json` and the Liberty `server.xml` and `configDropins`.
 
 Within `fhir-server-config.json`, the value of the `fhirServer/persistence/factoryClassname` is used to instantiate a FHIRPersistence object. By default, the server is configured to use the FHIRPersistenceJDBCFactory:
-```
+
+``` json
     {
         "fhirServer": {
             …
@@ -227,7 +231,8 @@ Within `fhir-server-config.json`, the value of the `fhirServer/persistence/facto
 
 ### 3.3.1 The JDBC persistence layer
 When the FHIRPersistenceJDBCFactory is in use, the `fhirServer/persistence/datasources` property must specify a mapping from datastore-id values to Liberty datasource definitions. For example, here is the configuration for a datastore with id `default` that is configured for the `jdbc/fhir_default_default` datasource of type `postgresql`:
-```
+
+``` json
 {
     "fhirServer":{
         "persistence":{
@@ -298,9 +303,10 @@ The IBM FHIR Server will look up the tenant and datastore id for each request an
 If you are using the `ibmcom/ibm-fhir-server` docker image, you can ask the entrypoint script to create (bootstrap) the database and the schema during startup by setting the `BOOTSTRAP_DB` environment variable to `true`.
 
 This database bootstrap step is only supported for Embedded Derby and will only bootstrap the default datastore of the default tenant (the default for requests with no tenant or datastore headers).
-Reminder:  the Embedded Derby support is designed to support simple getting started scenarios and is not recommended for production use.
 
-```
+*Reminder*: the Embedded Derby support is designed to support simple getting started scenarios and is not recommended for production use.
+
+``` xml
 <server>
     <!-- ============================================================== -->
     <!-- This datasource aligns with the Apache Derby database that is  -->
@@ -472,6 +478,26 @@ The TransactionManager controls the timeout of database queries.
 
 To modify the default transaction timeout value, set the environment variable `FHIR_TRANSACTION_MANAGER_TIMEOUT` or enter the value in the server.env file at the root of the WLP fhir-server instance. Example values are `120s` (seconds) or `2m` (minutes).
 
+## 3.4 “Update/Create” feature
+Normally, the _update_ operation is invoked with a FHIR resource which represents a new version of an existing resource. The resource specified in the _update_ operation would contain the same id of that existing resource. If a resource containing a non-existent id were specified in the _update_ invocation, an error would result.
+
+The FHIR specification defines optional behavior for the _update_ operation where it can create a new resource if a non-existent resource is specified in the invocation. The FHIR server supports this optional behavior via the `fhirServer/persistence/common/updateCreateEnabled` configuration parameter. If this configuration parameter is set to `true` (the default), then the _update_ operation will create a new resource if it is invoked with a resource containing a non-existent id. If the option is set to false, then the optional behavior is disabled and an error would be returned.
+
+The following example shows the JSON for enabling _update_ operations to create resources:
+```
+{
+    "fhirServer":{
+        …
+        "persistence":{
+            "common":{
+                "updateCreateEnabled":true
+            }
+        }
+        …
+    }
+}
+```
+
 # 4 Customization
 You can modify the default server implementation by taking advantage of the IBM FHIR server's extensibility. The following extension points are available:
  * Custom operations framework:  The IBM FHIR Server defines an operations framework that builds on the FHIR OperationDefinition resource in order to extend the FHIR REST API with custom endpoints.
@@ -480,14 +506,14 @@ You can modify the default server implementation by taking advantage of the IBM
  * Resource validation:  FHIRPath-based validation of FHIR resources on create or update with the ability to extend the system with custom constraints.
 
 ## 4.1 Extended operations
-In addition to the standard REST API (create, update, search, and so forth), the IBM FHIR Server supports the FHIR operations framework as described in the [FHIR specification]( https://www.hl7.org/fhir/r4/operations.html).
+In addition to the standard REST API (create, update, search, and so forth), the IBM FHIR Server supports the FHIR operations framework as described in the [FHIR specification](https://www.hl7.org/fhir/r4/operations.html).
 
 ### 4.1.1 Packaged operations
 The FHIR team provides implementations for the standard `$validate`, `$document`, `$everything`, `$expand`, `$lookup`, `$subsumes`, `$closure`, `$export`, `$import`, `$convert`, `$apply` and `$translate` operations, as well as a custom operation named `$healthcheck`, which queries the configured persistence layer to report its health.
 
 The server also bundles `$reindex` to reindex instances of Resources so they are searchable, and `$erase` to hard delete instances of Resources. To learn more about the $erase operation, read the [design document](https://github.com/IBM/FHIR/tree/main/operation/fhir-operation-erase/README.md).
 
-No other extended operations are packaged with the server at this time, but you can extend the server with your own operations.
+To extend the server with additional operations, see [Section 4.1.2 Custom operations](#412-custom-operations)
 
 #### 4.1.1.1 $validate
 The `$validate` operation checks whether the attached content would be acceptable either generally, or as a create, update, or delete against an existing resource instance or type.
@@ -531,18 +557,25 @@ Field name     | Type   | Description
 `lastUpdated`  | String | The date and time of the last update made to the resource associated with the notification event.
 `resourceId`   | String | The logical id of the resource associated with the notification event.
 `resource`     | String | A stringified JSON object which is the resource associated with the notification event.
+`tenantId`     | String | The tenant that generated this notification
+`datasourceId` | String | The datasource used by the tenant
 
 The following JSON is an example of a serialized notification event:
+
 ```
 {
   "lastUpdated":"2016-06-01T10:36:23.232-05:00",
   "location":"Observation/3859/_history/1",
   "operationType":"create",
   "resourceId":"3859",
+  "tenantId":"default",
+  "datasourceId":"default",
   "resource":{ …<contents of resource>… }
 }
 ```
 
+If the resource is over the limit specified in `fhirServer/notifications/common/maxNotificationSizeBytes`, the default value is to subset `id`, `meta` and `resourceType` and add the subset to the FHIRNotificationEvent. In alternative configurations, user may set `fhirServer/notifications/common/maxNotificationSizeBehavior` to `omit` and subsequently retrieve the resource using the location.
+
 ### 4.2.2 WebSocket
 The WebSocket implementation of the notification service will publish notification event messages to a WebSocket. To enable WebSocket notifications, set the `fhirServer/notifications/websocket/enabled` property to `true`, as in the following example:
 
@@ -604,6 +637,8 @@ Before you enable Kafka notifications, it's important to understand the topology
 
 On the other hand, if you have two completely independent FHIR server instances, then you should configure each one with its own topic name.
 
+The FHIRNotificationEvent is asynchronous by default. If you want to specify a synchronous request, you can set `fhirServer/notifications/kafka/sync` to true, which ensures no message is lost in publishing, however it does add latency in each request.
+
 ### 4.2.3 NATS
 The [NATS](http://nats.io) implementation of the notification service publishes notification event messages to a NATS streaming cluster. To configure the NATS notification publisher, configure properties in the `fhir-server-config.json` file as shown in the following example:
 
@@ -691,9 +726,30 @@ To implement a persistence interceptor, complete the following steps:
 
 4.  Re-start the FHIR server.
 
-## 4.4 Resource validation
+## 4.4 Registry resources
+The IBM FHIR Server includes a dynamic registry of conformance resources.
+The registry pre-packages all [FHIR Definitions from the specification](https://www.hl7.org/fhir/R4/downloads.html)
+and uses a Java ServiceLoader to discover additional registry resource providers on the classpath.
+
+The server consults this registry for:
+* StructureDefinition, ValueSet, and CodeSystem resources for resource validation.
+* SearchParameter and CompartmentDefinition resources for search.
+* ValueSet and CodeSystem resources for terminology operations.
+* And more.
+
+One common technique for extending FHIR with a set of conformance resources is to build or reference an [Implementation Guide](https://www.hl7.org/fhir/implementationguide.html).
 
-### 4.4.1 HL7 spec-defined validation support
+The IBM FHIR Server includes a [PackageRegistryResourceProvider](https://ibm.github.io/FHIR/guides/FHIRValidationGuide#making-profiles-available-to-the-fhir-registry-component-fhirregistry) for registering implementation guide resources.
+
+Additionally, we [pre-package a number of popular implementation guides](https://ibm.github.io/FHIR/guides/FHIRValidationGuide#optional-profile-support) and make those available from both our GitHub Releases and [Maven Central](https://repo1.maven.org/maven2/com/ibm/fhir/).
+
+Finally, the IBM FHIR Server includes a built-in ServerRegistryResourceProvider that can be used to bridge conformance resources from the tenant data store (uploaded through the REST API) to the registry.
+This provider can be enabled/disabled via the `fhirServer/core/serverRegistryResourceProviderEnabled` property, but we recommend leaving it disabled for performance-intensive workloads.
+
+## 4.5 Resource validation
+As mentioned in the previous section, the IBM FHIR Server registry is consulted during resource validation.
+
+### 4.5.1 HL7 spec-defined validation support
 The FHIR specification provides a number of different validation resources including:
 
 1.  XML Schemas
@@ -701,10 +757,18 @@ The FHIR specification provides a number of different validation resources inclu
 3.  Structure Definitions / Profiles for standard resource types, data types and built-in value sets
 
 The FHIR server validates incoming resources for create and update interactions using the resource definitions and their corresponding FHIRPath constraints. Additionally, the FHIR server provides the following `$validate` operation that API consumers can use to POST resources and get validation feedback:
- `POST <base>/Resource/$validate`
+```
+POST <base>/<resourceType>/$validate
+```
+
+### 4.5.2 Extension validation
+FHIR resources can be extended. Each extension has a url and servers can use these urls to validate the contents of the extension.
 
-### 4.4.2 User-provided validation
-The IBM FHIR Server can be extended with custom profile validation. This allows one to apply validation rules on the basis of the `Resource.meta.profile` codes included on the resource instance.
+The IBM FHIR Server performs extension validation by looking up the extension definition in its internal registry.
+If an instance contains extensions that are unknown to the server, then the server will include a validation warning that indicates this extension could not be validated.
+
+### 4.5.3 Profile validation
+The IBM FHIR Server can be extended with custom profile validation. This allows one to apply validation rules on the basis of the `Resource.meta.profile` values included on the resource instance.
 
 For example, you can configure a set of FHIRPath Constraints to run for resources that claim conformance to the `http://ibm.com/fhir/profile/partner` profile when you see an input resource like the following:
 ```
@@ -741,32 +805,20 @@ See [Validation Guide - Optional profile support](https://ibm.github.io/FHIR/gui
 
 See [Validation Guide - Making profiles available to the fhir registry](https://ibm.github.io/FHIR/guides/FHIRValidationGuide#making-profiles-available-to-the-fhir-registry-component-fhirregistry) for information about how to extend the server with additional Implementation Guide artifacts.
 
-## 4.5 “Update/Create” feature
-Normally, the _update_ operation is invoked with a FHIR resource which represents a new version of an existing resource. The resource specified in the _update_ operation would contain the same id of that existing resource. If a resource containing a non-existent id were specified in the _update_ invocation, an error would result.
+## 4.6 Extending search
+In addition to supporting tenant-specific search parameter extensions as described in [Section 3.2.2 Tenant-specific configuration properties](#322-tenant-specific-configuration-properties), the IBM FHIR Server also supports loading
+search parameters from the registry.
 
-The FHIR specification defines optional behavior for the _update_ operation where it can create a new resource if a non-existent resource is specified in the invocation. The FHIR server supports this optional behavior via the `fhirServer/persistence/common/updateCreateEnabled` configuration parameter. If this configuration parameter is set to `true` (the default), then the _update_ operation will create a new resource if it is invoked with a resource containing a non-existent id. If the option is set to false, then the optional behavior is disabled and an error would be returned.
+For performance reasons, the registry search parameters are retrieved once and only once during startup.
 
-The following example shows the JSON for enabling _update_ operations to create resources:
-```
-{
-    "fhirServer":{
-        …
-        "persistence":{
-            "common":{
-                "updateCreateEnabled":true
-            }
-        }
-        …
-    }
-}
-```
+The set of search parameters can filtered / refined via `fhirServer/resources/[resourceType]/searchParameters` as described in the [Search configuration guide](https://ibm.github.io/FHIR/guides/FHIRSearchConfiguration#12-filtering).
 
-## 4.6 FHIR client API
+## 4.7 FHIR client API
 
-### 4.6.1 Overview
+### 4.7.1 Overview
 In addition to the server, we also offer a Java API for invoking the FHIR REST APIs. The IBM FHIR Client API is based on the JAX-RS 2.0 standard and provides a simple properties-driven client that can be easily configured for a given endpoint, mutual authentication, request/response logging, and more.
 
-### 4.6.2 Maven coordinates
+### 4.7.2 Maven coordinates
 To use the FHIR Client from your application, specify the `fhir-client` artifact as a dependency within your `pom.xml` file, as in the following example:
 
 ```
@@ -777,182 +829,9 @@ To use the FHIR Client from your application, specify the `fhir-client` artifact
         </dependency>
 ```
 
-### 4.6.3 Sample usage
+### 4.7.3 Sample usage
 For examples on how to use the IBM FHIR Client, look for tests like `com.ibm.fhir.client.test.mains.FHIRClientSample` from the `fhir-client` project in git. Additionally, the FHIR Client is heavilly used from our integration tests in `fhir-server-test`.
 
-## 4.7 FHIR command-line interface (fhir-cli)
-The FHIR command-line interface (fhir-cli for short) is a command that can be used to invoke FHIR REST API operations from the command line. The compressed file for installing the fhir-cli tool is available from [Maven Central](https://repo1.maven.org/maven2/com/ibm/fhir/fhir-cli/).
-
-### 4.7.1 Installing fhir-cli
-Because the fhir-cli tool is intended to be used by clients that need to access the FHIR server, it has its own installation process separate from the server. To install the fhir-cli tool, complete the following steps:
-
-1.  Obtain the `fhir-cli.zip` file from the FHIR server installation zip or Maven.
-2.  Decompress the `fhir-cli.zip` file into a directory of your choosing, for example:
-
-    ```
-    cd /mydir
-    unzip fhir-cli.zip
-    ```
-
-3.  [Optional] To enable you to run fhir-cli from multiple directories, run the following command to add `fhir-cli` to your `PATH` environment variable.
-    ```
-    export PATH=$PATH:/mydir/fhir-cli
-    ```
-
-### 4.7.2 Configuring fhir-cli
-The fhir-cli tool requires a properties file containing various configuration properties, such as the base endpoint URL, the username and password for basic authentication, amd so forth. The properties contained in this file are the same properties supported by the FHIR client API. The fhir-cli tool comes with a sample properties file named `fhir-cli.properties` which contains a collection of default property settings.
-
-Using the sample properties file as a guide, you can create your own properties file to reflect the required endpoint configuration associated with the FHIR server endpoint that you would like to access. In the examples that follow, we'll refer to this file as `my-fhir-cli.properties`, although you can name the file anything you'd like.
-
-### 4.7.3 Running fhir-cli
-The fhir-cli tool comes with two shell scripts: `fhir-cli` (Linux&reg;) and `fhir-cli.bat` (Windows&trade;). In the examples that follow, we'll use `<fhir-cli-home>` as the location of the fhir-cli tool (that is, the `/mydir/fhir-cli` directory mentioned in preceding section).
-
-The following examples illustrate how to invoke the fhir-cli tool:
-
-*   Display help text
-```
-$ <fhir-cli-home>/fhir-cli –help
-
-FHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2016.
-
-usage: fhir-cli [options]
-
-Provides access to the FHIR Client API via the command line.
-
-Options:
-   -h,--help                           Display this help text
-   -id,--resourceId <ID>               Use resource identifier <ID> for the operation invocation
-   -o,--output <FILE>                  Write output resource to <FILE> (e.g. searchresults.json)
-   -op,--operation <OPERATION>         The operation to be invoked
-   -p,--properties <FILE>              Use FHIR Client properties contained in <FILE> (e.g.
-                                       fhir-cli.properties)
-   -qp,--queryParameter <NAME=VALUE>   Include query parameter NAME=VALUE with the operation
-                                       invocation (e.g. _count=100).
-   -r,--resource <FILE>                Use FHIR resource contained in <FILE> for operation
-                                       invocation (e.g. patient.json)
-   -t,--type <TYPE>                    Use resource type <TYPE> for the operation invocation (e.g.
-                                       "Patient")
-   -v,--verbose                        Display detailed output
-   -vid,--versionId <VID>              Use version # <VID> for the operation invocation
-
-OPERATION should be one of: batch | create | history | metadata | read | search | search-all |
-search-post | transaction | update | validate | vread
-```
-*   Invoke the 'metadata' operation
-```
-$ <fhir-cli-home>/fhir-cli --properties my-fhir-cli.properties --operation metadata --output conformance.json
-
-FHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2016.
-
-Invoking operation 'metadata'... done! (651ms)
-Status code: 200
-Response resource written to file: conformance.json
-```
-Note: in this example the “--output” option is used to specify that the Conformance resource should be saved in file 'conformance.json'.
-*   Perform a _create_ operation
-```
-$ <fhir-cli-home>/fhir-cli --properties my-fhir-cli.properties --operation create --resource newpatient.json
-
-FHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2016.
-
-Invoking operation _create_... done! (2719ms)
-Status code: 201
-Location URI: http://localhost:9443/fhir-server/api/v4/Patient/26b694ef-cea7-4485-a896-5ac2a1da9f64/_history/1
-ETag: W/"1"
-Last modified: 2016-09-13T20:51:21.048Z
-```
-Note: In this example, the “--resource” option is used to indicate that the contents of the new resource to be created should be read from file 'newpatient.json'.
-*   Perform a 'read' operation
-```
-$ <fhir-cli-home>/fhir-cli --properties my-fhir-cli.properties --operation read --type Patient --resourceId 26b694ef-cea7-4485-a896-5ac2a1da9f64 -o patient1.json
-
-FHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2016.
-
-Invoking operation 'read'... done! (321ms)
-Status code: 200
-ETag: W/"1"
-Last modified: 2016-09-13T20:51:21.048Z
-Response resource written to file: patient1.json
-```
-Note: the “-o” option is used as a shortcut for “--output”
-*   Perform an _update_ operation
-```
-$ <fhir-cli-home>/fhir-cli --properties my-fhir-cli.properties --operation update --resource updatedpatient1.json
-FHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2016.
-
-Invoking operation _update_... done! (2707ms)
-Status code: 200
-Location URI: http://localhost:9443/fhir-server/api/v4/Patient/26b694ef-cea7-4485-a896-5ac2a1da9f64/_history/2
-ETag: W/"2"
-Last modified: 2016-09-13T21:11:48.988Z
-```
-*   Perform a 'vread' operation
-```
-$ <fhir-cli-home>/fhir-cli --properties my-fhir-cli.properties --operation vread -t Patient -id 26b694ef-cea7-4485-a896-5ac2a1da9f64 -vid 3 -o patient1v3.json
-
-FHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2016.
-
-Invoking operation 'vread'... done! (290ms)
-Status code: 200
-ETag: W/"3"
-Last modified: 2016-09-13T21:18:28.412Z
-Response resource written to file: patient1v3.json
-```
-*   Perform a 'history' operation
-```
-$ <fhir-cli-home>/fhir-cli --properties my-fhir-cli.properties --operation history -t Patient -id 26b694ef-cea7-4485-a896-5ac2a1da9f64 -o patient1history.json
-
-FHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2016.
-
-Invoking operation 'history'... done! (414ms)
-Status code: 200
-Response resource written to file: patient1history.json
-```
-Note: in this example, the response resource is a Bundle containing the versions of the Patient resource.
-
-
-*   Perform a 'search' operation
-
-```
-$ <fhir-cli-home>/fhir-cli --properties my-fhir-cli.properties --operation search -t Patient -qp name=Doe -o searchresults.json
-
-FHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2016.
-
-Invoking operation 'search'... done! (543ms)
-Status code: 200
-Response resource written to file: searchresults.json
-```
-
-Note: in this example the `-qp` option (shortcut for `–queryParameter`) is used to specify the search criteria (that is, `name=Doe`). The response resource is a Bundle that is written to the file `searchresults.json`.
-
-*   Perform a 'validate' operation
-
-```
-$ <fhir-cli-home>/fhir-cli --properties my-fhir-cli.properties --operation validate --resource newpatient.json
-
-FHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2016.
-
-Invoking operation 'validate'... done! (3182ms)
-Status code: 200
-Response resource:
-
-{
-    "resourceType" : "OperationOutcome",
-    "id" : "allok",
-    "text" : {
-        "status" : "additional",
-        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>All OK</p></div>"
-    },
-    "issue" : [ {
-        "severity" : "information",
-        "code" : "informational",
-        "details" : {
-            "text" : "All OK"
-        }
-    } ]
-}
-```
-
 ## 4.8 Using local references within request bundles
 Inter-dependencies between resources are typically defined by one resource containing a field of type `Reference` which contains an _external reference_<sup id="a5">[5](#f5)</sup> to another resource. For example, an `Observation` resource could reference a `Patient` resource via the Observation's `subject` field. The value that is stored in the `Reference-type` field (for example, `subject` in the case of the `Observation` resource) could be an absolute URL, such as `https://fhirserver1:9443/fhir-server/api/v4/Patient/12345`, or a relative URL (for example, `Patient/12345`).
 
@@ -1184,7 +1063,7 @@ The global configuration contains non-tenant specific configuration parameters (
 
 `${server.config.dir}/config/default/fhir-server-config.json`
 
-```
+``` json
 {
     "__comment":"FHIR server global (default) configuration",
     "fhirServer":{
@@ -1320,8 +1199,7 @@ The Bulk Data web application writes the exported FHIR resources to an IBM Cloud
     "storageProviders": {
         "default" : {
             "type": "file",
-            "fileBase": "${WLP_OUTPUT_DIR}/fhir-server/output",
-            "exportPublic": true,
+            "fileBase": "/output/bulkdata",
             "disableOperationOutcomes": true,
             "duplicationCheck": false,
             "validateResources": false
@@ -1339,7 +1217,6 @@ The Bulk Data web application writes the exported FHIR resources to an IBM Cloud
             },
             "enableParquet": false,
             "disableBaseUrlValidation": true,
-            "exportPublic": true,
             "disableOperationOutcomes": true,
             "duplicationCheck": false,
             "validateResources": false,
@@ -1406,9 +1283,9 @@ The presigned URL is valid for 86400 seconds (1 day).
 
 Note, the deletion of an a job is split into two phases, ACCEPTED (202) response and DELETED (204).  202 is returned until the operation is stopped or removed, and then 204.
 
-Please note that IBM COS does not support retention limits for individual COS objects, so please configure an appropriate retention policy (e.g. 1 day) at the bucket level.
+Prior to version 4.8.1, the exported `ndjson` file is configured with public access automatically and with 2 hours expiration time using `fhirServer/bulkdata/storageProviders/(source)/exportPublic`. The exported content is best made available with  presigned urls with the `hmac` authentication type.
 
-As of Version 4.8.1, the exportPublic is deprecated and will be removed in future versions. `fhirServer/bulkdata/storageProviders/(source)/exportPublic` can be set to "false" to disable public access. Also, *minio* doesn't support object level ACL, so access token is always needed to download the exported `ndjson` files.
+In 4.8.1, the randomly generated path is used to uniquely identify the exported files in a single folder.
 
 JavaBatch feature must be enabled in `server.xml` as following on the Liberty server:
 
@@ -1482,10 +1359,139 @@ Note: If you use PostgreSQL database as IBM FHIR Server data store or the JavaBa
 
 For more information about Liberty JavaBatch configuration, please refer to [IBM WebSphere Liberty Java Batch White paper](https://www-03.ibm.com/support/techdocs/atsmastr.nsf/webindex/wp102544).
 
-### 4.10.1 Integration Testing
+### 4.10.1 *Path* and *Virtual Host* Bucket Access
+
+For BulkData storage types of `ibm-cos` and `aws-s3`, the IBM FHIR Server supports two styles of accessing the `s3` bucket - virtual host and path.  In the IBM FHIR Server, `path` is the default access. [Link](https://docs.aws.amazon.com/AmazonS3/latest/userguide/VirtualHosting.html)
+
+With path style access, the objects in a bucket are accessed using the pattern - `https://s3.region.host-name.com/bucket-name/object-key`. To configure path style access, one needs to configure the fhir-server-config.json. 
+
+There are three critical elements in the configuration to configure path style: 
+
+|Configuration|Details|
+|-------------|-------|
+|`endpointInternal`|the direct S3 API provider for the S3 API|
+|`endpointExternal`|the endpoint url used to generate the downloadUrl used in S3 Export|
+|`accessType`|"path", the default access type|
+
+Example of `path` based access: 
+
+``` json
+"bulkdata": {
+    ...
+    "storageProviders": {
+        "default" : {
+            "type": "aws-s3",
+            "bucketName": "bucket-name",
+            "location": "us",
+            "endpointInternal": "https://s3.region.host-name.com",
+            "endpointExternal": "https://s3.region.host-name.com",
+            "auth" : {
+                "type": "hmac",
+                "accessKeyId": "example",
+                "secretAccessKey": "example-password"
+            },
+            "enableParquet": false,
+            "disableBaseUrlValidation": true,
+            "exportPublic": true,
+            "disableOperationOutcomes": true,
+            "duplicationCheck": false,
+            "validateResources": false,
+            "create": false,
+            "presigned": true,
+            "accessType": "path"
+        }
+    }
+}
+```
+
+With virtual host style access, the objects in a bucket are accessed using the pattern - `https://bucket-name.s3.region.host-name.com/object-key`. To configure virtual host style access, one needs to configure the API. 
+
+There are three critical elements in the configuration to configure virtual host style: 
+
+|Configuration|Details|
+|-------------|-------|
+|`endpointInternal`|the direct API provider for the S3 API, and not the virtual host, the underlying S3 libraries generate the virtual host url|
+|`endpointExternal`|the Virtual Host endpoint url used to generate the downloadUrl generated after an Export|
+|`accessType`|"host"|
+
+Note, while the endpointInternal is specified with the S3 region endpoint, the calls to the API will use the virtual host directly.
+
+Example of `host` based access: 
+
+``` json
+"bulkdata": {
+    ...
+    "storageProviders": {
+        "default" : {
+            "type": "aws-s3",
+            "bucketName": "bucket-name",
+            "location": "us",
+            "endpointInternal": "https://s3.region.host-name.com",
+            "endpointExternal": "https://bucket-name.s3.region.host-name.com",
+            "auth" : {
+                "type": "hmac",
+                "accessKeyId": "example",
+                "secretAccessKey": "example-password"
+            },
+            "enableParquet": false,
+            "disableBaseUrlValidation": true,
+            "exportPublic": true,
+            "disableOperationOutcomes": true,
+            "duplicationCheck": false,
+            "validateResources": false,
+            "create": false,
+            "presigned": true,
+            "accessType": "host"
+        }
+    }
+}
+```
+
+### 4.10.2 S3 Import File with matching segments
+
+When Importing from an S3 Bucket, the IBM FHIR Server identifies the matching file segments. The `parameter.input.url` is used to query the S3 API to find the matching files.  For instance, the following import of `Patient.ndjson` matches `Patient.ndjson_seg0` and `Patient.ndjson_seg1` which are imported to the IBM FHIR Server.
+
+This feature is useful for imports which follow a prefix pattern:
+
+``` json
+{
+    "resourceType": "Parameters",
+    "id": "30321130-5032-49fb-be54-9b8b82b2445a",
+    "parameter": [
+        {
+            "name": "inputFormat",
+            "valueString": "application/fhir+ndjson"
+        },
+        {
+            "name": "inputSource",
+            "valueUri": "https://localhost:9443/source-fhir-server"
+        },
+        {
+            "name": "input",
+            "part": [
+                {
+                    "name": "type",
+                    "valueString": "Patient"
+                },
+                {
+                    "name": "url",
+                    "valueUrl": "test-import.ndjson"
+                }
+            ]
+        },
+        {
+            "name": "storageDetail",
+            "valueString": "ibm-cos"
+        }
+    ]
+}
+```
+
+
+### 4.10.3 Integration Testing
 To integration test, there are tests in `ExportOperationTest.java` in `fhir-server-test` module with server integration test cases for system, patient and group export. Further, there are tests in `ImportOperationTest.java` in `fhir-server-test` module. These tests rely on the `fhir-server-config-db2.json` which specifies two storageProviders.
 
-### 4.10.2 Export to Parquet
+### 4.10.4 Export to Parquet
 Version 4.4 of the IBM FHIR Server introduced experimental support for exporting to Parquet format (as an alternative to the default NDJSON export). However, due to the size of the dependencies needed to make this work, this feature is disabled by default.
 
 To enable export to parquet, an administrator must:
@@ -1494,7 +1500,7 @@ To enable export to parquet, an administrator must:
 
 An alternative way to accomplish the first part of this is to change the scope of these dependencies from the fhir-bulkdata-webapp pom.xml and rebuild the webapp to include them.
 
-### 4.10.3 Job Logs
+### 4.10.5 Job Logs
 Because the bulk import and export operations are built on Liberty's java batch implementation, users may need to check the [Liberty batch job logs](https://www.ibm.com/support/knowledgecenter/SSEQTP_liberty/com.ibm.websphere.wlp.doc/ae/rwlp_batch_view_joblog.html) for detailed step information / troubleshooting.
 
 In a standard installation, these logs will be at `wlp/usr/servers/fhir-server/logs/joblogs`.
@@ -1561,6 +1567,14 @@ The following table describes the JSON fields of the CADF audit log entries logg
 |`observer/geolocation/city`                           |Value is determined by "fhirServer/audit/serviceProperties/geoCity" configuration property.|
 |`observer/geolocation/state`                          |Value is determined by "fhirServer/audit/serviceProperties/geoState" configuration property.|
 |`observer/geolocation/region`                         |Value is determined by "fhirServer/audit/serviceProperties/geoCounty" configuration property.|
+|`target/id`                                           |Value is the Logical ID from the resource|
+|`target/typeUri`                                      |Value is always "compute/node".|
+|`target/addresses/url`                                |Value determined by the HttpServletRequest for the server. The value does not use the `X-FHIR-FORWARDED-URL` http header|
+|`target/geolocation/city`                             |Value determined by "fhirServer/audit/serviceProperties/geoCity" configuration property.|
+|`target/geolocation/state`                            |Value determined by "fhirServer/audit/serviceProperties/geoState" configuration property.|
+|`target/geolocation/region`                           |Value determined by "fhirServer/audit/serviceProperties/geoCounty" configuration property.|
+
+Note for Batch/Transactions, attachments/content includes counts of the number of C-R-U-D-E actions.
 
 ### 4.11.2 Enable audit logging service
 Please refer to the property names that start with `fhirServer/audit/` in [5.1 Configuration properties reference](#51-configuration-properties-reference) for how to enable and configure the CADF audit logging service.
@@ -1685,14 +1699,7 @@ The service can map to the CADF format or the FHIR AuditEvent resource format by
             "region": "USA",
             "annotations": [
             ]
-        },
-        "addresses": [
-            {
-                "url": "https://test.io:443/fhir-server/api/v4/Patient",
-                "name": "",
-                "port": ""
-            }
-        ]
+        }
     },
     "attachments": [
         {
@@ -1958,6 +1965,8 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/core/defaultPageSize`|integer|Sets the page size for search and history request results when no `_count` parameter is specified.|
 |`fhirServer/core/maxPageSize`|integer|Sets the maximum page size for search and history request results. If a user-specified `_count` parameter value exceeds the maximum page size, then a warning is logged and the maximum page size will be used.|
 |`fhirServer/core/maxPageIncludeCount`|integer|Sets the maximum number of 'include' resources allowed per page for search and history request results. If the number of 'include' resources returned for a page of results from a search or history request will exceed the maximum number of 'include' resources allowed per page, then an error will be returned in the request results.|
+|`fhirServer/core/capabilitiesUrl`|string|The URL that is embedded in the default Capabilities statement|
+|`fhirServer/term/capabilitiesUrl`|string|The URL that is embedded in the Terminology Capabilities statement using `mode=terminology`|
 |`fhirServer/term/disableCaching`|boolean|Indicates whether caching is disabled for the FHIR terminology module, this includes caching in `CodeSystemSupport`, `ValueSetSupport`, `GraphTermServiceProvider`, and `RemoteTermServiceProvider`|
 |`fhirServer/term/graphTermServiceProviders`|array of objects|The `graphTermServiceProviders` element is an array of objects|
 |`fhirServer/term/graphTermServiceProviders/enabled`|boolean|Indicates whether the graph term service provider should be used by the FHIR term service to access code system content|
@@ -1972,6 +1981,9 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/term/remoteTermServiceProviders/hostnameVerificationEnabled`|boolean|Indicates whether hostname verification should be performed when using SSL transport|
 |`fhirServer/term/remoteTermServiceProviders/basicAuth/username`|string|The basic authentication username for this remote term service provider|
 |`fhirServer/term/remoteTermServiceProviders/basicAuth/password`|string|The basic authentication password for this remote term service provider|
+|`fhirServer/term/remoteTermServiceProviders/headers`|array of objects|The `headers` element is an array of objects|
+|`fhirServer/term/remoteTermServiceProviders/headers/name`|string|The HTTP header name that will be added to requests by this remote term service provider|
+|`fhirServer/term/remoteTermServiceProviders/headers/value`|string|The HTTP header value that will be added to requests by this remote term service provider|
 |`fhirServer/term/remoteTermServiceProviders/httpTimeout`|integer|The HTTP read timeout for this remote term service provider (in milliseconds)|
 |`fhirServer/term/remoteTermServiceProviders/supports`|array of objects|The `supports` element is an array of objects|
 |`fhirServer/term/remoteTermServiceProviders/supports/system`|string|The system URI supported by this remote term service provider|
@@ -1992,8 +2004,11 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/resources/<resourceType>/searchParameterCombinations`|string list|A comma-separated list of search parameter combinations supported for this resource type. Each search parameter combination is a string, where a plus sign, `+`, separates the search parameters that can be used in combination. To indicate that searching without any search parameters is allowed, an empty string must be included in the list. Including an asterisk, `*`, in the list indicates support of any search parameter combination. For resources without the property, the value of `fhirServer/resources/Resource/searchParameterCombinations` is used.|
 |`fhirServer/resources/<resourceType>/profiles/atLeastOne`|string list|A comma-separated list of profiles, at least one of which must be specified in a resource's `meta.profile` element and be successfully validated against in order for a resource of this type to be persisted to the FHIR server. If this property is not specified, or if an empty list is specified, the value of `fhirServer/resources/Resource/profiles/atLeastOne` will be used.|
 |`fhirServer/notifications/common/includeResourceTypes`|string list|A comma-separated list of resource types for which notification event messages should be published.|
+|`fhirServer/notifications/common/maxNotificationSizeBytes`|integer|The maximum size in byte of the notification that should be sent|
+|`fhirServer/notifications/common/maxNotificationSizeBehavior`|string|The behavior of the notification framework when a notification is over the maxNotificationSizeBytes. Valid values are subset and omit|
 |`fhirServer/notifications/websocket/enabled`|boolean|A boolean flag which indicates whether or not websocket notifications are enabled.|
 |`fhirServer/notifications/kafka/enabled`|boolean|A boolean flag which indicates whether or not kafka notifications are enabled.|
+|`fhirServer/notifications/kafka/sync`|boolean|A boolean flag which indicates whether or not the FHIRNotificationEvent is sent in a synchronous mode|
 |`fhirServer/notifications/kafka/topicName`|string|The name of the topic to which kafka notification event messages should be published.|
 |`fhirServer/notifications/kafka/connectionProperties`|property list|A group of connection properties used to configure the KafkaProducer. These properties are used as-is when instantiating the KafkaProducer used by the FHIR server for publishing notification event messages.|
 |`fhirServer/notifications/nats/enabled`|boolean|A boolean flag which indicates whether or not NATS notifications are enabled.|
@@ -2010,8 +2025,11 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/persistence/common/updateCreateEnabled`|boolean|A boolean flag which indicates whether or not the 'update/create' feature should be enabled in the selected persistence layer.|
 |`fhirServer/persistence/datasources`|map|A map containing datasource definitions. See [Section 3.3.1 The JDBC persistence layer](#331-the-jdbc-persistence-layer) for more information.|
 |`fhirServer/persistence/datasources/<datasourceId>/type`|string|`derby` or `db2` or `postgresql`|
+|`fhirServer/persistence/datasources/<datasourceId>/jndiName`|string|The non-default jndiName for the datasource|
+|`fhirServer/persistence/datasources/<datasourceId>/currentSchema`|string|The current schema for the datasource|
 |`fhirServer/persistence/datasources/<datasourceId>/searchOptimizerOptions/from_collapse_limit`|int| For PostgreSQL, sets the from_collapse_limit query optimizer parameter to improve search performance. If not set, the IBM FHIR Server uses a value of 12. To use the database default (8), explicitly set this value to null. |
 |`fhirServer/persistence/datasources/<datasourceId>/searchOptimizerOptions/join_collapse_limit`|int| For PostgreSQL, sets the join_collapse_limit query optimizer parameter to improve search performance. If not set, the IBM FHIR Server uses a value of 12. To use the database default (8), explicitly set this value to null. |
+|`fhirServer/persistence/datasources/<datasourceId>/hints/search.reopt`|string|For Db2, reopt pragma that is injected into the Search query, ALWAYS or ONCE are valid values|
 |`fhirServer/security/cors`|boolean|Used to convey to clients whether cors is supported or not; actual cors support is configured separately in the Liberty server.xml configuration|
 |`fhirServer/security/basic/enabled`|boolean|Whether or not the server is enabled for HTTP Basic authentication|
 |`fhirServer/security/certificates/enabled`|boolean|Whether or not the server is enabled for Certificate-based client authentication|
@@ -2066,29 +2084,31 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/bulkdata/core/defaultExportProvider`|string| The default storage provider used by Bulk Data Export|
 |`fhirServer/bulkdata/core/defaultImportProvider`|string| The default storage provider used by Bulk Data Import|
 |`fhirServer/bulkdata/core/defaultOutcomeProvider`|string| The default storage provider used to output Operation Outcomes (file, s3 only)|
-|`fhirServer/bulkdata/storageProviders/<source>/type`|string|The type of storageProvider aws-s3, ibm-cos, file, https |
+|`fhirServer/bulkdata/core/enableSkippableUpdates`|boolean|Enables the skipping of identical resources|
+|`fhirServer/bulkdata/storageProviders/<source>/type`|string|The type of storageProvider aws-s3, ibm-cos, file, https, azure-blob |
 |`fhirServer/bulkdata/storageProviders/<source>/bucketName`|string| Object store bucket name |
 |`fhirServer/bulkdata/storageProviders/<source>/location`|string|Object store location |
 |`fhirServer/bulkdata/storageProviders/<source>/endpointInternal`|string|Object store end point url used to read/write from COS |
 |`fhirServer/bulkdata/storageProviders/<source>/endpointExternal`|string|Object store end point url used in the constructed download URLs|
-|`fhirServer/bulkdata/storageProviders/<source>/fileBase`|string| The absolute path of the output directory |
+|`fhirServer/bulkdata/storageProviders/<source>/fileBase`|string| The absolute path of the output directory. It is recommended this path is not the mount point of a volume. For instance, if a volume is mounted to /output/bulkdata, use /output/bulkdata/data to ensure a failed mount does not result in writing to the root file system.|
 |`fhirServer/bulkdata/storageProviders/<source>/validBaseUrls`|list|The list of supported urls which are approved for the fhir server to access|
 |`fhirServer/bulkdata/storageProviders/<source>/disableBaseUrlValidation`|boolean|Disables the URL checking feature, allowing all URLs to be imported|
-|`fhirServer/bulkdata/storageProviders/<source>/exportPublic`|boolean|Whether or not the server is configured to support export to parquet; to properly enable it the administrator must first make spark and stocator available to the fhir-bulkdata-webapp (e.g through the shared lib at `wlp/user/shared/resources/lib`)|
-|`fhirServer/bulkdata/storageProviders/<source>/enableParquet`|boolean|If give public read only access to the exported files|
+|`fhirServer/bulkdata/storageProviders/<source>/enableParquet`|boolean|Whether or not the server is configured to support export to parquet; to properly enable it the administrator must first make spark and stocator available to the fhir-bulkdata-webapp (e.g through the shared lib at `wlp/user/shared/resources/lib`)|
 |`fhirServer/bulkdata/storageProviders/<source>/disableOperationOutcomes`|boolean|Disables the base url validation, allowing all URLs to be imported|
 |`fhirServer/bulkdata/storageProviders/<source>/duplicationCheck`|boolean|Enables duplication check on import|
 |`fhirServer/bulkdata/storageProviders/<source>/validateResources`|boolean|Enables the validation of imported resources|
 |`fhirServer/bulkdata/storageProviders/<source>/presigned`|boolean|When an hmac auth type is used, presigns the URLs of an export|
 |`fhirServer/bulkdata/storageProviders/<source>/create`|boolean|Enables the creation of buckets|
-|`fhirServer/bulkdata/storageProviders/<source>/auth/type`|string|A type of hmac, iam, or basic|
-|`fhirServer/bulkdata/storageProviders/<source>/accessKeyId`|string|For HMAC, API key for accessing COS|
-|`fhirServer/bulkdata/storageProviders/<source>/secretAccessKey`|string|For HMAC, secret key for accessing COS|
-|`fhirServer/bulkdata/storageProviders/<source>/iamApiKey`|string|For IAM, API key for accessing IBM COS|
-|`fhirServer/bulkdata/storageProviders/<source>/iamResourceInstanceId`|string|For IAM, secret key for accessing IBM COS|
-|`fhirServer/bulkdata/storageProviders/<source>/user`|string|For basic, user COS|
-|`fhirServer/bulkdata/storageProviders/<source>/secretAccessKey`|string|For basic, password for accessing COS|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/type`|string|A type of hmac, iam, basic or connection|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/accessKeyId`|string|For HMAC, API key for accessing COS|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/secretAccessKey`|string|For HMAC, secret key for accessing COS|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/iamApiKey`|string|For IAM, API key for accessing IBM COS|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/iamResourceInstanceId`|string|For IAM, secret key for accessing IBM COS|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/username`|string|For basic, user COS|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/password`|string|For basic, password for accessing COS|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/connection`|string|For Azure Blob Service, the connection string is used|
 |`fhirServer/bulkdata/storageProviders/<source>/operationOutcomeProvider`|string| the default storage provider used to output Operation Outcomes (file, s3 only)|
+|`fhirServer/bulkdata/storageProviders/<source>/accessType`|string| The s3 access type, `host` or `path` (s3 only) [Link](https://docs.aws.amazon.com/AmazonS3/latest/userguide/VirtualHosting.html)|
 |`fhirServer/operations/erase/enabled`|boolean|Enables the $erase operation|
 |`fhirServer/operations/erase/allowedRoles`|list|The list of allowed roles, allowed entries are: `FHIRUsers` every authenticated user, `FHIROperationAdmin` which is authenticated `FHIRAdmin` users|
 
@@ -2111,6 +2131,8 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/core/defaultPageSize`|10|
 |`fhirServer/core/maxPageSize`|1000|
 |`fhirServer/core/maxPageIncludeCount`|1000|
+|`fhirServer/core/capabilitiesUrl`|string|null|
+|`fhirServer/term/capabilitiesUrl`|string|null|
 |`fhirServer/term/cachingDisabled`|false|
 |`fhirServer/term/graphTermServiceProviders/enabled`|false|
 |`fhirServer/term/graphTermServiceProviders/timeLimit`|90000|
@@ -2132,8 +2154,11 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/resources/<resourceType>/searchParameterCombinations`|null (inherits from `fhirServer/resources/Resource/searchParameterCombinations`)|
 |`fhirServer/resources/<resourceType>/profiles/atLeastOne`|null (inherits from `fhirServer/resources/Resource/profiles/atLeastOne`)|
 |`fhirServer/notifications/common/includeResourceTypes`|`["*"]`|
+|`fhirServer/notifications/common/maxNotificationSizeBytes`|integer|1000000|
+|`fhirServer/notifications/common/maxNotificationSizeBehavior`|string|subset|
 |`fhirServer/notifications/websocket/enabled`|false|
 |`fhirServer/notifications/kafka/enabled`|false|
+|`fhirServer/notifications/kafka/sync`|false|
 |`fhirServer/notifications/kafka/topicName`|fhirNotifications|
 |`fhirServer/notifications/kafka/connectionProperties`|`{}`|
 |`fhirServer/notifications/nats/enabled`|false|
@@ -2150,6 +2175,8 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/persistence/common/updateCreateEnabled`|true|
 |`fhirServer/persistence/datasources`|embedded Derby database: derby/fhirDB|
 |`fhirServer/persistence/datasources/<datasourceId>/type`|derby|
+|`fhirServer/persistence/datasources/<datasourceId>/jndiName`|`jndi/fhir_<tenantId>_<datasourceId>`|
+|`fhirServer/persistence/datasources/<datasourceId>/currentSchema`|null|
 |`fhirServer/persistence/datasources/<datasourceId>/searchOptimizerOptions/from_collapse_limit`|16|
 |`fhirServer/persistence/datasources/<datasourceId>/searchOptimizerOptions/join_collapse_limit`|16|
 |`fhirServer/search/enableOptQueryBuilder`|boolean|true|
@@ -2173,7 +2200,6 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/audit/serviceProperties/geoCounty`|UnknownCountry|
 |`fhirServer/audit/serviceProperties/mapper`|cadf|
 |`fhirServer/audit/serviceProperties/load`|environment|
-|`fhirServer/bulkdata/isExportPublic`|true|
 |`fhirServer/bulkdata/validBaseUrlsDisabled`|false|
 |`fhirServer/bulkdata/cosFileMaxResources`|200000|
 |`fhirServer/bulkdata/cosFileMaxSize`|209715200|
@@ -2198,14 +2224,15 @@ This section contains reference information about each of the configuration prop
 |`fhirServer/bulkdata/core/defaultExportProvider`|default|
 |`fhirServer/bulkdata/core/defaultImportProvider`|default|
 |`fhirServer/bulkdata/core/defaultOutcomeProvider`|default|
+|`fhirServer/bulkdata/core/enableSkippableUpdates`|true|
 |`fhirServer/bulkdata/storageProviders/<source>/disableBaseUrlValidation`|false|
-|`fhirServer/bulkdata/storageProviders/<source>/exportPublic`|false|
 |`fhirServer/bulkdata/storageProviders/<source>/enableParquet`|false|
 |`fhirServer/bulkdata/storageProviders/<source>/disableOperationOutcomes`|false|
 |`fhirServer/bulkdata/storageProviders/<source>/duplicationCheck`|false|
 |`fhirServer/bulkdata/storageProviders/<source>/validateResources`|false|
 |`fhirServer/bulkdata/storageProviders/<source>/presigned`|false|
 |`fhirServer/bulkdata/storageProviders/<source>/create`|false|
+|`fhirServer/bulkdata/storageProviders/<source>/accessType`|`path`|
 |`fhirServer/operations/erase/enabled`|false|
 |`fhirServer/operations/erase/allowedRoles`|empty, all roles|
 
@@ -2237,6 +2264,7 @@ must restart the server for that change to take effect.
 |`fhirServer/core/defaultPageSize`|Y|Y|
 |`fhirServer/core/maxPageSize`|Y|Y|
 |`fhirServer/core/maxPageIncludeCount`|Y|Y|
+|`fhirServer/core/capabilitiesUrl`|Y|Y|
 |`fhirServer/term/cachingDisabled`|N|N|
 |`fhirServer/term/graphTermServiceProviders/enabled`|N|N|
 |`fhirServer/term/graphTermServiceProviders/timeLimit`|N|N|
@@ -2246,8 +2274,10 @@ must restart the server for that change to take effect.
 |`fhirServer/term/remoteTermServiceProviders/trustStore`|N|N|
 |`fhirServer/term/remoteTermServiceProviders/hostnameVerificationEnabled`|N|N|
 |`fhirServer/term/remoteTermServiceProviders/basicAuth`|N|N|
+|`fhirServer/term/remoteTermServiceProviders/headers`|N|N|
 |`fhirServer/term/remoteTermServiceProviders/httpTimeout`|N|N|
 |`fhirServer/term/remoteTermServiceProviders/supports`|N|N|
+|`fhirServer/term/capabilitiesUrl`|Y|Y|
 |`fhirServer/resources/open`|Y|Y|
 |`fhirServer/resources/Resource/interactions`|Y|Y|
 |`fhirServer/resources/Resource/searchParameters`|Y|Y|
@@ -2264,8 +2294,11 @@ must restart the server for that change to take effect.
 |`fhirServer/resources/<resourceType>/searchParameterCombinations`|Y|Y|
 |`fhirServer/resources/<resourceType>/profiles/atLeastOne`|Y|Y|
 |`fhirServer/notifications/common/includeResourceTypes`|N|N|
+|`fhirServer/notifications/common/maxNotificationSizeBytes`|Y|N|
+|`fhirServer/notifications/common/maxNotificationSizeBehavior`|Y|N|
 |`fhirServer/notifications/websocket/enabled`|N|N|
 |`fhirServer/notifications/kafka/enabled`|N|N|
+|`fhirServer/notifications/kafka/sync`|Y|N|
 |`fhirServer/notifications/kafka/topicName`|N|N|
 |`fhirServer/notifications/kafka/connectionProperties`|N|N|
 |`fhirServer/notifications/nats/enabled`|N|N|
@@ -2282,6 +2315,8 @@ must restart the server for that change to take effect.
 |`fhirServer/persistence/common/updateCreateEnabled`|N|N|
 |`fhirServer/persistence/datasources`|Y|N|
 |`fhirServer/persistence/datasources/<datasourceId>/type`|Y|N|
+|`fhirServer/persistence/datasources/<datasourceId>/jndiName`|Y|Y|
+|`fhirServer/persistence/datasources/<datasourceId>/currentSchema`|Y|Y|
 |`fhirServer/persistence/datasources/<datasourceId>/searchOptimizerOptions/from_collapse_limit`|Y|Y|
 |`fhirServer/persistence/datasources/<datasourceId>/searchOptimizerOptions/join_collapse_limit`|Y|Y|
 |`fhirServer/search/enableOptQueryBuilder`|Y|Y|
@@ -2330,6 +2365,7 @@ must restart the server for that change to take effect.
 |`fhirServer/bulkdata/core/defaultExportProvider`|Y|Y|
 |`fhirServer/bulkdata/core/defaultImportProvider`|Y|Y|
 |`fhirServer/bulkdata/core/defaultOutcomeProvider`|Y|Y|
+|`fhirServer/bulkdata/core/enableSkippableUpdates`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/type`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/bucketName`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/location`|Y|Y|
@@ -2338,7 +2374,6 @@ must restart the server for that change to take effect.
 |`fhirServer/bulkdata/storageProviders/<source>/fileBase`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/validBaseUrls`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/disableBaseUrlValidation`|Y|Y|
-|`fhirServer/bulkdata/storageProviders/<source>/exportPublic`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/enableParquet`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/disableOperationOutcomes`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/duplicationCheck`|Y|Y|
@@ -2346,13 +2381,15 @@ must restart the server for that change to take effect.
 |`fhirServer/bulkdata/storageProviders/<source>/presigned`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/create`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/auth/type`|Y|Y|
-|`fhirServer/bulkdata/storageProviders/<source>/accessKeyId`|Y|Y|
-|`fhirServer/bulkdata/storageProviders/<source>/secretAccessKey`|Y|Y|
-|`fhirServer/bulkdata/storageProviders/<source>/iamApiKey`|Y|Y|
-|`fhirServer/bulkdata/storageProviders/<source>/iamResourceInstanceId`|Y|Y|
-|`fhirServer/bulkdata/storageProviders/<source>/user`|Y|Y|
-|`fhirServer/bulkdata/storageProviders/<source>/secretAccessKey`|Y|Y|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/accessKeyId`|Y|Y|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/secretAccessKey`|Y|Y|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/iamApiKey`|Y|Y|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/iamResourceInstanceId`|Y|Y|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/username`|Y|Y|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/password`|Y|Y|
+|`fhirServer/bulkdata/storageProviders/<source>/auth/connection`|Y|Y|
 |`fhirServer/bulkdata/storageProviders/<source>/operationOutcomeProvider`|Y|Y|
+|`fhirServer/bulkdata/storageProviders/<source>/accessType`|Y|Y|
 |`fhirServer/operations/erase/enabled`|Y|Y|
 |`fhirServer/operations/erase/allowedRoles`|Y|Y|
 
diff --git a/fhir-audit/pom.xml b/fhir-audit/pom.xml
index 10d3f060af6..d71415eca40 100644
--- a/fhir-audit/pom.xml
+++ b/fhir-audit/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/ApiParameters.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/ApiParameters.java
index da1da9af959..423d8fb2390 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/ApiParameters.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/ApiParameters.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -13,13 +13,13 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Batch.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Batch.java
index 6398b2c0bc8..595c9b63f1e 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Batch.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Batch.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -13,18 +13,18 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
 /**
- * This class defines the Batch parameters section of the FHIR server
+ * This class defines the Batch parameters section of the IBM FHIR server
  * AuditLogEntry.
  */
 public class Batch {
@@ -37,6 +37,10 @@ public class Batch {
 
     private Long resourcesUpdated;
 
+    private Long resourcesDeleted;
+
+    private Long resourcesExecuted;
+
     public Batch() {
         super();
     }
@@ -73,6 +77,22 @@ public void setResourcesUpdated(Long resourcesUpdated) {
         this.resourcesUpdated = resourcesUpdated;
     }
 
+    public Long getResourcesDeleted() {
+        return resourcesDeleted;
+    }
+
+    public void setResourcesDeleted(Long resourcesDeleted) {
+        this.resourcesDeleted = resourcesDeleted;
+    }
+
+    public Long getResourcesExecuted() {
+        return resourcesExecuted;
+    }
+
+    public void setResourcesExecuted(Long resourcesExecuted) {
+        this.resourcesExecuted = resourcesExecuted;
+    }
+
     /**
      * Generates JSON from this object.
      */
@@ -120,6 +140,14 @@ public static void generate(Batch obj, JsonGenerator generator)
                 generator.write("resources_updated", obj.getResourcesUpdated());
             }
 
+            if (obj.getResourcesDeleted() != null) {
+                generator.write("resources_deleted", obj.getResourcesDeleted());
+            }
+
+            if (obj.getResourcesExecuted() != null) {
+                generator.write("resources_executed", obj.getResourcesExecuted());
+            }
+
             if (obj.getStatus() != null) {
                 generator.write("status", obj.getStatus());
             }
@@ -169,6 +197,18 @@ public static Batch parse(JsonObject jsonObject) {
                 builder.resourcesUpdated(resourcesUpdated);
             }
 
+            t = jsonObject.get("resources_deleted");
+            if (t != null) {
+                long resourcesDeleted = jsonObject.getInt("resources_deleted");
+                builder.resourcesDeleted(resourcesDeleted);
+            }
+
+            t = jsonObject.get("resources_executed");
+            if (t != null) {
+                long resourcesExecuted = jsonObject.getInt("resources_executed");
+                builder.resourcesExecuted(resourcesExecuted);
+            }
+
             t = jsonObject.get("status");
             if (t != null) {
                 String status = jsonObject.getString("status");
@@ -209,6 +249,16 @@ public Builder resourcesUpdated(long resourcesUpdated) {
             return this;
         }
 
+        public Builder resourcesDeleted(long resourcesDeleted) {
+            batch.setResourcesDeleted(resourcesDeleted);
+            return this;
+        }
+
+        public Builder resourcesExecuted(long resourcesExecuted) {
+            batch.setResourcesExecuted(resourcesExecuted);
+            return this;
+        }
+
         public Batch build() {
             return batch;
         }
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/ConfigData.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/ConfigData.java
index 00fe984723a..4972f174a39 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/ConfigData.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/ConfigData.java
@@ -13,13 +13,13 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Context.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Context.java
index 160d621035e..50a0a9071a4 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Context.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Context.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -13,13 +13,13 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Data.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Data.java
index e8254dc8409..f99dc1ca3bb 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Data.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/Data.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -13,13 +13,13 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/FHIRContext.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/FHIRContext.java
index 23120145078..9039d136a57 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/FHIRContext.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/beans/FHIRContext.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -13,13 +13,13 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfAttachment.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfAttachment.java
index 5e99fe06e1d..431ee7058a9 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfAttachment.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfAttachment.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -18,12 +18,12 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfCredential.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfCredential.java
index cd2d078b787..624500546b5 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfCredential.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfCredential.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -15,13 +15,13 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfEndpoint.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfEndpoint.java
index 90633833d73..dccf8c88d9e 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfEndpoint.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfEndpoint.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -13,12 +13,12 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfEvent.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfEvent.java
index 6cb0f9e452e..b149e57aa53 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfEvent.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfEvent.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -18,14 +18,14 @@
 import java.util.Map;
 import java.util.UUID;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.audit.cadf.enums.Action;
 import com.ibm.fhir.audit.cadf.enums.EventType;
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfGeolocation.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfGeolocation.java
index 1aaa4c39a48..9dfc2b46fec 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfGeolocation.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfGeolocation.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -16,13 +16,13 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMapItem.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMapItem.java
index fc61c4bc2d7..f42cbef377b 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMapItem.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMapItem.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -18,12 +18,12 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMeasurement.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMeasurement.java
index 9dc99274d70..e9f2d4fa1ad 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMeasurement.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMeasurement.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -18,12 +18,12 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMetric.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMetric.java
index c287f3c19ba..f168a36ec15 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMetric.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfMetric.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -15,13 +15,13 @@
 import java.util.List;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfReason.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfReason.java
index e609f5b72ae..4ebaedcd623 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfReason.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfReason.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -13,12 +13,12 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIRException;
 
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfReporterStep.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfReporterStep.java
index 453de25b61b..5139edb53ed 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfReporterStep.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfReporterStep.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -22,13 +22,13 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.audit.cadf.enums.ReporterRole;
 import com.ibm.fhir.exception.FHIRException;
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfResource.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfResource.java
index 9b8f5e4a31e..c7c4f859aed 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfResource.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/cadf/CadfResource.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -15,14 +15,14 @@
 import java.util.Collections;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.audit.cadf.enums.ResourceType;
 import com.ibm.fhir.exception.FHIRException;
diff --git a/fhir-audit/src/main/java/com/ibm/fhir/audit/configuration/type/IBMEventStreamsType.java b/fhir-audit/src/main/java/com/ibm/fhir/audit/configuration/type/IBMEventStreamsType.java
index 3796d5e6799..56924541727 100644
--- a/fhir-audit/src/main/java/com/ibm/fhir/audit/configuration/type/IBMEventStreamsType.java
+++ b/fhir-audit/src/main/java/com/ibm/fhir/audit/configuration/type/IBMEventStreamsType.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -16,17 +16,17 @@
 import java.util.logging.Logger;
 import java.util.stream.Collectors;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonString;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
-
 import com.ibm.fhir.exception.FHIRException;
 
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonString;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
+
 /**
  * Helper class to process IBM Event Streams bindings into useful Kafka
  * entries.
@@ -222,7 +222,7 @@ public static EventStreamsCredentials parse(String in)
                     }
 
                     return builder.build();
-                } catch (javax.json.stream.JsonParsingException jpe) {
+                } catch (jakarta.json.stream.JsonParsingException jpe) {
                     throw new FHIRException("Parsed invalid ", jpe);
                 }
             }
diff --git a/fhir-audit/src/test/java/com/ibm/fhir/audit/cadf/test/AuditCadfTest.java b/fhir-audit/src/test/java/com/ibm/fhir/audit/cadf/test/AuditCadfTest.java
index 035333d3c88..838ee68cfde 100644
--- a/fhir-audit/src/test/java/com/ibm/fhir/audit/cadf/test/AuditCadfTest.java
+++ b/fhir-audit/src/test/java/com/ibm/fhir/audit/cadf/test/AuditCadfTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -12,9 +12,9 @@
 
 import java.util.Date;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
 
 import org.testng.annotations.BeforeClass;
 import org.testng.annotations.Test;
diff --git a/fhir-audit/src/test/java/com/ibm/fhir/audit/configuration/ConfigurationTest.java b/fhir-audit/src/test/java/com/ibm/fhir/audit/configuration/ConfigurationTest.java
index 8cb3f498844..291db6931c2 100644
--- a/fhir-audit/src/test/java/com/ibm/fhir/audit/configuration/ConfigurationTest.java
+++ b/fhir-audit/src/test/java/com/ibm/fhir/audit/configuration/ConfigurationTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2020
+ * (C) Copyright IBM Corp. 2020, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -8,9 +8,9 @@
 import static org.junit.Assert.assertNotNull;
 import static org.testng.Assert.assertEquals;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
 
 import org.testng.annotations.BeforeClass;
 import org.testng.annotations.Test;
diff --git a/fhir-audit/src/test/java/com/ibm/fhir/audit/environment/KafkaEnvironmentTest.java b/fhir-audit/src/test/java/com/ibm/fhir/audit/environment/KafkaEnvironmentTest.java
index 497f0e01040..5f35f7578fd 100644
--- a/fhir-audit/src/test/java/com/ibm/fhir/audit/environment/KafkaEnvironmentTest.java
+++ b/fhir-audit/src/test/java/com/ibm/fhir/audit/environment/KafkaEnvironmentTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2020
+ * (C) Copyright IBM Corp. 2020, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -9,9 +9,9 @@
 
 import java.util.Properties;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
 
 import org.testng.annotations.BeforeClass;
 import org.testng.annotations.Test;
diff --git a/fhir-benchmark/pom.xml b/fhir-benchmark/pom.xml
index f70b7122b4b..162f02ca502 100644
--- a/fhir-benchmark/pom.xml
+++ b/fhir-benchmark/pom.xml
@@ -5,7 +5,7 @@
 
     <groupId>com.ibm.fhir</groupId>
     <artifactId>fhir-benchmark</artifactId>
-    <version>4.8.0-SNAPSHOT</version>
+    <version>4.9.0-SNAPSHOT</version>
     <packaging>jar</packaging>
 
     <name>IBM FHIR Server - FHIR Benchmark</name>
@@ -14,7 +14,7 @@
         <maven.deploy.skip>true</maven.deploy.skip>
         <project.build.sourceEncoding>UTF-8</project.build.sourceEncoding>
         <!-- JMH version to use with this project. -->
-        <jmh.version>1.21</jmh.version>
+        <jmh.version>1.32</jmh.version>
     
         <!-- Java source/target to use for compilation. -->
         <javac.target>1.8</javac.target>
@@ -38,17 +38,17 @@
         <dependency>
             <groupId>com.ibm.fhir</groupId>
             <artifactId>fhir-model</artifactId>
-            <version>4.8.0-SNAPSHOT</version>
+            <version>4.9.0-SNAPSHOT</version>
         </dependency>
         <dependency>
             <groupId>com.ibm.fhir</groupId>
             <artifactId>fhir-examples</artifactId>
-            <version>4.8.0-SNAPSHOT</version>
+            <version>4.8.2</version>
         </dependency>
         <dependency>
             <groupId>com.ibm.fhir</groupId>
             <artifactId>fhir-validation</artifactId>
-            <version>4.8.0-SNAPSHOT</version>
+            <version>4.9.0-SNAPSHOT</version>
         </dependency>
         <!-- Updated to 4.0.1 -->
         <dependency>
diff --git a/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRIndexParserBenchmark.java b/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRIndexParserBenchmark.java
new file mode 100644
index 00000000000..24f4cb56b68
--- /dev/null
+++ b/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRIndexParserBenchmark.java
@@ -0,0 +1,127 @@
+/*
+ * (C) Copyright IBM Corp. 2019, 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.benchmark;
+
+import java.io.BufferedReader;
+import java.io.IOException;
+import java.io.Reader;
+import java.io.StringReader;
+import java.util.HashSet;
+import java.util.Set;
+import java.util.stream.Collectors;
+
+import org.apache.commons.io.IOUtils;
+import org.openjdk.jmh.annotations.Benchmark;
+import org.openjdk.jmh.annotations.Scope;
+import org.openjdk.jmh.annotations.Setup;
+import org.openjdk.jmh.annotations.State;
+
+import com.ibm.fhir.benchmark.runner.FHIRBenchmarkRunner;
+import com.ibm.fhir.examples.ExamplesUtil;
+import com.ibm.fhir.examples.Index;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.parser.FHIRParser;
+import com.ibm.fhir.model.parser.exception.FHIRParserException;
+
+
+public class FHIRIndexParserBenchmark {
+    @State(Scope.Benchmark)
+    public static class FHIRParserState {
+        public static final Index INDEX = Index.PROFILES_PDEX_PLAN_NET_JSON;
+
+        Set<String> JSON_SPEC_EXAMPLES = new HashSet<>();
+
+        @Setup
+        public void setUp() throws IOException {
+            System.out.println("Setting up for index " + INDEX);
+
+            // Each line of the index file should be a path to an example resource and an expected outcome
+            try (BufferedReader br = new BufferedReader(ExamplesUtil.indexReader(INDEX))) {
+                String line;
+
+                while ((line = br.readLine()) != null) {
+                    String[] tokens = line.split("\\s+");
+                    if (tokens.length == 2) {
+                        String expectation = tokens[0];
+                        String example = tokens[1];
+                        if ("OK".equals(expectation)) {
+                            Reader resourceReader = ExamplesUtil.resourceReader(example);
+                            JSON_SPEC_EXAMPLES.add(IOUtils.toString(resourceReader));
+                        }
+                    }
+                }
+            }
+        }
+    }
+
+    @Benchmark
+    public Set<?> benchmarkJsonParserStream(FHIRParserState state) throws Exception {
+        return state.JSON_SPEC_EXAMPLES.stream()
+            .map(s -> new StringReader(s))
+            .map(r -> {
+                try {
+                    FHIRParser parser = FHIRParser.parser(Format.JSON);
+                    return parser.parse(r);
+                } catch (FHIRParserException e) {
+                    throw new RuntimeException("exception during parse", e);
+                }
+            })
+            .collect(Collectors.toSet());
+    }
+
+    @Benchmark
+    public Set<?> benchmarkJsonParserStreamParallel(FHIRParserState state) throws Exception {
+        return state.JSON_SPEC_EXAMPLES.parallelStream()
+            .map(s -> new StringReader(s))
+            .map(r -> {
+                try {
+                    FHIRParser parser = FHIRParser.parser(Format.JSON);
+                    return parser.parse(r);
+                } catch (FHIRParserException e) {
+                    throw new RuntimeException("exception during parse", e);
+                }
+            })
+            .collect(Collectors.toSet());
+    }
+
+    @Benchmark
+    public Set<?> benchmarkJsonParserNonValidatingStream(FHIRParserState state) throws Exception {
+        return state.JSON_SPEC_EXAMPLES.stream()
+            .map(s -> new StringReader(s))
+            .map(r -> {
+                try {
+                    FHIRParser parser = FHIRParser.parser(Format.JSON);
+                    parser.setValidating(false);
+                    return parser.parse(r);
+                } catch (FHIRParserException e) {
+                    throw new RuntimeException("exception during parse", e);
+                }
+            })
+            .collect(Collectors.toSet());
+    }
+
+    @Benchmark
+    public Set<?> benchmarkJsonParserNonValidatingStreamParallel(FHIRParserState state) throws Exception {
+        return state.JSON_SPEC_EXAMPLES.parallelStream()
+            .map(s -> new StringReader(s))
+            .map(r -> {
+                try {
+                    FHIRParser parser = FHIRParser.parser(Format.JSON);
+                    parser.setValidating(false);
+                    return parser.parse(r);
+                } catch (FHIRParserException e) {
+                    throw new RuntimeException("exception during parse", e);
+                }
+            })
+            .collect(Collectors.toSet());
+    }
+
+
+    public static void main(String[] args) throws Exception {
+        new FHIRBenchmarkRunner(FHIRIndexParserBenchmark.class).run();
+    }
+}
diff --git a/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRParserBenchmark.java b/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRParserBenchmark.java
index eaf43fbcccf..b68374e6ec3 100644
--- a/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRParserBenchmark.java
+++ b/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRParserBenchmark.java
@@ -1,16 +1,17 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
 
 package com.ibm.fhir.benchmark;
 
+import static com.ibm.fhir.benchmark.runner.FHIRBenchmarkRunner.PROPERTY_EXAMPLE_NAME;
+
 import java.io.IOException;
 import java.io.StringReader;
 
 import org.openjdk.jmh.annotations.Benchmark;
-import org.openjdk.jmh.annotations.Param;
 import org.openjdk.jmh.annotations.Scope;
 import org.openjdk.jmh.annotations.Setup;
 import org.openjdk.jmh.annotations.State;
@@ -31,23 +32,18 @@ public static class FHIRParsers {
         FHIRParser jsonParser = FHIRParser.parser(Format.JSON);
         FHIRParser xmlParser = FHIRParser.parser(Format.XML);
     }
-    
+
     @State(Scope.Benchmark)
     public static class FHIRParserState {
+        public static final String SPEC_EXAMPLE_NAME = System.getProperty(PROPERTY_EXAMPLE_NAME);
+
         FhirContext context;
         String JSON_SPEC_EXAMPLE;
         String XML_SPEC_EXAMPLE;
-        
-        // JMH will inject the value into the annotated field before any Setup method is called.
-        @Param({"valuesets"})
-        public String exampleName;
-        
+
         @Setup
         public void setUp() throws IOException {
-            if (exampleName == null) {
-                System.err.println("exampleName is null; if you're in Eclipse then make sure annotation processing is on and you've ran 'mvn clean package'.");
-                System.exit(1);
-            }
+            String exampleName = SPEC_EXAMPLE_NAME;
             System.out.println("Setting up for example " + exampleName);
             context = FhirContext.forR4();
             context.setParserErrorHandler(new StrictErrorHandler());
@@ -55,28 +51,44 @@ public void setUp() throws IOException {
             XML_SPEC_EXAMPLE = BenchmarkUtil.getSpecExample(Format.XML, exampleName);
         }
     }
-    
+
     @Benchmark
     public Resource benchmarkJsonParser(FHIRParsers parsers, FHIRParserState state) throws Exception {
+        parsers.jsonParser.setValidating(true);
         return parsers.jsonParser.parse(new StringReader(state.JSON_SPEC_EXAMPLE));
     }
-    
+
+    @Benchmark
+    public Resource benchmarkJsonParserNonValidating(FHIRParsers parsers, FHIRParserState state) throws Exception {
+        parsers.jsonParser.setValidating(false);
+        return parsers.jsonParser.parse(new StringReader(state.JSON_SPEC_EXAMPLE));
+    }
+
     @Benchmark
     public Resource benchmarkXMLParser(FHIRParsers parsers, FHIRParserState state) throws Exception {
+        parsers.xmlParser.setValidating(true);
+        return parsers.xmlParser.parse(new StringReader(state.XML_SPEC_EXAMPLE));
+    }
+
+    @Benchmark
+    public Resource benchmarkXMLParserNonValidating(FHIRParsers parsers, FHIRParserState state) throws Exception {
+        parsers.xmlParser.setValidating(false);
         return parsers.xmlParser.parse(new StringReader(state.XML_SPEC_EXAMPLE));
     }
-    
+
     @Benchmark
     public void benchmarkHAPIJsonParser(FHIRParserState state) throws Exception {
         state.context.newJsonParser().parseResource(new StringReader(state.JSON_SPEC_EXAMPLE));
     }
-    
+
     @Benchmark
     public void benchmarkHAPIXMLParser(FHIRParserState state) throws Exception {
         state.context.newXmlParser().parseResource(new StringReader(state.XML_SPEC_EXAMPLE));
     }
-    
+
     public static void main(String[] args) throws Exception {
-        new FHIRBenchmarkRunner(FHIRParserBenchmark.class).run();
+        new FHIRBenchmarkRunner(FHIRParserBenchmark.class)
+            .property(PROPERTY_EXAMPLE_NAME, BenchmarkUtil.getRandomSpecExampleName())
+            .run();
     }
 }
diff --git a/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRPatchBenchmark.java b/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRPatchBenchmark.java
index 78296b88aec..0dc22cbe7ef 100644
--- a/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRPatchBenchmark.java
+++ b/fhir-benchmark/src/main/java/com/ibm/fhir/benchmark/FHIRPatchBenchmark.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -9,10 +9,10 @@
 import java.io.StringReader;
 import java.time.Instant;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
-import javax.json.spi.JsonProvider;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
+import jakarta.json.spi.JsonProvider;
 
 import org.openjdk.jmh.annotations.Benchmark;
 import org.openjdk.jmh.annotations.Param;
diff --git a/fhir-bucket/pom.xml b/fhir-bucket/pom.xml
index 67d9c8021ec..2389ec0dbcf 100644
--- a/fhir-bucket/pom.xml
+++ b/fhir-bucket/pom.xml
@@ -7,7 +7,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-bulkdata-webapp/pom.xml b/fhir-bulkdata-webapp/pom.xml
index c83eff78329..1c0b7e0cbb8 100644
--- a/fhir-bulkdata-webapp/pom.xml
+++ b/fhir-bulkdata-webapp/pom.xml
@@ -8,7 +8,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
       
@@ -107,6 +107,25 @@
             <artifactId>fhir-provider</artifactId>
             <version>${project.version}</version>
         </dependency>
+        <dependency>
+            <!-- azure needs to come before spark/stocator -->
+            <groupId>com.azure</groupId>
+            <artifactId>azure-storage-blob</artifactId>
+            <exclusions>
+                <exclusion>
+                    <groupId>com.azure</groupId>
+                    <artifactId>azure-core-http-netty</artifactId>
+                </exclusion>
+            </exclusions>
+        </dependency>
+        <dependency>
+            <groupId>com.azure</groupId>
+            <artifactId>azure-core-http-okhttp</artifactId>
+        </dependency>
+        <dependency>
+            <groupId>com.azure</groupId>
+            <artifactId>azure-core</artifactId>
+        </dependency>
         <dependency>
             <groupId>org.apache.spark</groupId>
             <artifactId>spark-sql_2.12</artifactId>
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/common/BulkDataUtils.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/common/BulkDataUtils.java
index 637c9b99269..67707fba3a4 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/common/BulkDataUtils.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/common/BulkDataUtils.java
@@ -15,11 +15,9 @@
 import java.nio.charset.StandardCharsets;
 import java.nio.file.Files;
 import java.nio.file.Paths;
-import java.time.Instant;
 import java.util.ArrayList;
 import java.util.Arrays;
 import java.util.Base64;
-import java.util.Date;
 import java.util.HashMap;
 import java.util.List;
 import java.util.Map;
@@ -28,18 +26,16 @@
 import java.util.stream.Collectors;
 import java.util.stream.Stream;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonReader;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonReader;
 
 import com.ibm.cloud.objectstorage.services.s3.AmazonS3;
 import com.ibm.cloud.objectstorage.services.s3.model.AbortMultipartUploadRequest;
-import com.ibm.cloud.objectstorage.services.s3.model.CannedAccessControlList;
 import com.ibm.cloud.objectstorage.services.s3.model.CompleteMultipartUploadRequest;
 import com.ibm.cloud.objectstorage.services.s3.model.GetObjectRequest;
 import com.ibm.cloud.objectstorage.services.s3.model.InitiateMultipartUploadRequest;
 import com.ibm.cloud.objectstorage.services.s3.model.InitiateMultipartUploadResult;
-import com.ibm.cloud.objectstorage.services.s3.model.ObjectMetadata;
 import com.ibm.cloud.objectstorage.services.s3.model.PartETag;
 import com.ibm.cloud.objectstorage.services.s3.model.S3Object;
 import com.ibm.cloud.objectstorage.services.s3.model.S3ObjectInputStream;
@@ -76,20 +72,11 @@ private static void log(String method, Object msg) {
         logger.info(method + ": " + String.valueOf(msg));
     }
 
-    public static String startPartUpload(AmazonS3 cosClient, String bucketName, String itemName, boolean isPublicAccess) throws Exception {
+    public static String startPartUpload(AmazonS3 cosClient, String bucketName, String itemName) throws Exception {
         try {
             log("startPartUpload", "Start multi-part upload for " + itemName + " to bucket - " + bucketName);
 
             InitiateMultipartUploadRequest initMultipartUploadReq = new InitiateMultipartUploadRequest(bucketName, itemName);
-            if (isPublicAccess) {
-                initMultipartUploadReq.setCannedACL(CannedAccessControlList.PublicRead);
-                ObjectMetadata metadata = new ObjectMetadata();
-                // Set expiration time to 2 hours(7200 seconds).
-                // Note: IBM COS doesn't honor this but also doesn't fail on this.
-                metadata.setExpirationTime(Date.from(Instant.now().plusSeconds(7200)));
-                initMultipartUploadReq.setObjectMetadata(metadata);
-            }
-
             InitiateMultipartUploadResult mpResult = cosClient.initiateMultipartUpload(initMultipartUploadReq);
             return mpResult.getUploadId();
         } catch (Exception sdke) {
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/export/patient/resource/PatientResourceHandler.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/export/patient/resource/PatientResourceHandler.java
index 4e9a7fe0f5e..45eab8be72a 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/export/patient/resource/PatientResourceHandler.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/export/patient/resource/PatientResourceHandler.java
@@ -76,7 +76,7 @@ public void register(ExportTransientUserData chunkData, BulkDataContext ctx, FHI
      * @param patientIds the patient ids to use to scope the search
      * @throws Exception
      */
-    public List<Resource> executeSearch(List<String> patientIds) throws Exception {
+    public List<Resource> executeSearch(Set<String> patientIds) throws Exception {
         List<Map<String, List<String>>> typeFilters = searchParametersForResoureTypes.get(resourceType);
         boolean isDoDuplicationCheck = typeFilters != null && typeFilters.size() > 1 ?
                 true : adapter.shouldStorageProviderCheckDuplicate(ctx.getSource());
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/context/BatchContextAdapter.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/context/BatchContextAdapter.java
index fc542665f24..3e45fd1e674 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/context/BatchContextAdapter.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/context/BatchContextAdapter.java
@@ -187,7 +187,7 @@ private void source(BulkDataContext ctx) {
 
     private void addImport(BulkDataContext ctx) {
         ctx.setPartitionResourceType(props.getProperty(OperationFields.PARTITION_RESOURCETYPE));
-        ctx.setImportPartitionWorkitem(props.getProperty(OperationFields.PARTITTION_WORKITEM));
+        ctx.setImportPartitionWorkitem(props.getProperty(OperationFields.PARTITION_WORKITEM));
         ctx.setDataSourceStorageType(props.getProperty(OperationFields.FHIR_IMPORT_STORAGE_TYPE));
     }
 }
\ No newline at end of file
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/fast/ResourcePayloadReader.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/fast/ResourcePayloadReader.java
index ed241b660b0..42c7f877f42 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/fast/ResourcePayloadReader.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/fast/ResourcePayloadReader.java
@@ -38,6 +38,8 @@
 import com.ibm.fhir.bulkdata.jbatch.export.fast.checkpoint.ResourceExportCheckpointAlgorithm;
 import com.ibm.fhir.bulkdata.jbatch.export.fast.data.CheckpointUserData;
 import com.ibm.fhir.bulkdata.jbatch.export.fast.data.TransientUserData;
+import com.ibm.fhir.bulkdata.provider.Provider;
+import com.ibm.fhir.bulkdata.provider.impl.AzureProvider;
 import com.ibm.fhir.bulkdata.provider.impl.S3Provider;
 import com.ibm.fhir.model.resource.Resource;
 import com.ibm.fhir.model.util.ModelSupport;
@@ -45,6 +47,7 @@
 import com.ibm.fhir.operation.bulkdata.config.ConfigurationFactory;
 import com.ibm.fhir.operation.bulkdata.model.type.BulkDataContext;
 import com.ibm.fhir.operation.bulkdata.model.type.OperationFields;
+import com.ibm.fhir.operation.bulkdata.model.type.StorageType;
 import com.ibm.fhir.persistence.FHIRPersistence;
 import com.ibm.fhir.persistence.ResourcePayload;
 import com.ibm.fhir.persistence.helper.FHIRPersistenceHelper;
@@ -86,8 +89,8 @@ public class ResourcePayloadReader extends AbstractItemReader {
 
     private BulkAuditLogger auditLogger = new BulkAuditLogger();
 
-    // S3 client API to IBM Cloud Object Storage
-    private S3Provider wrapper = null;
+    // Provider client API to IBM Cloud Object Storage or Azure
+    private Provider provider = null;
     private AmazonS3 cosClient = null;
 
     // The handle to the persistence instance used to fetch the resources we want to export
@@ -99,7 +102,6 @@ public class ResourcePayloadReader extends AbstractItemReader {
     private BulkDataContext ctx = null;
 
     String fhirResourceType;
-    private boolean isExportPublic = true;
 
     String cosBucketName;
     String cosBucketPathPrefix;
@@ -263,14 +265,15 @@ public void open(Serializable checkpoint) throws Exception {
         fhirPersistence = fhirPersistenceHelper.getFHIRPersistenceImplementation();
         resourceType = ModelSupport.getResourceType(fhirResourceType);
 
-        isExportPublic = adapter.isStorageProviderExportPublic(source);
-
-        wrapper = new S3Provider(source);
-
-        // Make sure we have the bucket and conditionally create it.
-        wrapper.createSource();
-
-        cosClient = wrapper.getClient();
+        if (StorageType.AZURE == adapter.getStorageProviderStorageType(source)) {
+            provider = new AzureProvider(source);
+        } else {
+            // Make sure we have the bucket and conditionally create it.
+            S3Provider s3 = new S3Provider(source);
+            cosClient = s3.getClient();
+            provider = s3;
+        }
+        provider.createSource();
     }
 
     @Override
@@ -322,7 +325,7 @@ public Object readItem() throws Exception {
                     if (!isTxTimeExpired()) {
                         // The fetchResourcePayloads returned before the tx time expired, so
                         // we really don't have any more data
-                        logger.fine(logPrefix() + " no more data");
+                        logger.fine(() -> logPrefix() + " no more data");
                         moreData = false;
                     }
                 }
@@ -366,7 +369,6 @@ public Object readItem() throws Exception {
      * @return
      */
     public Boolean processPayload(ResourcePayload t) {
-
         try {
             // Track resources we've seen on the most recent timestamp. Resources will be fed
             // in timestamp order, but not necessarily resource order, so we need to skip resources
@@ -444,16 +446,22 @@ protected boolean isTxTimeExpired() {
     private void uploadWhenReady() throws Exception {
         // Initiate the upload if we don't have one active
         if (this.uploadId == null) {
-            // Start a new upload
-            if (cosBucketPathPrefix != null && cosBucketPathPrefix.trim().length() > 0) {
-                this.currentObjectName = cosBucketPathPrefix + "/" + fhirResourceType + "_" + this.currentUploadNumber + ".ndjson";
-            } else {
-                this.currentObjectName = "job" + jobContext.getExecutionId() + "/" + fhirResourceType + "_" + this.currentUploadNumber + ".ndjson";
-            }
-            uploadId = BulkDataUtils.startPartUpload(cosClient, cosBucketName, this.currentObjectName, isExportPublic);
+            if (cosClient != null) {
+                // Start a new upload
+                if (cosBucketPathPrefix != null && cosBucketPathPrefix.trim().length() > 0) {
+                    this.currentObjectName = cosBucketPathPrefix + "/" + fhirResourceType + "_" + this.currentUploadNumber + ".ndjson";
+                } else {
+                    this.currentObjectName = "job" + jobContext.getExecutionId() + "/" + fhirResourceType + "_" + this.currentUploadNumber + ".ndjson";
+                }
+                uploadId = BulkDataUtils.startPartUpload(cosClient, cosBucketName, this.currentObjectName);
 
-            if (logger.isLoggable(Level.FINE)) {
-                logger.fine(logPrefix() + " Started new multi-part upload: '" + this.uploadId + "'");
+                if (logger.isLoggable(Level.FINE)) {
+                    logger.fine(logPrefix() + " Started new multi-part upload: '" + this.uploadId + "'");
+                }
+            } else if (provider instanceof AzureProvider) {
+                // Must be Azure
+                uploadId = "azure";
+                currentObjectName = cosBucketPathPrefix + "/" + fhirResourceType + "_" + this.currentUploadNumber + ".ndjson";
             }
         }
 
@@ -462,10 +470,30 @@ private void uploadWhenReady() throws Exception {
         // upload would take too long and exceed our transaction
         // timeout.
         if (this.ioBuffer.size() > this.partUploadTriggerSize) {
-            uploadPart();
+            if (cosClient != null) {
+                uploadPart();
+            } else {
+                uploadPartToAzure();
+            }
         }
     }
 
+    /**
+     * writes to Azure blob
+     * @throws Exception
+     */
+    private void uploadPartToAzure() throws Exception {
+        // Azure API: Part number must be an integer between 1 and 10000
+        int currentObjectPartNumber = uploadedParts.size() + 1;
+        logger.fine(() -> logPrefix() + " Uploading part# " + currentObjectPartNumber + " ["+ ioBuffer.size() + " bytes] for uploadId '" + uploadId + "'");
+
+        // The ioBuffer can provide us with an InputStream without having to copy the byte-buffer
+        InputStream in = ioBuffer.inputStream();
+        AzureProvider pro = (AzureProvider) provider;
+        pro.writeDirectly(currentObjectName, in, ioBuffer.size());
+        ioBuffer.reset();
+    }
+
     /**
      * Upload the contents of the outputStream (data buffer) using the current multi-part upload
      * @throws Exception
@@ -473,9 +501,7 @@ private void uploadWhenReady() throws Exception {
     private void uploadPart() throws Exception {
         // S3 API: Part number must be an integer between 1 and 10000
         int currentObjectPartNumber = uploadedParts.size() + 1;
-        if (logger.isLoggable(Level.FINE)) {
-            logger.fine(logPrefix() + " Uploading part# " + currentObjectPartNumber + " ["+ ioBuffer.size() + " bytes] for uploadId '" + uploadId + "'");
-        }
+        logger.fine(() -> logPrefix() + " Uploading part# " + currentObjectPartNumber + " ["+ ioBuffer.size() + " bytes] for uploadId '" + uploadId + "'");
 
         // The ioBuffer can provide us with an InputStream without having to copy the byte-buffer
         InputStream is = ioBuffer.inputStream();
@@ -495,15 +521,20 @@ private void completeCurrentUpload() throws Exception {
 
         // upload any final amount of data we have in the buffer
         if (this.ioBuffer.size() > 0) {
-            logger.fine(logPrefix() + " uploading final part for '" + this.uploadId + "'");
-            uploadPart();
+            logger.fine(() -> logPrefix() + " uploading final part for '" + this.uploadId + "'");
+            if (cosClient != null) {
+                uploadPart();
+            } else {
+                uploadPartToAzure();
+            }
         }
 
         // Ask COS to finalize the upload for the current object.
         try  {
-            logger.fine(logPrefix() + " finishing multi-part upload '" + this.uploadId + "'");
-            BulkDataUtils.finishMultiPartUpload(cosClient, cosBucketName, currentObjectName, uploadId,
-                    uploadedParts);
+            logger.fine(() -> logPrefix() + " finishing multi-part upload '" + this.uploadId + "'");
+            if (cosClient != null) {
+                BulkDataUtils.finishMultiPartUpload(cosClient, cosBucketName, currentObjectName, uploadId, uploadedParts);
+            }
 
             // record how many resources we've exported for COS object. This is
             // used by the collector/analyzer to generate a list of objects. Inherited from
@@ -522,7 +553,7 @@ private void resetUploadState() {
         // Note this only resets the state related to upload...it does not and
         // should not affect the state related to reading because we might still
         // have more data to process and upload into a new COS object.
-        logger.fine(logPrefix() + " resetting state so we are ready to upload the next object");
+        logger.fine(() -> logPrefix() + " resetting state so we are ready to upload the next object");
         this.uploadedParts.clear();
         this.uploadId = null;
         this.currentObjectName = null;
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/group/ChunkReader.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/group/ChunkReader.java
index dff3d71d3ae..2500bcba788 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/group/ChunkReader.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/group/ChunkReader.java
@@ -148,7 +148,7 @@ public Object readItem() throws Exception {
             if (!patientIds.isEmpty()) {
                 patientHandler.register(chunkData, ctx, getPersistence(), pageSize, resourceType, searchParametersForResoureTypes, ctx.getSource());
 
-                List<Resource> resources = patientHandler.executeSearch(new ArrayList<>(patientIds));
+                List<Resource> resources = patientHandler.executeSearch(patientIds);
                 if (FHIRMediaType.APPLICATION_PARQUET.equals(ctx.getFhirExportFormat())) {
                     dto.setResources(resources);
                 }
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/patient/ChunkReader.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/patient/ChunkReader.java
index 33b7cb7ba56..3394a96d380 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/patient/ChunkReader.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/patient/ChunkReader.java
@@ -241,9 +241,9 @@ public Object readItem() throws Exception {
                     logger.fine("readItem[" + ctx.getPartitionResourceType() + "]: loaded " + patientResources.size() + " patients");
                 }
 
-                List<String> patientIds = patientResources.stream()
+                Set<String> patientIds = patientResources.stream()
                             .map(item -> item.getId())
-                            .collect(Collectors.toList());
+                            .collect(Collectors.toSet());
 
                 if (!patientIds.isEmpty()) {
                     handler.register(chunkData, ctx, fhirPersistence, pageSize, resourceType, searchParametersForResoureTypes, ctx.getSource());
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/system/ChunkWriter.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/system/ChunkWriter.java
index 5b678fdbbbc..7350d3712bd 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/system/ChunkWriter.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/export/system/ChunkWriter.java
@@ -36,8 +36,6 @@
  */
 @Dependent
 public class ChunkWriter extends AbstractItemWriter {
-    private boolean isExportPublic = true;
-
     private BulkDataContext ctx = null;
     private Provider wrapper = null;
 
@@ -93,7 +91,7 @@ public void writeItems(List<java.lang.Object> resourceLists) throws Exception {
         wrapper.createSource();
 
         ExportTransientUserData chunkData = (ExportTransientUserData) stepCtx.getTransientUserData();
-        wrapper.registerTransient(executionId, chunkData, cosBucketPathPrefix, fhirResourceType, isExportPublic);
+        wrapper.registerTransient(executionId, chunkData, cosBucketPathPrefix, fhirResourceType);
 
         if (!resourceLists.stream().allMatch(ReadResultDTO.class::isInstance)) {
             throw new IllegalStateException("Expected a list of ReadResultDTO");
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/listener/StepChunkListener.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/listener/StepChunkListener.java
index 4a02b6b92a1..f6a8126afcb 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/listener/StepChunkListener.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/listener/StepChunkListener.java
@@ -3,6 +3,7 @@
  *
  * SPDX-License-Identifier: Apache-2.0
  */
+
 package com.ibm.fhir.bulkdata.jbatch.listener;
 
 import java.util.logging.Level;
@@ -14,13 +15,12 @@
 import javax.enterprise.context.Dependent;
 import javax.inject.Inject;
 
-
 /**
  * Enables Logging for the Given Step
  */
 @Dependent
 public class StepChunkListener implements ChunkListener {
-    private final static Logger logger = Logger.getLogger(StepChunkListener.class.getName());
+    private static final Logger logger = Logger.getLogger(StepChunkListener.class.getName());
 
     @Inject
     StepContext stepCtx;
@@ -38,7 +38,7 @@ public void onError(Exception ex) throws Exception {
         long stepExecutionId = stepCtx.getStepExecutionId();
         long jobExecutionId = jobCtx.getInstanceId();
         logger.log(Level.SEVERE, "StepChunkListener: job[" + jobCtx.getJobName() + "/" + jobExecutionId + "/" + stepExecutionId + "] --- " + ex.getMessage(), ex);
-        // Enable PrintStackTrace when debugging in dev - ex.printStackTrace();
+        logger.throwing("StepChunkListener", "onError", ex);
     }
 
     @Override
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ChunkReader.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ChunkReader.java
index 4580ce0a2e3..a836c5af4ba 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ChunkReader.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ChunkReader.java
@@ -49,7 +49,7 @@ public class ChunkReader extends AbstractItemReader {
 
     @Inject
     @Any
-    @BatchProperty(name = OperationFields.PARTITTION_WORKITEM)
+    @BatchProperty(name = OperationFields.PARTITION_WORKITEM)
     private String workItem;
 
     @Inject
@@ -57,6 +57,11 @@ public class ChunkReader extends AbstractItemReader {
     @BatchProperty(name = OperationFields.PARTITION_RESOURCETYPE)
     private String resourceType;
 
+    @Inject
+    @Any
+    @BatchProperty(name = OperationFields.PARTITION_MATRIX)
+    private String matrix;
+
     long numOfLinesToSkip = 0;
 
     private BulkDataContext ctx = null;
@@ -89,6 +94,7 @@ public void open(Serializable checkpoint) throws Exception {
         } else {
             ImportTransientUserData chunkData = ImportTransientUserData.Builder.builder()
                     .importPartitionWorkitem(ctx.getImportPartitionWorkitem())
+                    .matrixWorkItem(matrix)
                     .numOfProcessedResources(numOfLinesToSkip)
                     .importPartitionResourceType(ctx.getPartitionResourceType())
                     // This naming pattern is used in bulkdata operation to generate file links for import
@@ -135,6 +141,7 @@ public Object readItem() throws Exception {
 
         ImportTransientUserData chunkData = (ImportTransientUserData) stepCtx.getTransientUserData();
         numOfLinesToSkip = chunkData.getNumOfProcessedResources();
+        logger.fine(() -> "Number of lines to skip are: '" + numOfLinesToSkip + "'");
 
         Provider wrapper = ProviderFactory.getSourceWrapper(ctx.getSource(), ctx.getDataSourceStorageType());
         wrapper.registerTransient(chunkData);
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ChunkWriter.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ChunkWriter.java
index 25d69dab882..21c420ad867 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ChunkWriter.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ChunkWriter.java
@@ -6,10 +6,14 @@
 
 package com.ibm.fhir.bulkdata.jbatch.load;
 
+import static com.ibm.fhir.model.type.String.string;
+
 import java.io.Serializable;
 import java.sql.Date;
+import java.util.HashMap;
 import java.util.HashSet;
 import java.util.List;
+import java.util.Map;
 import java.util.Set;
 import java.util.logging.Level;
 import java.util.logging.Logger;
@@ -36,8 +40,14 @@
 import com.ibm.fhir.model.format.Format;
 import com.ibm.fhir.model.generator.FHIRGenerator;
 import com.ibm.fhir.model.resource.OperationOutcome;
+import com.ibm.fhir.model.resource.OperationOutcome.Issue;
 import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.type.CodeableConcept;
+import com.ibm.fhir.model.type.code.IssueSeverity;
+import com.ibm.fhir.model.type.code.IssueType;
 import com.ibm.fhir.model.util.FHIRUtil;
+import com.ibm.fhir.model.util.SaltHash;
+import com.ibm.fhir.model.visitor.ResourceFingerprintVisitor;
 import com.ibm.fhir.operation.bulkdata.config.ConfigurationAdapter;
 import com.ibm.fhir.operation.bulkdata.config.ConfigurationFactory;
 import com.ibm.fhir.operation.bulkdata.model.type.BulkDataContext;
@@ -46,6 +56,7 @@
 import com.ibm.fhir.persistence.FHIRPersistence;
 import com.ibm.fhir.persistence.context.FHIRPersistenceContext;
 import com.ibm.fhir.persistence.context.FHIRPersistenceContextFactory;
+import com.ibm.fhir.persistence.exception.FHIRPersistenceException;
 import com.ibm.fhir.persistence.helper.FHIRPersistenceHelper;
 import com.ibm.fhir.persistence.helper.FHIRTransactionHelper;
 import com.ibm.fhir.validation.exception.FHIRValidationException;
@@ -70,9 +81,14 @@ public class ChunkWriter extends AbstractItemWriter {
 
     @Inject
     @Any
-    @BatchProperty (name = OperationFields.PARTITTION_WORKITEM)
+    @BatchProperty (name = OperationFields.PARTITION_WORKITEM)
     private String workItem;
 
+    @Inject
+    @Any
+    @BatchProperty(name = OperationFields.PARTITION_MATRIX)
+    private String matrix;
+
     @Inject
     @Any
     @BatchProperty (name = OperationFields.PARTITION_RESOURCETYPE)
@@ -163,8 +179,11 @@ public void writeItems(List<java.lang.Object> arg0) throws Exception {
             // Similar code @see ImportPartitionCollector
             StorageType type = adapter.getStorageProviderStorageType(ctx.getOutcome());
             boolean collectImportOperationOutcomes = adapter.shouldStorageProviderCollectOperationOutcomes(ctx.getSource())
-                    && (StorageType.AWSS3.equals(type) || StorageType.IBMCOS.equals(type));
+                    && (StorageType.AWSS3.equals(type) || StorageType.IBMCOS.equals(type) ||  StorageType.AZURE.equals(type));
 
+            // Get the Skippable Update status
+            boolean skip = adapter.enableSkippableUpdates();
+            Map<String,SaltHash> localCache = new HashMap<>();
             try {
                 for (Object objResJsonList : arg0) {
                     @SuppressWarnings("unchecked")
@@ -190,8 +209,7 @@ public void writeItems(List<java.lang.Object> arg0) throws Exception {
                                 }
                             } else {
                                 long startTime = System.currentTimeMillis();
-                                operationOutcome =
-                                        fhirPersistence.update(persistenceContext, id, fhirResource).getOutcome();
+                                operationOutcome = conditionalFingerprintUpdate(chunkData, skip, localCache, fhirPersistence, persistenceContext, id, fhirResource);
                                 if (auditLogger.shouldLog()) {
                                     long endTime = System.currentTimeMillis();
                                     String location = "@source:" + ctx.getSource() + "/" + ctx.getImportPartitionWorkitem();
@@ -236,9 +254,10 @@ public void writeItems(List<java.lang.Object> arg0) throws Exception {
 
             // Pushes to the Outcome Site
             if (collectImportOperationOutcomes) {
-                Provider wrapper = ProviderFactory.getSourceWrapper(ctx.getOutcome(), "ibm-cos");
-                wrapper.registerTransient(chunkData);
-                wrapper.pushOperationOutcomes();
+                Provider provider = ProviderFactory.getSourceWrapper(ctx.getOutcome(),
+                    ConfigurationFactory.getInstance().getStorageProviderType(ctx.getOutcome()));
+                provider.registerTransient(chunkData);
+                provider.pushOperationOutcomes();
             }
         } catch (FHIRException e) {
             logger.log(Level.SEVERE, "Import ChunkWriter.writeItems during job[" + executionId + "] - " + e.getMessage(), e);
@@ -248,4 +267,76 @@ public void writeItems(List<java.lang.Object> arg0) throws Exception {
             throw e;
         }
     }
+
+    /**
+     * conditional update checks to see if our cache contains the key, if not reads from the db, and calculates the cache.
+     * The cache is saved within the context of this particular execution, and then destroyed.
+     *
+     * @implNote considered using a shared cache, a few things with that to consider:
+     * 1 - the shared cache would have to be updated at the end of a transaction (we don't control it).
+     * 2 - we would have to use a transaction sync registry to control the synchronization of the cache.
+     * 3 - Instead, we're doing a read then update.
+     *
+     * @param chunkData the transient user data used increment the number of skips
+     * @param skip should skip the resource if it matches
+     * @param localCache map containing the key-saltHash
+     * @param persistence used to facilitate the calls to the underlying db
+     * @param context used in db calls
+     * @param logicalId the logical id of the FHIR resource (e.g. 1-2-3-4)
+     * @param resource the FHIR Resource
+     * @return outcomes including information or warnings
+     * @throws FHIRPersistenceException
+     */
+    public OperationOutcome conditionalFingerprintUpdate(ImportTransientUserData chunkData, boolean skip, Map<String, SaltHash> localCache, FHIRPersistence persistence, FHIRPersistenceContext context, String logicalId, Resource resource) throws FHIRPersistenceException {
+        OperationOutcome oo;
+        if (!skip) {
+            // Key is scoped to the ResourceType.
+            String key = resourceType + "/" + logicalId;
+            SaltHash oldBaseLine = localCache.get(key);
+
+            Resource oldResource = null;
+            ResourceFingerprintVisitor fp = new ResourceFingerprintVisitor();
+            if (oldBaseLine == null) {
+                // Go get the latest resource in the database and fingerprint the resource.
+                // If the resource exists, then we need to fingerprint.
+                oldResource = persistence.read(context, resource.getClass(), logicalId).getResource();
+                if (oldResource != null) {
+                    ResourceFingerprintVisitor fpOld = new ResourceFingerprintVisitor();
+                    oldResource.accept(fpOld);
+                    oldBaseLine = fpOld.getSaltAndHash();
+                    fp = new ResourceFingerprintVisitor(oldBaseLine);
+                }
+            }
+
+            resource.accept(fp);
+            SaltHash newBaseLine = fp.getSaltAndHash();
+
+            if (oldBaseLine != null && oldBaseLine.equals(newBaseLine)) {
+                if (logger.isLoggable(Level.FINE)) {
+                    logger.fine("Skipping $import - update for '" + key + "'");
+                }
+                chunkData.addToNumOfSkippedResources(1);
+                oo =  OperationOutcome.builder()
+                    .issue(Issue.builder()
+                        .severity(IssueSeverity.INFORMATION)
+                        .code(IssueType.INFORMATIONAL)
+                        .details(CodeableConcept.builder()
+                            .text(string("Update resource matches the existing resource; skipping the update for '" + key + "'"))
+                            .build())
+                        .build())
+                    .build();
+            } else {
+                // We need to update the db and update the local cache
+                if (oldResource != null) {
+                    // Old Resource is set so we avoid an extra read
+                    context.getPersistenceEvent().setPrevFhirResource(oldResource);
+                }
+                oo = persistence.update(context, logicalId, resource).getOutcome();
+                localCache.put(key, newBaseLine);
+            }
+        } else {
+            oo = persistence.update(context, logicalId, resource).getOutcome();
+        }
+        return oo;
+    }
 }
\ No newline at end of file
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportJobListener.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportJobListener.java
index 5dc65463040..e109840fd0f 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportJobListener.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportJobListener.java
@@ -13,11 +13,12 @@
 import javax.batch.api.listener.JobListener;
 import javax.batch.operations.JobOperator;
 import javax.batch.runtime.BatchRuntime;
+import javax.batch.runtime.BatchStatus;
 import javax.batch.runtime.JobExecution;
 import javax.batch.runtime.context.JobContext;
 import javax.enterprise.context.Dependent;
 import javax.inject.Inject;
-import javax.json.JsonArray;
+import jakarta.json.JsonArray;
 
 import com.ibm.fhir.bulkdata.common.BulkDataUtils;
 import com.ibm.fhir.bulkdata.jbatch.context.BatchContextAdapter;
@@ -48,6 +49,10 @@ public void beforeJob() {
 
     @Override
     public void afterJob() {
+        if (BatchStatus.FAILED.equals(jobCtx.getBatchStatus())) {
+            return;
+        }
+
         long executionId = -1;
         try {
             executionId = jobCtx.getExecutionId();
@@ -89,4 +94,4 @@ public void afterJob() {
             throw e;
         }
     }
-}
\ No newline at end of file
+}
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportPartitionCollector.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportPartitionCollector.java
index cc77c05ae04..4e5f663efe2 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportPartitionCollector.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportPartitionCollector.java
@@ -90,7 +90,7 @@ public Serializable collectPartitionData() throws Exception {
                     if (partitionSummaryData.getBufferStreamForImport().size() > 0) {
                         if (partitionSummaryData.getUploadIdForOperationOutcomes()  == null) {
                             partitionSummaryData.setUploadIdForOperationOutcomes(BulkDataUtils.startPartUpload(wrapper.getClient(),
-                                    cosOperationOutcomesBucketName, partitionSummaryData.getUniqueIDForImportOperationOutcomes(), true));
+                                    cosOperationOutcomesBucketName, partitionSummaryData.getUniqueIDForImportOperationOutcomes()));
                         }
 
                         partitionSummaryData.getDataPacksForOperationOutcomes().add(BulkDataUtils.multiPartUpload(wrapper.getClient(),
@@ -117,7 +117,7 @@ public Serializable collectPartitionData() throws Exception {
                     if (partitionSummaryData.getBufferStreamForImportError().size() > 0) {
                         if (partitionSummaryData.getUploadIdForFailureOperationOutcomes()  == null) {
                             partitionSummaryData.setUploadIdForFailureOperationOutcomes(BulkDataUtils.startPartUpload(wrapper.getClient(),
-                                    cosOperationOutcomesBucketName, partitionSummaryData.getUniqueIDForImportFailureOperationOutcomes(), true));
+                                    cosOperationOutcomesBucketName, partitionSummaryData.getUniqueIDForImportFailureOperationOutcomes()));
                         }
 
                         partitionSummaryData.getDataPacksForFailureOperationOutcomes().add(BulkDataUtils.multiPartUpload(wrapper.getClient(),
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportPartitionMapper.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportPartitionMapper.java
index 3344b9761ec..2d3aa17f994 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportPartitionMapper.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/ImportPartitionMapper.java
@@ -6,7 +6,6 @@
 
 package com.ibm.fhir.bulkdata.jbatch.load;
 
-import java.util.ArrayList;
 import java.util.List;
 import java.util.Properties;
 import java.util.logging.Level;
@@ -22,6 +21,7 @@
 import javax.inject.Inject;
 
 import com.ibm.fhir.bulkdata.jbatch.context.BatchContextAdapter;
+import com.ibm.fhir.bulkdata.jbatch.load.exception.FHIRLoadException;
 import com.ibm.fhir.bulkdata.load.partition.transformer.PartitionSourceTransformerFactory;
 import com.ibm.fhir.exception.FHIRException;
 import com.ibm.fhir.operation.bulkdata.config.ConfigurationAdapter;
@@ -57,8 +57,7 @@ public PartitionPlan mapPartitions() throws Exception {
             ConfigurationAdapter adapter = ConfigurationFactory.getInstance();
             adapter.registerRequestContext(ctx.getTenantId(), ctx.getDatastoreId(), ctx.getIncomingUrl());
 
-            List<BulkDataSource> bdSources = new ArrayList<>();
-            bdSources = PartitionSourceTransformerFactory.transformToSources(ctx.getSource(), ctx.getDataSourcesInfo());
+            List<BulkDataSource> bdSources = PartitionSourceTransformerFactory.transformToSources(ctx.getSource(), ctx.getDataSourcesInfo());
 
             PartitionPlanImpl pp = new PartitionPlanImpl();
             pp.setPartitions(bdSources.size());
@@ -68,13 +67,18 @@ public PartitionPlan mapPartitions() throws Exception {
             int propCount = 0;
             for (BulkDataSource fhirDataSource : bdSources) {
                 Properties p = new Properties();
-                p.setProperty(OperationFields.PARTITTION_WORKITEM, fhirDataSource.getUrl());
+                p.setProperty(OperationFields.PARTITION_WORKITEM, fhirDataSource.getUrl());
                 p.setProperty(OperationFields.PARTITION_RESOURCETYPE, fhirDataSource.getType());
+                p.setProperty(OperationFields.PARTITION_MATRIX, fhirDataSource.getOriginalLocation());
                 partitionProps[propCount++] = p;
             }
             pp.setPartitionProperties(partitionProps);
             return pp;
-        }catch (FHIRException e) {
+        } catch (FHIRLoadException e) {
+            jobCtx.setExitStatus("FAILED_BAD_SOURCE");
+            logger.log(Level.SEVERE, "Import PartitionMapper source[" + executionId + "] - " + e.getMessage(), e);
+            throw e;
+        } catch (FHIRException e) {
             logger.log(Level.SEVERE, "Import PartitionMapper.mapPartitions during job[" + executionId + "] - " + e.getMessage(), e);
             throw e;
         } catch (Exception e) {
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/data/ImportCheckPointData.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/data/ImportCheckPointData.java
index 973144b894a..508449ecd8f 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/data/ImportCheckPointData.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/data/ImportCheckPointData.java
@@ -18,16 +18,21 @@ public class ImportCheckPointData implements Serializable {
     private static final long serialVersionUID = 2189917861035732241L;
     // URL or COS/S3 object name.
     protected String importPartitionWorkitem;
+    protected String matrixWorkItem;
 
     // Values for metrics calculation.
     protected long numOfProcessedResources = 0;
     protected long numOfImportedResources = 0;
     protected long numOfImportFailures = 0;
+    protected long numOfSkipped = 0;
     protected long totalReadMilliSeconds = 0;
     protected long totalWriteMilliSeconds = 0;
     protected long totalValidationMilliSeconds = 0;
     protected long importFileSize = 0;
 
+    // Track the Azure Progress
+    protected long currentBytes = 0;
+
     protected long inFlyRateBeginMilliSeconds = 0;
 
     // Value used to sign the successful ending of the import.
@@ -88,6 +93,18 @@ public void addToNumOfImportedResources(long numOfImportedResources) {
         this.numOfImportedResources += numOfImportedResources;
     }
 
+    public long getNumOfSkippedResources() {
+        return numOfSkipped;
+    }
+
+    public void setNumOfSkippedResources(long skipped) {
+        this.numOfSkipped = skipped;
+    }
+
+    public void addToNumOfSkippedResources(long skipped) {
+        this.numOfSkipped += skipped;
+    }
+
     public long getNumOfImportFailures() {
         return numOfImportFailures;
     }
@@ -112,9 +129,18 @@ public String getImportPartitionResourceType() {
         return importPartitionResourceType;
     }
 
+    public long getCurrentBytes() {
+        return currentBytes;
+    }
+
+    public void setCurrentBytes(long currentBytes) {
+        this.currentBytes = currentBytes;
+    }
+
     public static ImportCheckPointData fromImportTransientUserData(ImportTransientUserData userData) {
         return ImportCheckPointData.Builder.builder()
                 .importPartitionWorkitem(userData.getImportPartitionWorkitem())
+                .matrixWorkItem(userData.matrixWorkItem)
                 .numOfProcessedResources(userData.getNumOfProcessedResources())
                 .importPartitionResourceType(userData.getImportPartitionResourceType())
                 .numOfImportedResources(userData.getNumOfImportedResources())
@@ -132,6 +158,8 @@ public static ImportCheckPointData fromImportTransientUserData(ImportTransientUs
                 .totalWriteMilliSeconds(userData.getTotalWriteMilliSeconds())
                 .importFileSize(userData.getImportFileSize())
                 .inFlyRateBeginMilliSeconds(userData.getInFlyRateBeginMilliSeconds())
+                .numOfSkippedResources(userData.getNumOfSkippedResources())
+                .currentBytes(userData.getCurrentBytes())
                 .build();
     }
 
@@ -247,9 +275,18 @@ public void setInFlyRateBeginMilliSeconds(long inFlyRateBeginMilliSeconds) {
         this.inFlyRateBeginMilliSeconds = inFlyRateBeginMilliSeconds;
     }
 
+    public void setMatrixWorkItem(String matrixWorkItem) {
+        this.matrixWorkItem = matrixWorkItem;
+    }
+
+    public String getMatrixWorkItem() {
+        return matrixWorkItem;
+    }
+
     public static class Builder {
 
         protected String importPartitionWorkitem;
+        protected String matrixWorkItem;
         protected long numOfProcessedResources;
         protected String importPartitionResourceType;
         protected long numOfImportedResources;
@@ -267,6 +304,8 @@ public static class Builder {
         protected long totalWriteMilliSeconds;
         protected long importFileSize;
         protected long inFlyRateBeginMilliSeconds;
+        protected long currentBytes;
+        protected long numOfSkippedResources;
 
         public Builder() {
             super();
@@ -281,6 +320,11 @@ public Builder importPartitionWorkitem(String importPartitionWorkitem) {
             return this;
         }
 
+        public Builder matrixWorkItem(String matrixWorkItem) {
+            this.matrixWorkItem = matrixWorkItem;
+            return this;
+        }
+
         public Builder numOfProcessedResources(long numOfProcessedResources) {
             this.numOfProcessedResources = numOfProcessedResources;
             return this;
@@ -296,6 +340,11 @@ public Builder numOfImportedResources(long numOfImportedResources) {
             return this;
         }
 
+        public Builder numOfSkippedResources(long numOfSkippedResources) {
+            this.numOfSkippedResources = numOfSkippedResources;
+            return this;
+        }
+
         public Builder numOfImportFailures(long numOfImportFailures) {
             this.numOfImportFailures = numOfImportFailures;
             return this;
@@ -366,9 +415,15 @@ public Builder inFlyRateBeginMilliSeconds(long inFlyRateBeginMilliSeconds) {
             return this;
         }
 
+        public Builder currentBytes(long currentBytes) {
+            this.currentBytes = currentBytes;
+            return this;
+        }
+
         public ImportCheckPointData build() {
             ImportCheckPointData importCheckPointData = new ImportCheckPointData();
             importCheckPointData.importPartitionWorkitem = this.importPartitionWorkitem;
+            importCheckPointData.matrixWorkItem = this.matrixWorkItem;
             importCheckPointData.numOfProcessedResources = this.numOfProcessedResources;
             importCheckPointData.importPartitionResourceType = this.importPartitionResourceType;
             importCheckPointData.numOfImportedResources = this.numOfImportedResources;
@@ -386,6 +441,8 @@ public ImportCheckPointData build() {
             importCheckPointData.totalWriteMilliSeconds = this.totalWriteMilliSeconds;
             importCheckPointData.importFileSize = this.importFileSize;
             importCheckPointData.inFlyRateBeginMilliSeconds = this.inFlyRateBeginMilliSeconds;
+            importCheckPointData.numOfSkipped = this.numOfSkippedResources;
+            importCheckPointData.currentBytes = this.currentBytes;
             return importCheckPointData;
         }
     }
@@ -393,14 +450,15 @@ public ImportCheckPointData build() {
     @Override
     public String toString() {
         return "ImportCheckPointData [importPartitionWorkitem=" + importPartitionWorkitem + ", numOfProcessedResources=" + numOfProcessedResources
+                + ", matrixWorkItem=" + matrixWorkItem
                 + ", numOfImportedResources=" + numOfImportedResources + ", numOfImportFailures=" + numOfImportFailures + ", totalReadMilliSeconds="
                 + totalReadMilliSeconds + ", totalWriteMilliSeconds=" + totalWriteMilliSeconds + ", totalValidationMilliSeconds=" + totalValidationMilliSeconds
-                + ", importFileSize=" + importFileSize + ", inFlyRateBeginMilliSeconds=" + inFlyRateBeginMilliSeconds + ", numOfToBeImported="
-                + numOfToBeImported + ", numOfParseFailures=" + numOfParseFailures + ", importPartitionResourceType=" + importPartitionResourceType
-                + ", uniqueIDForImportOperationOutcomes=" + uniqueIDForImportOperationOutcomes + ", partNumForOperationOutcomes=" + partNumForOperationOutcomes
-                + ", uploadIdForOperationOutcomes=" + uploadIdForOperationOutcomes + ", dataPacksForOperationOutcomes=" + dataPacksForOperationOutcomes
-                + ", uniqueIDForImportFailureOperationOutcomes=" + uniqueIDForImportFailureOperationOutcomes + ", partNumForFailureOperationOutcomes="
-                + partNumForFailureOperationOutcomes + ", uploadIdForFailureOperationOutcomes=" + uploadIdForFailureOperationOutcomes
-                + ", dataPacksForFailureOperationOutcomes=" + dataPacksForFailureOperationOutcomes + "]";
-    }
-}
\ No newline at end of file
+                + ", importFileSize=" + importFileSize + ", currentBytes=" + currentBytes + ", inFlyRateBeginMilliSeconds=" + inFlyRateBeginMilliSeconds
+                + ", numOfToBeImported=" + numOfToBeImported + ", numOfParseFailures=" + numOfParseFailures + ", importPartitionResourceType="
+                + importPartitionResourceType + ", uniqueIDForImportOperationOutcomes=" + uniqueIDForImportOperationOutcomes + ", partNumForOperationOutcomes="
+                + partNumForOperationOutcomes + ", uploadIdForOperationOutcomes=" + uploadIdForOperationOutcomes + ", dataPacksForOperationOutcomes="
+                + dataPacksForOperationOutcomes + ", uniqueIDForImportFailureOperationOutcomes=" + uniqueIDForImportFailureOperationOutcomes
+                + ", partNumForFailureOperationOutcomes=" + partNumForFailureOperationOutcomes + ", uploadIdForFailureOperationOutcomes="
+                + uploadIdForFailureOperationOutcomes + ", dataPacksForFailureOperationOutcomes=" + dataPacksForFailureOperationOutcomes + "]";
+    }
+}
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/data/ImportTransientUserData.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/data/ImportTransientUserData.java
index a8a63829223..ea559db2f55 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/data/ImportTransientUserData.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/data/ImportTransientUserData.java
@@ -63,6 +63,7 @@ public void setBufferReader(BufferedReader bufferReader) {
     public static ImportTransientUserData fromImportCheckPointData(ImportCheckPointData importCheckPointData) {
         return ImportTransientUserData.Builder.builder()
                 .importPartitionWorkitem(importCheckPointData.importPartitionWorkitem)
+                .matrixWorkItem(importCheckPointData.matrixWorkItem)
                 .numOfProcessedResources(importCheckPointData.numOfProcessedResources)
                 .importPartitionResourceType(importCheckPointData.importPartitionResourceType)
                 .numOfImportedResources(importCheckPointData.numOfImportedResources)
@@ -80,6 +81,7 @@ public static ImportTransientUserData fromImportCheckPointData(ImportCheckPointD
                 .totalWriteMilliSeconds(importCheckPointData.totalWriteMilliSeconds)
                 .importFileSize(importCheckPointData.importFileSize)
                 .inFlyRateBeginMilliSeconds(importCheckPointData.inFlyRateBeginMilliSeconds)
+                .currentBytes(importCheckPointData.currentBytes)
                 .build();
     }
 
@@ -94,6 +96,11 @@ public Builder importPartitionWorkitem(String importPartitionWorkitem) {
             return (Builder) super.importPartitionWorkitem(importPartitionWorkitem);
         }
 
+        @Override
+        public Builder matrixWorkItem(String matrixWorkItem) {
+            return (Builder) super.matrixWorkItem(matrixWorkItem);
+        }
+
         @Override
         public Builder numOfProcessedResources(long numOfProcessedResources) {
             return (Builder) super.numOfProcessedResources(numOfProcessedResources);
@@ -179,10 +186,16 @@ public Builder inFlyRateBeginMilliSeconds(long inFlyRateBeginMilliSeconds) {
             return (Builder) super.inFlyRateBeginMilliSeconds(inFlyRateBeginMilliSeconds);
         }
 
+        @Override
+        public Builder currentBytes(long currentBytes) {
+            return (Builder) super.currentBytes(currentBytes);
+        }
+
         @Override
         public ImportTransientUserData build() {
             ImportTransientUserData importTransientUserData = new ImportTransientUserData();
             importTransientUserData.importPartitionWorkitem = this.importPartitionWorkitem;
+            importTransientUserData.matrixWorkItem = this.matrixWorkItem;
             importTransientUserData.numOfProcessedResources = this.numOfProcessedResources;
             importTransientUserData.importPartitionResourceType = this.importPartitionResourceType;
             importTransientUserData.numOfImportedResources = this.numOfImportedResources;
@@ -200,6 +213,7 @@ public ImportTransientUserData build() {
             importTransientUserData.totalWriteMilliSeconds = this.totalWriteMilliSeconds;
             importTransientUserData.importFileSize = this.importFileSize;
             importTransientUserData.inFlyRateBeginMilliSeconds = this.inFlyRateBeginMilliSeconds;
+            importTransientUserData.currentBytes = this.currentBytes;
             return importTransientUserData;
         }
     }
@@ -207,6 +221,7 @@ public ImportTransientUserData build() {
     @Override
     public String toString() {
         return "ImportTransientUserData [bufferStreamForImportError=" + bufferStreamForImportError + ", bufferStreamForImport=" + bufferStreamForImport
+                + ", matrix=" + matrixWorkItem
                 + ", inputStream=" + inputStream + ", bufferReader=" + bufferReader + ", importPartitionWorkitem=" + importPartitionWorkitem
                 + ", numOfProcessedResources=" + numOfProcessedResources + ", numOfImportedResources=" + numOfImportedResources + ", numOfImportFailures="
                 + numOfImportFailures + ", totalReadMilliSeconds=" + totalReadMilliSeconds + ", totalWriteMilliSeconds=" + totalWriteMilliSeconds
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/exception/FHIRLoadException.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/exception/FHIRLoadException.java
new file mode 100644
index 00000000000..c5ae239782c
--- /dev/null
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/exception/FHIRLoadException.java
@@ -0,0 +1,19 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.bulkdata.jbatch.load.exception;
+
+import com.ibm.fhir.exception.FHIRException;
+
+
+public class FHIRLoadException extends FHIRException {
+
+    private static final long serialVersionUID = 12434123435239981L;
+
+    public FHIRLoadException(String msg) {
+        super(msg);
+    }
+}
\ No newline at end of file
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/listener/ExitStatus.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/listener/ExitStatus.java
index be7b73aac91..2992a168d7f 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/listener/ExitStatus.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/listener/ExitStatus.java
@@ -12,13 +12,13 @@
 import java.util.Map;
 import java.util.logging.Logger;
 
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonValue;
-
 import com.ibm.fhir.bulkdata.jbatch.load.data.ImportCheckPointData;
 import com.ibm.fhir.operation.bulkdata.model.type.OperationFields;
 
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonValue;
+
 /**
  * Adapts the partitionSummaries and DatasourceArray into an Exit Status
  */
@@ -45,14 +45,22 @@ public String generateResultExitStatus() {
         }
 
         String[] resultInExitStatus = new String[sequenceNum];
-        System.out.println(partitionSummaries);
+        logger.fine(() -> "The partitions are " + partitionSummaries);
         for (ImportCheckPointData partitionSummary : partitionSummaries) {
-            String key = partitionSummary.getImportPartitionResourceType() + ":" + partitionSummary.getImportPartitionWorkitem();
+            String key;
+            if (partitionSummary.getMatrixWorkItem() == null) {
+                key = partitionSummary.getImportPartitionResourceType() + ":" + partitionSummary.getImportPartitionWorkitem();
+            } else {
+                // must be matrixed
+                key = partitionSummary.getImportPartitionResourceType() + ":" + partitionSummary.getMatrixWorkItem();
+            }
+
             if (!inputUrlSequenceMap.containsKey(key)) {
                 // Highly unlikely to hit now that the partition-resource-type is fixed
                 // So... this means that the Key is some how mutated.
-                logger.warning("Partition Key is incorrect '" + key + "'");
+                logger.warning("Partition Key is incorrect '" + key + "' matrix='" + partitionSummary.getMatrixWorkItem() + "'");
             }
+
             int index = inputUrlSequenceMap.get(key);
             resultInExitStatus[index] = partitionSummary.getNumOfImportedResources() + ":" + partitionSummary.getNumOfImportFailures();
         }
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/listener/Reporter.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/listener/Reporter.java
index 0ea9267b863..bb73c598756 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/listener/Reporter.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/jbatch/load/listener/Reporter.java
@@ -65,6 +65,7 @@ public void report(List<ImportCheckPointData> partitionSummaries) {
                 partitionSummaryInMap.setNumOfImportFailures(partitionSummaryInMap.getNumOfImportFailures() + partitionSummary.getNumOfImportFailures());
                 partitionSummaryInMap.setNumOfImportedResources(partitionSummaryInMap.getNumOfImportedResources() + partitionSummary.getNumOfImportedResources());
                 partitionSummaryInMap.setNumOfProcessedResources(partitionSummaryInMap.getNumOfProcessedResources() + partitionSummary.getNumOfProcessedResources());
+                partitionSummaryInMap.setNumOfSkippedResources(partitionSummaryInMap.getNumOfSkippedResources() + partitionSummary.getNumOfSkippedResources());
                 partitionSummaryInMap.setTotalReadMilliSeconds(partitionSummaryInMap.getTotalReadMilliSeconds() + partitionSummary.getTotalReadMilliSeconds());
                 partitionSummaryInMap.setTotalValidationMilliSeconds(partitionSummaryInMap.getTotalValidationMilliSeconds() + partitionSummary.getTotalValidationMilliSeconds());
                 partitionSummaryInMap.setTotalWriteMilliSeconds(partitionSummaryInMap.getTotalWriteMilliSeconds() + partitionSummary.getTotalWriteMilliSeconds());
@@ -77,8 +78,8 @@ public void report(List<ImportCheckPointData> partitionSummaries) {
 
         // log the simple metrics.
         logger.info("Operation Type: $import");
-        logger.info(String.format("%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s",
-            "Resource Type","failures", "success", "processed", "totalRead", "totalValidation", "totalWrite", "fileSize", "Resource Size"));
+        logger.info(String.format("%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s",
+            "Resource Type","failures", "success", "processed", "totalRead", "totalSkip", "totalValidation", "totalWrite", "fileSize", "Resource Size"));
         long totalImportedFhirResources = 0;
         for (ImportCheckPointData importedResourceTypeSummary : importedResourceTypeSummaries.values()) {
             String resourceType = importedResourceTypeSummary.getImportPartitionResourceType();
@@ -86,6 +87,7 @@ public void report(List<ImportCheckPointData> partitionSummaries) {
             long success = importedResourceTypeSummary.getNumOfImportedResources();
             long totalRead = importedResourceTypeSummary.getTotalReadMilliSeconds();
             long totalWrite = importedResourceTypeSummary.getTotalWriteMilliSeconds();
+            long totalSkip = importedResourceTypeSummary.getNumOfSkippedResources();
             long totalValidation = importedResourceTypeSummary.getTotalValidationMilliSeconds();
             long processed = importedResourceTypeSummary.getNumOfImportedResources();
             long fileSize = importedResourceTypeSummary.getImportFileSize();
@@ -98,8 +100,8 @@ public void report(List<ImportCheckPointData> partitionSummaries) {
             } else {
                 logger.fine("No Content was imported");
             }
-            logger.info(String.format("%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s",
-               resourceType,failures, success, processed, totalRead, totalValidation, totalWrite, fileSize, resourceSize));
+            logger.info(String.format("%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s%-22s",
+               resourceType,failures, success, processed, totalRead, totalSkip, totalValidation, totalWrite, fileSize, resourceSize));
         }
         logger.info(" ---- Total: " + totalImportedFhirResources
                 + " ImportRate: " + new DecimalFormat("#0.00").format(totalImportedFhirResources/jobProcessingSeconds) + " ----");
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/PartitionSourceTransformerFactory.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/PartitionSourceTransformerFactory.java
index 32e10043f13..f3d23e184fc 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/PartitionSourceTransformerFactory.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/PartitionSourceTransformerFactory.java
@@ -3,16 +3,18 @@
  *
  * SPDX-License-Identifier: Apache-2.0
  */
+
 package com.ibm.fhir.bulkdata.load.partition.transformer;
 
 import java.util.ArrayList;
 import java.util.List;
 
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonValue;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonValue;
 
 import com.ibm.fhir.bulkdata.common.BulkDataUtils;
+import com.ibm.fhir.bulkdata.load.partition.transformer.impl.AzureTransformer;
 import com.ibm.fhir.bulkdata.load.partition.transformer.impl.FileTransformer;
 import com.ibm.fhir.bulkdata.load.partition.transformer.impl.HttpsTransformer;
 import com.ibm.fhir.bulkdata.load.partition.transformer.impl.S3Transformer;
@@ -30,6 +32,7 @@ public class PartitionSourceTransformerFactory {
     private static final FileTransformer fileTransformer = new FileTransformer();
     private static final HttpsTransformer httpsTransformer = new HttpsTransformer();
     private static final S3Transformer s3Transformer = new S3Transformer();
+    private static final AzureTransformer azureTransformer = new AzureTransformer();
 
     private PartitionSourceTransformerFactory() {
         // No Operation
@@ -66,6 +69,9 @@ public static List<BulkDataSource> transformToSources(String source, String data
             case IBMCOS:
                 sources.addAll(s3Transformer.transformToDataSources(source, type, location));
                 break;
+            case AZURE:
+                sources.addAll(azureTransformer.transformToDataSources(source, type, location));
+                break;
             default:
                 break;
             }
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/impl/AzureTransformer.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/impl/AzureTransformer.java
new file mode 100644
index 00000000000..96e487afdc3
--- /dev/null
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/impl/AzureTransformer.java
@@ -0,0 +1,28 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.bulkdata.load.partition.transformer.impl;
+
+import java.util.Arrays;
+import java.util.List;
+
+import com.ibm.fhir.bulkdata.load.partition.transformer.PartitionSourceTransformer;
+import com.ibm.fhir.bulkdata.provider.impl.AzureProvider;
+import com.ibm.fhir.exception.FHIRException;
+import com.ibm.fhir.operation.bulkdata.model.type.BulkDataSource;
+
+/**
+ * At most one BulkDataSource is created in a List, but throws when Azure doesn't exist.
+ */
+public class AzureTransformer implements PartitionSourceTransformer {
+    @Override
+    public List<BulkDataSource> transformToDataSources(String source, String type, String location) throws FHIRException {
+        AzureProvider provider = new AzureProvider(source);
+        // We want to get the Provider
+        provider.getSize(location);
+        return Arrays.asList(new BulkDataSource(type, location));
+    }
+}
\ No newline at end of file
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/impl/S3Transformer.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/impl/S3Transformer.java
index 6f34c6d2b98..2b8b3dd9813 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/impl/S3Transformer.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/load/partition/transformer/impl/S3Transformer.java
@@ -6,12 +6,12 @@
 package com.ibm.fhir.bulkdata.load.partition.transformer.impl;
 
 import java.util.ArrayList;
-import java.util.Collections;
 import java.util.List;
 import java.util.logging.Logger;
 
 import com.ibm.cloud.objectstorage.services.s3.model.ListObjectsV2Result;
 import com.ibm.cloud.objectstorage.services.s3.model.S3ObjectSummary;
+import com.ibm.fhir.bulkdata.jbatch.load.exception.FHIRLoadException;
 import com.ibm.fhir.bulkdata.load.partition.transformer.PartitionSourceTransformer;
 import com.ibm.fhir.bulkdata.provider.impl.S3Provider;
 import com.ibm.fhir.exception.FHIRException;
@@ -25,40 +25,34 @@
  */
 public class S3Transformer implements PartitionSourceTransformer {
 
-    private static final Logger logger = Logger.getLogger(S3Transformer.class.getName());
+    private static final Logger LOG = Logger.getLogger(S3Transformer.class.getName());
 
     @Override
     public List<BulkDataSource> transformToDataSources(String source, String type, String location) throws FHIRException {
-        S3Provider wrapper = new S3Provider(source);
-        wrapper.listBuckets();
-        // Checks and return empty list.
-        if (!wrapper.exists()) {
-            wrapper.listBuckets();
-            return Collections.emptyList();
+        List<BulkDataSource> sources = new ArrayList<>();
+
+        S3Provider provider = new S3Provider(source);
+        if (!provider.exists()) {
+            provider.listBuckets();
         }
 
-        List<BulkDataSource> sources = new ArrayList<>();
+        String loc = location.trim();
+        LOG.fine(() -> "Location being verified is'" + loc + "'");
+
         String continuationToken = null;
         ListObjectsV2Result result = null;
         boolean shouldContinue = true;
         while (shouldContinue) {
-            result = wrapper.getListObject(continuationToken);
+            result = provider.getListObject(loc, continuationToken);
             for (S3ObjectSummary objectSummary : result.getObjectSummaries()) {
-                boolean isToBeProccessed = false;
-                if (location != null && !location.trim().isEmpty()) {
-                    if (objectSummary.getKey().startsWith(location.trim())) {
-                        isToBeProccessed = true;
-                    }
-                } else {
-                    isToBeProccessed = true;
-                }
-                if (isToBeProccessed) {
-                    logger.info("ObjectStorge Object -'" + objectSummary.getKey()
-                            + "' - '" + objectSummary.getSize() + "' bytes.");
-                    if (objectSummary.getSize() >= 0) {
-                        // We  want these to line up when we align with the output of the Job Listener
-                        sources.add(new BulkDataSource(type, objectSummary.getKey()));
-                    }
+                LOG.fine(() -> "Object to be added [" + objectSummary.getKey() + "]");
+
+                if (!loc.isEmpty() && objectSummary.getKey().startsWith(loc)) {
+                    LOG.fine(() -> "Object Summary -'" + objectSummary.getKey() + "' - '" + objectSummary.getSize() + "' bytes.");
+
+                    BulkDataSource ds = new BulkDataSource(type, objectSummary.getKey());
+                    ds.setOriginalLocation(location);
+                    sources.add(ds);
                 }
             }
 
@@ -66,6 +60,11 @@ public List<BulkDataSource> transformToDataSources(String source, String type, S
             continuationToken = result.getNextContinuationToken();
         }
 
+        // We shouldn't hit this situation.
+        if (sources.isEmpty()) {
+            throw new FHIRLoadException("The source is not found '" + location + "'");
+        }
+
         return sources;
     }
 }
\ No newline at end of file
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/Provider.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/Provider.java
index dcb17c4c817..c20ed99ab21 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/Provider.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/Provider.java
@@ -71,13 +71,13 @@ default void createSource() throws FHIRException {
 
     void registerTransient(ImportTransientUserData transientUserData);
 
-    void registerTransient(long executionId, ExportTransientUserData transientUserData, String cosBucketPathPrefix, String fhirResourceType, boolean isExportPublic) throws Exception;
+    void registerTransient(long executionId, ExportTransientUserData transientUserData, String cosBucketPathPrefix, String fhirResourceType) throws Exception;
 
     /**
      * Pushes the Operation Outcomes
      */
     default void pushOperationOutcomes() throws FHIRException {
-        // No Operation;
+        // No Operation
     }
 
     void close() throws Exception;
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/ProviderFactory.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/ProviderFactory.java
index a74583f1be2..43bdddddf63 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/ProviderFactory.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/ProviderFactory.java
@@ -5,13 +5,14 @@
  */
 package com.ibm.fhir.bulkdata.provider;
 
+import com.ibm.fhir.bulkdata.provider.impl.AzureProvider;
 import com.ibm.fhir.bulkdata.provider.impl.FileProvider;
 import com.ibm.fhir.bulkdata.provider.impl.HttpsProvider;
 import com.ibm.fhir.bulkdata.provider.impl.S3Provider;
 import com.ibm.fhir.operation.bulkdata.model.type.StorageType;
 
 /**
- * Wrapper
+ * Provider Factory picks the ideal provider based on the type.
  */
 public class ProviderFactory {
 
@@ -27,21 +28,24 @@ private ProviderFactory() {
      */
     public static Provider getSourceWrapper(String source, String type) throws Exception {
         StorageType storageType = StorageType.from(type);
-        Provider wrapper = null;
+        Provider provider = null;
         switch (storageType) {
         case HTTPS:
-            wrapper = new HttpsProvider(source);
+            provider = new HttpsProvider(source);
             break;
         case FILE:
-            wrapper = new FileProvider(source);
+            provider = new FileProvider(source);
             break;
         case AWSS3:
         case IBMCOS:
-            wrapper = new S3Provider(source);
+            provider = new S3Provider(source);
+            break;
+        case AZURE:
+            provider = new AzureProvider(source);
             break;
         default:
             throw new IllegalStateException ("Doesn't support data source storage type '" + type + "'!");
         }
-        return wrapper;
+        return provider;
     }
 }
\ No newline at end of file
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/AzureProvider.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/AzureProvider.java
new file mode 100644
index 00000000000..0d89a815ed0
--- /dev/null
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/AzureProvider.java
@@ -0,0 +1,392 @@
+
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.bulkdata.provider.impl;
+
+import java.io.BufferedReader;
+import java.io.ByteArrayInputStream;
+import java.io.ByteArrayOutputStream;
+import java.io.IOException;
+import java.io.InputStream;
+import java.io.InputStreamReader;
+import java.util.ArrayList;
+import java.util.List;
+import java.util.logging.Level;
+import java.util.logging.Logger;
+import java.util.stream.Collectors;
+
+import com.azure.storage.blob.BlobClient;
+import com.azure.storage.blob.BlobClientBuilder;
+import com.azure.storage.blob.BlobContainerClient;
+import com.azure.storage.blob.BlobContainerClientBuilder;
+import com.azure.storage.blob.models.BlobRange;
+import com.azure.storage.blob.models.BlobRequestConditions;
+import com.azure.storage.blob.models.BlobStorageException;
+import com.azure.storage.blob.specialized.AppendBlobClient;
+import com.ibm.fhir.bulkdata.dto.ReadResultDTO;
+import com.ibm.fhir.bulkdata.jbatch.export.data.ExportTransientUserData;
+import com.ibm.fhir.bulkdata.jbatch.load.data.ImportTransientUserData;
+import com.ibm.fhir.bulkdata.jbatch.load.exception.FHIRLoadException;
+import com.ibm.fhir.bulkdata.provider.Provider;
+import com.ibm.fhir.exception.FHIRException;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.generator.FHIRGenerator;
+import com.ibm.fhir.model.parser.FHIRParser;
+import com.ibm.fhir.model.parser.exception.FHIRParserException;
+import com.ibm.fhir.model.resource.OperationOutcome;
+import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.type.code.IssueType;
+import com.ibm.fhir.model.util.FHIRUtil;
+import com.ibm.fhir.operation.bulkdata.config.ConfigurationFactory;
+
+/**
+ * AzureProvider integrates the BulkData feature with Azure Blob Storage.
+ * The code uses the Blob Clients.
+ *
+ * $export: The AppendBlobClient is used during upload to append to an export file.
+ * $import: The BlobClient with BlobRange is used to retrieve windows of data.
+ *
+ * @see  https://docs.microsoft.com/en-us/dotnet/api/azure.storage.blobs.specialized.appendblobclient?view=azure-dotnet
+ */
+public class AzureProvider implements Provider {
+    private static final Logger LOG = Logger.getLogger(AzureProvider.class.getName());
+
+    private static final byte[] NEWLINE = "\r\n".getBytes();
+
+    private ImportTransientUserData transientUserData = null;
+    private ExportTransientUserData chunkData = null;
+
+    private String cosBucketPathPrefix = null;
+    private String fhirResourceType = null;
+
+    private List<Resource> resources = new ArrayList<>();
+
+    private long parseFailures = 0;
+    private long currentBytes = 0;
+
+    private String connectionString;
+    private String container;
+
+    private String workItem;
+
+    private boolean collect = false;
+
+    private BlobClient client;
+
+    /**
+     * Configures the Azure based on the storageProvider source
+     * @param source
+     */
+    public AzureProvider(String source) {
+        this.connectionString = ConfigurationFactory.getInstance().getStorageProviderAuthTypeConnectionString(source);
+        this.container = ConfigurationFactory.getInstance().getStorageProviderBucketName(source);
+        this.collect = ConfigurationFactory.getInstance().shouldStorageProviderCollectOperationOutcomes(source);
+    }
+
+    /**
+     * registers the overrides for testing.
+     * @param connectionString
+     * @param container the container (also known as a bucket)
+     * @param chunkData the export data
+     * @param cosBucketPathPrefix path prefix
+     * @param fhirResourceType resource type
+     * @param currentBytes the long value or location of the end of the last resource
+     */
+    protected void registerOverride(String connectionString, String container, ExportTransientUserData chunkData,
+        String cosBucketPathPrefix, String fhirResourceType, long currentBytes) {
+        this.connectionString = connectionString;
+        this.container = container;
+        this.chunkData = chunkData;
+        this.cosBucketPathPrefix = cosBucketPathPrefix;
+        this.fhirResourceType = fhirResourceType;
+        this.currentBytes = currentBytes;
+    }
+
+    /**
+     * initializes the blob client
+     * @param workItem
+     */
+    protected void initializeBlobClient(String workItem) {
+        if (client == null) {
+            client = new BlobClientBuilder()
+                .connectionString(connectionString)
+                .containerName(container)
+                .blobName(workItem)
+                .buildClient();
+        }
+    }
+
+    @Override
+    public void createSource() throws FHIRException {
+        try {
+            BlobContainerClient blobContainerClient = new BlobContainerClientBuilder()
+                .connectionString(connectionString)
+                .containerName(container)
+                .buildClient();
+            blobContainerClient.create();
+            LOG.info("Container is created '" + container + "'");
+        } catch (BlobStorageException error) {
+            LOG.fine("Can't create container. It already exists");
+            LOG.throwing(this.getClass().getName(), "createSource", error);
+        }
+    }
+
+    @Override
+    public long getSize(String workItem) throws FHIRException {
+        try {
+            initializeBlobClient(workItem);
+            long size = client.getProperties().getBlobSize();
+            LOG.fine(() -> workItem + " [" + size + "]");
+            return size;
+        } catch (Exception e) {
+            LOG.throwing("AzureProvider", "getSize", e);
+            LOG.fine("Error Getting File Size '" + container + "/" + workItem + "'");
+            throw new FHIRLoadException("Error Getting File Size '" + container + "/" + workItem + "'");
+        }
+    }
+
+    /**
+     * lists the blobs on the container.
+     * @throws FHIRException
+     */
+    public void listBlobsForContainer() throws FHIRException {
+        try {
+            BlobContainerClient containerClient = new BlobContainerClientBuilder()
+                    .connectionString(connectionString)
+                    .containerName(container)
+                    .buildClient();
+            LOG.info("Listing the blobs");
+            containerClient.listBlobs().forEach(blob -> LOG.info("BLOB: " + blob.getName()));
+            LOG.info("Finished listing the blobs");
+        } catch (Exception e) {
+            throw new FHIRException("Error listing the blobs for '" + container + "'", e);
+        }
+    }
+
+    /**
+     * writes directly to Azure using AppendBlock client
+     * @param workItem the file
+     * @param in
+     * @param size
+     * @throws Exception
+     */
+    public void writeDirectly(String workItem, InputStream in, int size) throws Exception{
+        initializeBlobClient(workItem);
+
+        AppendBlobClient aClient = client.getAppendBlobClient();
+        if (!client.exists().booleanValue()) {
+            aClient.create();
+        }
+        // Append a new line.
+        aClient.appendBlock(in, size);
+        try (ByteArrayInputStream bais = new ByteArrayInputStream(NEWLINE)) {
+            aClient.appendBlock(bais, NEWLINE.length);
+        }
+    }
+
+    @Override
+    public void writeResources(String mediaType, List<ReadResultDTO> dtos) throws Exception {
+        String workItem = cosBucketPathPrefix + "/" + fhirResourceType + "_" + chunkData.getUploadCount() + ".ndjson";
+
+        initializeBlobClient(workItem);
+
+        AppendBlobClient aClient = client.getAppendBlobClient();
+        if (!client.exists().booleanValue()) {
+            aClient.create();
+        }
+        aClient.appendBlock(
+            new ByteArrayInputStream(chunkData.getBufferStream().toByteArray()),
+                chunkData.getBufferStream().size());
+
+        chunkData.getBufferStream().reset();
+
+        if (chunkData.isFinishCurrentUpload()) {
+            // Partition status for the exported resources, e.g, Patient[1000,1000,200]
+            if (chunkData.getResourceTypeSummary() == null) {
+                chunkData.setResourceTypeSummary(fhirResourceType + "[" + chunkData.getCurrentUploadResourceNum());
+                if (chunkData.getPageNum() >= chunkData.getLastPageNum()) {
+                    chunkData.setResourceTypeSummary(chunkData.getResourceTypeSummary() + "]");
+                }
+            } else {
+                chunkData.setResourceTypeSummary(chunkData.getResourceTypeSummary() + "," + chunkData.getCurrentUploadResourceNum());
+                if (chunkData.getPageNum() >= chunkData.getLastPageNum()) {
+                    chunkData.setResourceTypeSummary(chunkData.getResourceTypeSummary() + "]");
+                }
+            }
+
+            if (chunkData.getPageNum() < chunkData.getLastPageNum()) {
+                chunkData.setPartNum(1);
+                chunkData.setUploadId(null);
+                chunkData.setCurrentUploadResourceNum(0);
+                chunkData.setCurrentUploadSize(0);
+                chunkData.setFinishCurrentUpload(false);
+                chunkData.getCosDataPacks().clear();
+                chunkData.setUploadCount(chunkData.getUploadCount() + 1);
+            }
+        }
+    }
+
+    /*
+     * We process the BlobRange as a window
+     */
+    @Override
+    public void readResources(long numOfLinesToSkip, String workItem) throws FHIRException {
+        initializeBlobClient(workItem);
+        this.workItem = workItem;
+
+        boolean complete = false;
+        int window = 0;
+
+        // 200 means 2000M! has been retrieved, our maximum single resource size.
+        StringBuilder previous = new StringBuilder();
+        while (!complete && window < 200) {
+            BlobRequestConditions options = new BlobRequestConditions();
+            BlobRange range = new BlobRange(currentBytes, 10000L);
+            // Now we need to calculate where we left off in the download, and adjust the resume point.
+            try (InputStream in = client.openInputStream(range, options);
+                    CountInputStreamReader counter = new CountInputStreamReader(in);
+                    BufferedReader reader = new BufferedReader(counter)) {
+
+                List<String> lines = reader.lines().collect(Collectors.toList());
+                int idx = 1;
+                for (String line : lines) {
+                    idx++;
+                    String compLine = previous + line;
+
+                    try (ByteArrayInputStream bais = new ByteArrayInputStream(compLine.getBytes())) {
+                        resources.add(FHIRParser.parser(Format.JSON).parse(bais));
+                        if (LOG.isLoggable(Level.FINE)) {
+                            LOG.fine("Azure Resource [R] " + compLine);
+                        }
+                        // There is no reason to reset compLine as we're now stopping this proccessing block.
+                        // previous, baos are all going to go out of scope.
+                        if (window > 0) {
+                            // Doesn't need to be closed per JavaDocs
+                            ByteArrayOutputStream baos = new ByteArrayOutputStream();
+                            baos.write(line.getBytes());
+                            currentBytes += baos.size();
+                            complete = true;
+                            break;
+                        }
+                    } catch(FHIRParserException fpe) {
+                        // We're on the last line, so there might be more
+                        if (idx -1 == lines.size()) {
+                            previous.append(line);
+                        } else {
+                            parseFailures++;
+                            OperationOutcome.Issue ooi = FHIRUtil.buildOperationOutcomeIssue("Failed to Process " + this.transientUserData.getNumOfProcessedResources() + idx, IssueType.EXCEPTION);
+                            OperationOutcome oo = OperationOutcome.builder().issue(ooi).build();
+                            FHIRGenerator.generator(Format.JSON).generate(oo, this.transientUserData.getBufferStreamForImportError());
+                            this.transientUserData.getBufferStreamForImportError().write("\r\n".getBytes());
+                        }
+                    }
+                }
+                if (!complete) {
+                    currentBytes += counter.getLength();
+                    window++;
+                }
+
+                // Set so we can move the window forward.
+                this.transientUserData.setCurrentBytes(currentBytes);
+                LOG.fine(() -> "Number of bytes read are: '" + currentBytes + "'");
+            } catch (IOException e) {
+                LOG.throwing("AzureProvider", "readResources", e);
+                LOG.severe("Problem accessing backend on Azure" + e.getMessage());
+                throw new FHIRException("Problem accessing backend Container or Blob on Azure", e);
+            }
+        }
+    }
+
+    /**
+     * CountInputStreamReader counts the size of the input.
+     */
+    private static class CountInputStreamReader extends InputStreamReader {
+        private long l = 0;
+
+        public CountInputStreamReader(InputStream in) {
+            super(in);
+        }
+
+        @Override
+        public int read(char[] cbuf, int offset, int length) throws IOException {
+            int r = super.read(cbuf, offset, length);
+            if (r != -1) {
+                l += r;
+            }
+            return r;
+        }
+
+        /**
+         * @return the length of the resources returned in the reader
+         */
+        public long getLength() {
+            return l;
+        }
+    }
+
+    @Override
+    public void pushOperationOutcomes() throws FHIRException {
+        if (collect && this.transientUserData.getBufferStreamForImportError().size() != 0) {
+            // Push the error
+            String workItemError = this.workItem + "_oo_errors.ndjson";
+            LOG.fine(() -> "Outputting the error to " +  workItemError);
+            initializeBlobClient(workItemError);
+
+            AppendBlobClient aClient = client.getAppendBlobClient();
+            if (!client.exists().booleanValue()) {
+                aClient.create();
+            }
+            aClient.appendBlock(
+                new ByteArrayInputStream(this.transientUserData.getBufferStreamForImportError().toByteArray()),
+                    this.transientUserData.getBufferStreamForImportError().size());
+
+            this.transientUserData.getBufferStreamForImportError().reset();
+            // Push the success
+            // @implNote Sadly we don't do this right now.
+        }
+    }
+
+
+    @Override
+    public void close() throws Exception {
+        // No Operation
+    }
+
+    @Override
+    public List<Resource> getResources() throws FHIRException {
+        return resources;
+    }
+
+    @Override
+    public long getNumberOfParseFailures() throws FHIRException {
+        return parseFailures;
+    }
+
+    @Override
+    public long getNumberOfLoaded() throws FHIRException {
+        return resources.size();
+    }
+
+    @Override
+    public void registerTransient(ImportTransientUserData transientUserData) {
+        this.transientUserData = transientUserData;
+        this.currentBytes = transientUserData.getCurrentBytes();
+    }
+
+    @Override
+    public void registerTransient(long executionId, ExportTransientUserData transientUserData, String cosBucketPathPrefix, String fhirResourceType) throws Exception {
+        if (transientUserData == null) {
+            LOG.warning("registerTransient: chunkData is null, this should never happen!");
+            throw new Exception("registerTransient: chunkData is null, this should never happen!");
+        }
+
+        this.cosBucketPathPrefix = cosBucketPathPrefix;
+        this.fhirResourceType = fhirResourceType;
+
+        this.chunkData = transientUserData;
+    }
+}
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/FileProvider.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/FileProvider.java
index 35a051f7017..57cf0926d8c 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/FileProvider.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/FileProvider.java
@@ -136,8 +136,7 @@ public long getNumberOfLoaded() throws FHIRException {
     }
 
     @Override
-    public void registerTransient(long executionId, ExportTransientUserData transientUserData, String exportPathPrefix, String fhirResourceType,
-            boolean isExportPublic) throws Exception {
+    public void registerTransient(long executionId, ExportTransientUserData transientUserData, String exportPathPrefix, String fhirResourceType) throws Exception {
         if (transientUserData == null) {
             String msg = "registerTransient: chunkData is null, this should never happen!";
             logger.warning(msg);
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/HttpsProvider.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/HttpsProvider.java
index 1a14fc822a2..4145db7173e 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/HttpsProvider.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/HttpsProvider.java
@@ -85,8 +85,7 @@ public long getNumberOfLoaded() throws FHIRException {
     }
 
     @Override
-    public void registerTransient(long executionId, ExportTransientUserData transientUserData, String cosBucketPathPrefix, String fhirResourceType,
-        boolean isExportPublic) {
+    public void registerTransient(long executionId, ExportTransientUserData transientUserData, String cosBucketPathPrefix, String fhirResourceType) {
 
     }
 
diff --git a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/S3Provider.java b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/S3Provider.java
index d590cd0c04c..98ab9fc649d 100644
--- a/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/S3Provider.java
+++ b/fhir-bulkdata-webapp/src/main/java/com/ibm/fhir/bulkdata/provider/impl/S3Provider.java
@@ -44,6 +44,7 @@
 import com.ibm.fhir.operation.bulkdata.client.HttpWrapper;
 import com.ibm.fhir.operation.bulkdata.config.ConfigurationAdapter;
 import com.ibm.fhir.operation.bulkdata.config.ConfigurationFactory;
+import com.ibm.fhir.operation.bulkdata.config.s3.S3HostStyle;
 
 /**
  * S3Provider for ibm-cos and aws-s3
@@ -64,15 +65,21 @@ public class S3Provider implements Provider {
     private SparkParquetWriter parquetWriter = null;
 
     private String bucketName = null;
+    private boolean pathStyle;
 
     private boolean create = false;
 
-    private boolean isExportPublic = false;
     private long executionId = -1;
 
     private String cosBucketPathPrefix = null;
     private String fhirResourceType = null;
 
+    /**
+     * The provider loads the Client based on the Source.
+     * The Source (storageProvider) must be s3 compatible.
+     * @param source
+     * @throws FHIRException
+     */
     public S3Provider(String source) throws FHIRException {
         ConfigurationAdapter adapter = ConfigurationFactory.getInstance();
 
@@ -80,10 +87,9 @@ public S3Provider(String source) throws FHIRException {
 
         String cosLocation = adapter.getStorageProviderLocation(source);
         String cosEndpointUrl = adapter.getStorageProviderEndpointInternal(source);
-        String bucketName = adapter.getStorageProviderBucketName(source);
+        bucketName = adapter.getStorageProviderBucketName(source);
 
         boolean iam = adapter.isStorageProviderAuthTypeIam(source);
-        isExportPublic = adapter.isStorageProviderExportPublic(source);
 
         String apiKey = null;
         String resourceId = null;
@@ -103,11 +109,15 @@ public S3Provider(String source) throws FHIRException {
 
         // Set up the connection to Cos
         if (logger.isLoggable(Level.FINE)) {
-            logger.fine("Connecting to S3: " + cosEndpointUrl + " [" + cosLocation + "]");
+            logger.fine("Connecting to S3: [" + cosEndpointUrl + "] [" + cosLocation + "]");
         }
 
         create = adapter.shouldStorageProviderCreate(source);
 
+        // There are two styles PATH/VIRTUAL_HOST
+        S3HostStyle kind = adapter.getS3HostStyleByStorageProvider(source);
+        pathStyle = S3HostStyle.PATH.equals(kind);
+
         // Create a COS/S3 client if it's not created yet.
         client = getClient(iam, apiKey, resourceId, cosEndpointUrl, cosLocation, useFhirServerTrustStore);
 
@@ -115,15 +125,14 @@ public S3Provider(String source) throws FHIRException {
             logger.warning("Failed to get client!");
             throw new FHIRException("Failed to get client!!");
         } else {
-            logger.fine("Succeed get client!");
+            logger.fine("Succeed to get client!");
         }
 
-        if (bucketName == null) {
-            logger.warning("Failed to get BucketName!");
-        } else {
-            logger.fine("Succeed get BucketName!");
+        if (bucketName != null) {
+            logger.fine("Succeed to get BucketName!");
+            // Naming convention has it as - The bucket name can be between 3 and 63 characters long, and can contain only lower-case characters, numbers, periods, and dashes.
+            this.bucketName = bucketName.trim().toLowerCase();
         }
-        this.bucketName = bucketName.trim().toLowerCase();
 
         if (adapter.isStorageProviderParquetEnabled(source)) {
             try {
@@ -135,8 +144,17 @@ public S3Provider(String source) throws FHIRException {
         }
     }
 
-    private static AmazonS3 getClient(boolean iam, String cosApiKeyProperty, String cosSrvinstId,
-        String cosEndpointUrl, String cosLocation, boolean useFhirServerTrustStore) {
+    /**
+     * gets the s3 client used with ibm/aws/minio
+     * @param iam
+     * @param cosApiKeyProperty
+     * @param cosSrvinstId
+     * @param cosEndpointUrl
+     * @param cosLocation
+     * @param useFhirServerTrustStore
+     * @return
+     */
+    private AmazonS3 getClient(boolean iam, String cosApiKeyProperty, String cosSrvinstId, String cosEndpointUrl, String cosLocation, boolean useFhirServerTrustStore) {
         ConfigurationAdapter configAdapter = ConfigurationFactory.getInstance();
 
         AWSCredentials credentials;
@@ -148,7 +166,10 @@ private static AmazonS3 getClient(boolean iam, String cosApiKeyProperty, String
         }
 
         ClientConfiguration clientConfig =
-                new ClientConfiguration().withRequestTimeout(configAdapter.getCoreCosRequestTimeout()).withTcpKeepAlive(configAdapter.getCoreCosTcpKeepAlive()).withSocketTimeout(configAdapter.getCoreCosSocketTimeout());
+                new ClientConfiguration()
+                    .withRequestTimeout(configAdapter.getCoreCosRequestTimeout())
+                    .withTcpKeepAlive(configAdapter.getCoreCosTcpKeepAlive())
+                    .withSocketTimeout(configAdapter.getCoreCosSocketTimeout());
 
         if (useFhirServerTrustStore) {
             ApacheHttpClientConfig apacheClientConfig = clientConfig.getApacheHttpClientConfig();
@@ -162,7 +183,16 @@ private static AmazonS3 getClient(boolean iam, String cosApiKeyProperty, String
             }
         }
 
-        return AmazonS3ClientBuilder.standard().withCredentials(new AWSStaticCredentialsProvider(credentials)).withEndpointConfiguration(new EndpointConfiguration(cosEndpointUrl, cosLocation)).withPathStyleAccessEnabled(true).withClientConfiguration(clientConfig).build();
+        logger.fine(() -> "The Path Style access is '" + pathStyle + "'");
+
+        // A useful link for the builder describing the pathStyle:
+        // https://docs.aws.amazon.com/AWSJavaSDK/latest/javadoc/com/amazonaws/services/s3/AmazonS3Builder.html#withPathStyleAccessEnabled-java.lang.Boolean-
+        return AmazonS3ClientBuilder.standard()
+                .withCredentials(new AWSStaticCredentialsProvider(credentials))
+                .withEndpointConfiguration(new EndpointConfiguration(cosEndpointUrl, cosLocation))
+                .withClientConfiguration(clientConfig)
+                .withPathStyleAccessEnabled(pathStyle)
+                .build();
     }
 
     /**
@@ -171,15 +201,13 @@ private static AmazonS3 getClient(boolean iam, String cosApiKeyProperty, String
      * @return
      */
     public boolean exists() {
-        boolean ex = client != null && client.doesBucketExistV2(bucketName);
-        if (ex == false) {
-            logger.warning("Bucket '" + bucketName + "' not found! Client [" + (client != null) + "]");
-        }
-        return ex;
+        // Only valid with a path access style, else we short circuit
+        return client != null &&
+                (!pathStyle || !client.doesBucketExistV2(bucketName));
     }
 
     /**
-     * lists the buckets when logging
+     * lists the buckets when logging out bucket details
      */
     public void listBuckets() {
         if (client != null && logger.isLoggable(Level.FINE)) {
@@ -195,15 +223,20 @@ public void listBuckets() {
     /**
      * get the list of objects based on the continuation token.
      *
+     * @param prefix the search key
      * @param continuationToken
      *            null or string indicating a continuation token.
      * @return
      * @throws FHIRException
      */
-    public ListObjectsV2Result getListObject(String continuationToken) throws FHIRException {
+    public ListObjectsV2Result getListObject(String prefix, String continuationToken) throws FHIRException {
         if (client != null) {
             ListObjectsV2Request request =
-                    new ListObjectsV2Request().withBucketName(bucketName).withMaxKeys(1000).withContinuationToken(continuationToken);
+                    new ListObjectsV2Request()
+                            .withPrefix(prefix)
+                            .withMaxKeys(1000)
+                            .withContinuationToken(continuationToken)
+                            .withBucketName(bucketName);
             return client.listObjectsV2(request);
         } else {
             throw new FHIRException("Client is not created");
@@ -256,7 +289,7 @@ public void pushOperationOutcomes() throws FHIRException {
             if (transientUserData.getBufferStreamForImport().size() > COS_PART_MINIMALSIZE) {
                 if (transientUserData.getUploadIdForOperationOutcomes() == null) {
                     transientUserData.setUploadIdForOperationOutcomes(BulkDataUtils.startPartUpload(client,
-                            bucketName, transientUserData.getUniqueIDForImportOperationOutcomes(), true));
+                            bucketName, transientUserData.getUniqueIDForImportOperationOutcomes()));
                 }
 
                 transientUserData.getDataPacksForOperationOutcomes().add(BulkDataUtils.multiPartUpload(client,
@@ -279,7 +312,7 @@ public void pushOperationOutcomes() throws FHIRException {
             if (transientUserData.getBufferStreamForImportError().size() > COS_PART_MINIMALSIZE) {
                 if (transientUserData.getUploadIdForFailureOperationOutcomes() == null) {
                     transientUserData.setUploadIdForFailureOperationOutcomes(BulkDataUtils.startPartUpload(client,
-                            bucketName, transientUserData.getUniqueIDForImportFailureOperationOutcomes(), true));
+                            bucketName, transientUserData.getUniqueIDForImportFailureOperationOutcomes()));
                 }
 
                 transientUserData.getDataPacksForFailureOperationOutcomes().add(BulkDataUtils.multiPartUpload(client,
@@ -350,8 +383,7 @@ public void writeResources(String mediaType, List<ReadResultDTO> dtos) throws Ex
     }
 
     @Override
-    public void registerTransient(long executionId, ExportTransientUserData transientUserData, String cosBucketPathPrefix, String fhirResourceType,
-            boolean isExportPublic) throws Exception {
+    public void registerTransient(long executionId, ExportTransientUserData transientUserData, String cosBucketPathPrefix, String fhirResourceType) throws Exception {
         if (transientUserData == null) {
             logger.warning("registerTransient: chunkData is null, this should never happen!");
             throw new Exception("registerTransient: chunkData is null, this should never happen!");
@@ -361,7 +393,6 @@ public void registerTransient(long executionId, ExportTransientUserData transien
         this.chunkData = transientUserData;
         this.cosBucketPathPrefix = cosBucketPathPrefix;
         this.fhirResourceType = fhirResourceType;
-        this.isExportPublic = isExportPublic;
     }
 
     private void pushFhirJsonsToCos(InputStream in, int dataLength) throws Exception {
@@ -374,7 +405,7 @@ private void pushFhirJsonsToCos(InputStream in, int dataLength) throws Exception
 
         String uploadId = chunkData.getUploadId();
         if (uploadId == null) {
-            uploadId = BulkDataUtils.startPartUpload(client, bucketName, itemName, isExportPublic);
+            uploadId = BulkDataUtils.startPartUpload(client, bucketName, itemName);
             chunkData.setUploadId(uploadId);
         }
 
diff --git a/fhir-bulkdata-webapp/src/main/resources/META-INF/batch-jobs/FhirBulkImportChunkJob.xml b/fhir-bulkdata-webapp/src/main/resources/META-INF/batch-jobs/FhirBulkImportChunkJob.xml
index 13dd2735392..94f2a95edab 100644
--- a/fhir-bulkdata-webapp/src/main/resources/META-INF/batch-jobs/FhirBulkImportChunkJob.xml
+++ b/fhir-bulkdata-webapp/src/main/resources/META-INF/batch-jobs/FhirBulkImportChunkJob.xml
@@ -31,6 +31,7 @@
                     <property name="import.fhir.storagetype" value="#{jobParameters['import.fhir.storagetype']}"/>
                     
                     <property name="partition.workitem" value="#{partitionPlan['partition.workitem']}"/>
+                    <property name="partition.matrix" value="#{partitionPlan['partition.matrix']}"/>
                     <property name="partition.resourcetype" value="#{partitionPlan['partition.resourcetype']}"/>
                 </properties>
             </reader>
@@ -43,6 +44,7 @@
                     <property name="fhir.bulkdata.outcome" value="#{jobParameters['fhir.bulkdata.outcome']}"/>
                     
                     <property name="partition.workitem" value="#{partitionPlan['partition.workitem']}"/>
+                    <property name="partition.matrix" value="#{partitionPlan['partition.matrix']}"/>
                     <property name="partition.resourcetype" value="#{partitionPlan['partition.resourcetype']}"/>
                 </properties>
             </writer>
diff --git a/fhir-bulkdata-webapp/src/test/java/com/ibm/fhir/bulkdata/provider/impl/AzureProviderMain.java b/fhir-bulkdata-webapp/src/test/java/com/ibm/fhir/bulkdata/provider/impl/AzureProviderMain.java
new file mode 100644
index 00000000000..f7f8fd1789e
--- /dev/null
+++ b/fhir-bulkdata-webapp/src/test/java/com/ibm/fhir/bulkdata/provider/impl/AzureProviderMain.java
@@ -0,0 +1,181 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.bulkdata.provider.impl;
+
+import static com.ibm.fhir.model.type.String.string;
+
+import java.io.ByteArrayOutputStream;
+import java.time.LocalDate;
+import java.time.ZoneOffset;
+import java.time.temporal.ChronoUnit;
+import java.util.Collections;
+import java.util.UUID;
+
+import com.ibm.fhir.bulkdata.jbatch.export.data.ExportTransientUserData;
+import com.ibm.fhir.exception.FHIRException;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.generator.FHIRGenerator;
+import com.ibm.fhir.model.resource.Observation;
+import com.ibm.fhir.model.resource.Patient;
+import com.ibm.fhir.model.type.Code;
+import com.ibm.fhir.model.type.CodeableConcept;
+import com.ibm.fhir.model.type.Coding;
+import com.ibm.fhir.model.type.Date;
+import com.ibm.fhir.model.type.DateTime;
+import com.ibm.fhir.model.type.HumanName;
+import com.ibm.fhir.model.type.Id;
+import com.ibm.fhir.model.type.Instant;
+import com.ibm.fhir.model.type.Meta;
+import com.ibm.fhir.model.type.Narrative;
+import com.ibm.fhir.model.type.Reference;
+import com.ibm.fhir.model.type.Uri;
+import com.ibm.fhir.model.type.Xhtml;
+import com.ibm.fhir.model.type.code.AdministrativeGender;
+import com.ibm.fhir.model.type.code.NarrativeStatus;
+import com.ibm.fhir.model.type.code.ObservationStatus;
+
+public class AzureProviderMain {
+
+    public static void main(String[] args) throws Exception {
+        AzureProviderMain main = new AzureProviderMain();
+        AzureProvider provider = new AzureProvider("dummy");
+
+        main.test1(args[0]);
+        //main.test2(args[0], provider);
+    }
+
+    public void test2(String arg0, AzureProvider provider) throws FHIRException {
+        ExportTransientUserData chunkData = ExportTransientUserData.Builder.builder().build();
+        ByteArrayOutputStream os = chunkData.getBufferStream();
+
+        String cosBucketPathPrefix =  "DEMO0.956558326916514";
+        provider.registerOverride(arg0, "test", chunkData, cosBucketPathPrefix, "Patient", 0);
+        provider.readResources(0, cosBucketPathPrefix + "/Patient_1.ndjson");
+        provider.readResources(0, cosBucketPathPrefix + "/Patient_1.ndjson");
+        provider.readResources(0, cosBucketPathPrefix + "/Patient_1.ndjson");
+        System.out.println(provider.getResources().size());
+    }
+
+    public void test1(String arg0) throws Exception {
+        AzureProviderMain main = new AzureProviderMain();
+        Patient patient = main.buildTestPatient();
+        Observation observation = main.buildObservation(patient.getId());
+
+        ExportTransientUserData chunkData = ExportTransientUserData.Builder.builder().build();
+        ByteArrayOutputStream os = chunkData.getBufferStream();
+
+        FHIRGenerator.generator(Format.JSON).generate(patient, os);
+        os.write("\r\n".getBytes());
+        FHIRGenerator.generator(Format.JSON).generate(observation, os);
+        os.write("\r\n".getBytes());
+
+        String cosBucketPathPrefix = ("DEMO" + Math.random());
+
+        AzureProvider provider = new AzureProvider("dummy");
+        provider.registerOverride(arg0, "test", chunkData, cosBucketPathPrefix, "Patient", 0);
+        provider.createSource();
+        provider.listBlobsForContainer();
+        provider.writeResources("application/ndjson", Collections.emptyList());
+        provider.listBlobsForContainer();
+        System.out.println(provider.getSize(cosBucketPathPrefix + "/null_1.ndjson"));
+
+        os = chunkData.getBufferStream();
+        FHIRGenerator.generator(Format.JSON).generate(patient, os);
+        os.write("\r\n".getBytes());
+        FHIRGenerator.generator(Format.JSON).generate(observation, os);
+        os.write("\r\n".getBytes());
+        provider.writeResources("application/ndjson", Collections.emptyList());
+        provider.listBlobsForContainer();
+        System.out.println(provider.getSize(cosBucketPathPrefix + "/null_1.ndjson"));
+
+        os = chunkData.getBufferStream();
+        FHIRGenerator.generator(Format.JSON).generate(patient, os);
+        os.write("\r\n".getBytes());
+        FHIRGenerator.generator(Format.JSON).generate(observation, os);
+        os.write("\r\n".getBytes());
+        provider.writeResources("application/ndjson", Collections.emptyList());
+        provider.listBlobsForContainer();
+        System.out.println(provider.getSize(cosBucketPathPrefix + "/null_1.ndjson"));
+
+        provider.readResources(0, cosBucketPathPrefix + "/Patient_1.ndjson");
+        provider.readResources(0, cosBucketPathPrefix + "/Patient_1.ndjson");
+        provider.readResources(0, cosBucketPathPrefix + "/Patient_1.ndjson");
+        provider.readResources(0, cosBucketPathPrefix + "/Patient_1.ndjson");
+        System.out.println(provider.getResources().size());
+
+    }
+
+    private Patient buildTestPatient() {
+        String id = UUID.randomUUID().toString();
+        Meta meta =
+                Meta.builder()
+                    .versionId(Id.of("1"))
+                    .lastUpdated(Instant.now(ZoneOffset.UTC))
+                    .build();
+
+        com.ibm.fhir.model.type.String given =
+                com.ibm.fhir.model.type.String.builder()
+                .value("John")
+                .build();
+
+        HumanName name =
+                HumanName.builder()
+                    .id("someId")
+                    .given(given)
+                    .family(string("Doe")).build();
+
+        java.lang.String uUID = UUID.randomUUID().toString();
+
+        Reference providerRef =
+                Reference.builder().reference(string("urn:uuid:" + uUID)).build();
+
+        return Patient.builder().id(id)
+                .active(com.ibm.fhir.model.type.Boolean.TRUE)
+                .multipleBirth(com.ibm.fhir.model.type.Integer.of(2))
+                .meta(meta).name(name).birthDate(Date.of(LocalDate.now().minus(30,ChronoUnit.YEARS)))
+                .gender(AdministrativeGender.FEMALE)
+                .generalPractitioner(providerRef).text(
+                    Narrative.builder()
+                        .div(Xhtml.of("<div xmlns=\"http://www.w3.org/1999/xhtml\">loaded from the datastore</div>"))
+                        .status(NarrativeStatus.GENERATED).build())
+                .build();
+    }
+
+    public Observation buildObservation(String patientId) {
+        CodeableConcept code = CodeableConcept.builder().coding(
+            Coding.builder()
+                .code(Code.of("82810-3"))
+                .system(Uri.of("http://loinc.org"))
+                .display(string("Pregnancy status"))
+                .build())
+            .text(string("Pregnancy status"))
+            .build();
+
+        Narrative text = Narrative.builder()
+                .div(Xhtml.of("<div xmlns=\"http://www.w3.org/1999/xhtml\">loaded from the datastore</div>"))
+                .status(NarrativeStatus.GENERATED).build();
+
+        CodeableConcept value = CodeableConcept.builder().coding(
+            Coding.builder()
+                .code(Code.of("LA15173-0"))
+                .system(Uri.of("http://loinc.org"))
+                .display(string("Pregnant"))
+                .build())
+            .text(string("Pregnant"))
+            .build();
+
+        Observation observation = Observation.builder()
+                .text(text)
+                .status(ObservationStatus.FINAL)
+                .code(code)
+                .subject(Reference.builder().reference(string("Patient/" + patientId)).build())
+                .value(value)
+                .effective(DateTime.of(LocalDate.of(2020, 6, 20)))
+             .build();
+        return observation;
+    }
+}
diff --git a/fhir-cache/pom.xml b/fhir-cache/pom.xml
index e47aaf46f1c..142572c433d 100644
--- a/fhir-cache/pom.xml
+++ b/fhir-cache/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-cache</artifactId>
diff --git a/fhir-cli/.gitignore b/fhir-cli/.gitignore
deleted file mode 100644
index e69de29bb2d..00000000000
diff --git a/fhir-cli/pom.xml b/fhir-cli/pom.xml
deleted file mode 100644
index 08c83acb9ac..00000000000
--- a/fhir-cli/pom.xml
+++ /dev/null
@@ -1,66 +0,0 @@
-<project xmlns="http://maven.apache.org/POM/4.0.0" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
-    xsi:schemaLocation="http://maven.apache.org/POM/4.0.0 http://maven.apache.org/xsd/maven-4.0.0.xsd">
-    <modelVersion>4.0.0</modelVersion>
-
-    <parent>
-        <groupId>com.ibm.fhir</groupId>
-        <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
-        <relativePath>../fhir-parent</relativePath>
-    </parent>
-
-    <artifactId>fhir-cli</artifactId>
-    <description>Command-line interface for FHIR Client API</description>
-    <packaging>jar</packaging>
-    
-    <properties>
-    </properties>
-
-    <dependencies>
-        <dependency>
-            <groupId>${project.groupId}</groupId>
-            <artifactId>fhir-core</artifactId>
-            <version>${project.version}</version>
-        </dependency>
-        <dependency>
-            <groupId>${project.groupId}</groupId>
-            <artifactId>fhir-client</artifactId>
-            <version>${project.version}</version>
-        </dependency>
-        <dependency>
-            <groupId>commons-cli</groupId>
-            <artifactId>commons-cli</artifactId>
-        </dependency>
-        <dependency>
-            <groupId>org.testng</groupId>
-            <artifactId>testng</artifactId>
-            <scope>test</scope>
-        </dependency>
-    </dependencies>
-
-    <build>
-        <plugins>
-            <plugin>
-                <groupId>org.apache.maven.plugins</groupId>
-                <artifactId>maven-assembly-plugin</artifactId>
-                <executions>
-                    <execution>
-                        <id>fhir-cli</id>
-                        <goals>
-                            <goal>single</goal>
-                        </goals>
-                        <phase>package</phase>
-                        <configuration>
-                            <finalName>fhir-cli</finalName>
-                            <appendAssemblyId>false</appendAssemblyId>
-                            <attach>true</attach>
-                            <descriptors>
-                                <descriptor>src/main/assembly/distribution.xml</descriptor>
-                            </descriptors>
-                        </configuration>
-                    </execution>
-                </executions>
-            </plugin>
-        </plugins>
-    </build>
-</project>
diff --git a/fhir-cli/src/main/assembly/distribution.xml b/fhir-cli/src/main/assembly/distribution.xml
deleted file mode 100644
index 527e0bc4014..00000000000
--- a/fhir-cli/src/main/assembly/distribution.xml
+++ /dev/null
@@ -1,35 +0,0 @@
-<?xml version="1.0" encoding="UTF-8"?>
-<assembly
-    xmlns="http://maven.apache.org/plugins/maven-assembly-plugin/assembly/1.1.2"
-    xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
-    xsi:schemaLocation="http://maven.apache.org/plugins/maven-assembly-plugin/assembly/1.1.2 http://maven.apache.org/xsd/assembly-1.1.2.xsd">
-    <id>distribution</id>
-    <baseDirectory>fhir-cli</baseDirectory>
-    <includeBaseDirectory>true</includeBaseDirectory>
-    <formats>
-        <format>zip</format>
-    </formats>
-
-    <fileSets>
-        <fileSet>
-            <directory>src/main/resources/scripts</directory>
-            <outputDirectory></outputDirectory>
-            <fileMode>0755</fileMode>
-        </fileSet>
-    </fileSets>
-    <files>
-        <file>
-            <source>src/main/resources/fhir-cli.properties</source>
-            <outputDirectory></outputDirectory>
-            <fileMode>0644</fileMode>
-        </file>
-    </files>
-    <dependencySets>
-        <dependencySet>
-            <useProjectArtifact>true</useProjectArtifact>
-            <outputDirectory>lib</outputDirectory>
-            <directoryMode>0755</directoryMode>
-            <fileMode>0755</fileMode>
-        </dependencySet>
-    </dependencySets>
-</assembly>
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/FHIRCLI.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/FHIRCLI.java
deleted file mode 100644
index 771ce3391f9..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/FHIRCLI.java
+++ /dev/null
@@ -1,388 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016, 2020
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli;
-
-import java.io.FileOutputStream;
-import java.io.OutputStreamWriter;
-import java.io.PrintStream;
-import java.io.PrintWriter;
-import java.io.StringWriter;
-import java.io.Writer;
-import java.util.HashMap;
-import java.util.List;
-import java.util.Map;
-
-import javax.ws.rs.core.MultivaluedMap;
-import javax.ws.rs.core.Response;
-
-import org.apache.commons.cli.CommandLine;
-import org.apache.commons.cli.CommandLineParser;
-import org.apache.commons.cli.DefaultParser;
-import org.apache.commons.cli.HelpFormatter;
-import org.apache.commons.cli.Option;
-import org.apache.commons.cli.Options;
-
-import com.ibm.fhir.cli.invoker.BatchInvoker;
-import com.ibm.fhir.cli.invoker.ConditionalCreateInvoker;
-import com.ibm.fhir.cli.invoker.ConditionalDeleteInvoker;
-import com.ibm.fhir.cli.invoker.ConditionalUpdateInvoker;
-import com.ibm.fhir.cli.invoker.CreateInvoker;
-import com.ibm.fhir.cli.invoker.DeleteInvoker;
-import com.ibm.fhir.cli.invoker.HistoryInvoker;
-import com.ibm.fhir.cli.invoker.InvocationContext;
-import com.ibm.fhir.cli.invoker.MetadataInvoker;
-import com.ibm.fhir.cli.invoker.OperationInvoker;
-import com.ibm.fhir.cli.invoker.ReadInvoker;
-import com.ibm.fhir.cli.invoker.SearchAllInvoker;
-import com.ibm.fhir.cli.invoker.SearchInvoker;
-import com.ibm.fhir.cli.invoker.SearchPostInvoker;
-import com.ibm.fhir.cli.invoker.TransactionInvoker;
-import com.ibm.fhir.cli.invoker.UpdateInvoker;
-import com.ibm.fhir.cli.invoker.ValidateInvoker;
-import com.ibm.fhir.cli.invoker.VreadInvoker;
-import com.ibm.fhir.client.FHIRResponse;
-import com.ibm.fhir.core.FHIRMediaType;
-import com.ibm.fhir.model.format.Format;
-import com.ibm.fhir.model.generator.FHIRGenerator;
-import com.ibm.fhir.model.resource.Resource;
-
-/**
- * This class provides a command-line interface (CLI) to the FHIR Client API, allowing
- * the user to invoke commands on the command-line that invoke the FHIR Client API to
- * carry out various FHIR-related operations.
- * 
- * @author padams
- */
-public class FHIRCLI {
-    
-    public static void main(String[] args) {
-        FHIRCLI fhircli = null;
-        try {
-            println(copyright);
-            fhircli = new FHIRCLI(args);
-            fhircli.processCommand();
-            System.exit(0);
-        } catch (Throwable t) {
-            println("\nUnexpected exception: " + t);
-            println(getStackTrace(t));
-            System.exit(1);
-        }
-    }
-    
-    private static final String copyright = "\nFHIR Client Command Line Interface (fhir-cli)    (c) Copyright IBM Corporation, 2018, 2020.\n";
-    private static final String header = "\nProvides access to the FHIR Client API via the command line.\n\nOptions:\n";
-    private static final String syntax = "fhir-cli [options]";
-    private static final String DEFAULT_MIMETYPE = FHIRMediaType.APPLICATION_FHIR_JSON;
-    
-    private static PrintStream console = System.err;
-    
-    private String[] args;
-    
-    private Map<Operations, OperationInvoker> invokers = null;
-
-    public FHIRCLI(String[] args) {
-        this.args = args;
-        initInvokersMap();
-    }
-    
-    public static void setConsoleStream(PrintStream stream) {
-        console = stream;
-    }
-    
-    private static void println(String s) {
-        console.println(s);
-    }
-    
-    private static void print(String s) {
-        console.print(s);
-    }
-    
-    public static String getStackTrace(Throwable t) {
-        StringWriter sw = new StringWriter();
-        t.printStackTrace(new PrintWriter(sw));
-        return sw.toString();
-    }
-
-    /**
-     * Instantiates an OperationInvoker for each supported operation and adds it to a Map.
-     */
-    private void initInvokersMap() {
-        invokers = new HashMap<Operations, OperationInvoker>();
-        invokers.put(Operations.BATCH, new BatchInvoker());
-        invokers.put(Operations.CREATE, new CreateInvoker());
-        invokers.put(Operations.COND_CREATE, new ConditionalCreateInvoker());
-        invokers.put(Operations.DELETE, new DeleteInvoker());
-        invokers.put(Operations.COND_DELETE, new ConditionalDeleteInvoker());
-        invokers.put(Operations.HISTORY, new HistoryInvoker());
-        invokers.put(Operations.METADATA, new MetadataInvoker());
-        invokers.put(Operations.READ, new ReadInvoker());
-        invokers.put(Operations.SEARCH, new SearchInvoker());
-        invokers.put(Operations.SEARCHALL, new SearchAllInvoker());
-        invokers.put(Operations.SEARCH_POST, new SearchPostInvoker());
-        invokers.put(Operations.TRANSACTION, new TransactionInvoker());
-        invokers.put(Operations.UPDATE, new UpdateInvoker());
-        invokers.put(Operations.COND_UPDATE, new ConditionalUpdateInvoker());
-        invokers.put(Operations.VALIDATE, new ValidateInvoker());
-        invokers.put(Operations.VREAD, new VreadInvoker());
-    }
-
-    public void processCommand() throws Exception {
-        Options options = createOptions();
-
-        // Parse the command-line args into a CommandLine.
-        CommandLineParser parser = new DefaultParser();
-        CommandLine cmdline = null;
-        try {
-            cmdline = parser.parse(options, args);
-        } catch (Throwable t) {
-            throw new IllegalArgumentException("Error while parsing command line options.", t);
-        }
-        
-        // If "help" was requested, then let's display that and we're done.
-        if (cmdline.hasOption(OptionNames.HELP.getShortName())) {
-            displayHelp(options);
-            return;
-        } 
-        
-        try {
-            // Next, build an InvocationContext object.
-            InvocationContext context = buildInvocationContext(cmdline);
-            
-            // Invoke the operation.
-            invokeOperation(context);
-            
-            // Process the response.
-            processResponse(context);
-
-        } catch (Throwable t) {
-            throw new IllegalStateException("Unexpected exception occurred while invoking the operation.", t);
-        }
-    }
-
-    /**
-     * Builds an InvocationContext that holds all the important pieces of context for the
-     * requested API invocation.
-     * @param cmdline a CommandLine object that holds all the command-line options specified by the user
-     */
-    private InvocationContext buildInvocationContext(CommandLine cmdline) {
-        InvocationContext ic = new InvocationContext();
-        
-        // Set the operation in the IC.
-        if (cmdline.hasOption(OptionNames.OPERATION.getShortName())) {
-            String opString = cmdline.getOptionValue(OptionNames.OPERATION.getShortName());
-            Operations operation = Operations.fromString(opString);
-            if (operation == null) {
-                throw new IllegalArgumentException("Unrecognized operation name: " + opString);
-            }
-            ic.setOperation(operation);
-        } else {
-            throw new IllegalArgumentException("The 'operation' option was missing.");
-        }
-        
-        // Set the mime type.
-        ic.setMimeType(getMimetype(cmdline));
-        
-        // Set the properties filename in the IC.
-        if (cmdline.hasOption(OptionNames.PROPERTIES.getShortName())) {
-            ic.setPropertiesFile(cmdline.getOptionValue(OptionNames.PROPERTIES.getShortName()));
-        } else {
-            throw new IllegalArgumentException("The 'properties' option was missing.");
-        }
-        
-        // Set the resource filename in the IC.
-        if (cmdline.hasOption(OptionNames.RESOURCE.getShortName())) {
-            ic.setResourceFile(cmdline.getOptionValue(OptionNames.RESOURCE.getShortName()));
-        }
-        
-        // Set the resource type in the IC.
-        if (cmdline.hasOption(OptionNames.RESOURCETYPE.getShortName())) {
-            ic.setResourceType(cmdline.getOptionValue(OptionNames.RESOURCETYPE.getShortName()));
-        }
-        
-        // Set the object id in the IC.
-        if (cmdline.hasOption(OptionNames.ID.getShortName())) {
-            ic.setResourceId(cmdline.getOptionValue(OptionNames.ID.getShortName()));
-        }
-        
-        // Set the version # in the IC.
-        if (cmdline.hasOption(OptionNames.VERSIONID.getShortName())) {
-            ic.setVersionId(cmdline.getOptionValue(OptionNames.VERSIONID.getShortName()));
-        }
-        
-        // Set the output filename in the IC.
-        if (cmdline.hasOption(OptionNames.OUTPUT.getShortName())) {
-            ic.setOutputFile(cmdline.getOptionValue(OptionNames.OUTPUT.getShortName()));
-        }
-        
-        // Set the verbose flag in the IC.
-        if (cmdline.hasOption(OptionNames.VERBOSE.getShortName())) {
-            ic.setVerbose(true);
-        }
-        
-        collectQueryParameters(cmdline, ic);
-        collectHeaders(cmdline, ic);
-        
-        return ic;
-    }
-
-    /**
-     * Invokes the operation that is described by the InvocationContext.
-     * @param ic the InvocationContext that holds all the relevant information
-     * @throws Exception
-     */
-    private void invokeOperation(InvocationContext ic) throws Exception {
-        OperationInvoker invoker = invokers.get(ic.getOperation());
-        if (invoker == null) {
-            throw new UnsupportedOperationException("Operation '" + ic.getOperation().getOpName() + "' is not yet implemented");
-        }
-        
-        long startTime = 0;
-        
-        print("Invoking operation '" + ic.getOperation().getOpName() + "'...");
-        startTime = System.currentTimeMillis();
-        
-        invoker.invoke(ic);
-        
-        long elapsedTime = System.currentTimeMillis() - startTime;
-        print(" done! (" + elapsedTime + "ms)\n");
-    }
-
-    /**
-     * Processes the results of the operation invocation by retrieving the
-     * response information from the InvocationContext and displaying it
-     * according to the specified options.
-     * 
-     * @param context the InvocationContext that holds the response information
-     * @throws Exception 
-     */
-    private void processResponse(InvocationContext ic) throws Exception {
-        FHIRResponse response = ic.getResponse();
-        if (response != null) {
-            Response jaxrsResponse = response.getResponse();
-            
-            println("Status code: " + response.getStatus());
-
-            String locationURI = response.getLocation();
-            if (locationURI != null) {
-                println("Location URI: " + locationURI);
-            }
-
-            String etag = response.getETag();
-            if (etag != null) {
-                println("ETag: " + etag);
-            }
-            
-            String lastModified = (response.getLastModified() != null ? response.getLastModified().toString() : null);
-            if (lastModified != null) {
-                println("Last modified: " + lastModified);
-            }
-            
-            // If verbose is requested, then display the headers.
-            if (ic.isVerbose()) {
-                println("Response headers:");
-                MultivaluedMap<String, String> headers = jaxrsResponse.getStringHeaders();
-                for (Map.Entry<String, List<String>> headerEntry : headers.entrySet()) {
-                    for (String value : headerEntry.getValue()) {
-                        println("   " + headerEntry.getKey() + ": " + value);
-                    }
-                }
-                println("");
-            }
-            
-            if (!response.isEmpty()) {
-                Resource responseObj = response.getResource(Resource.class);
-                if (responseObj != null) {
-                    Writer writer = null;
-                    String outputFile = ic.getOutputFile();
-                    if (outputFile != null && !outputFile.isEmpty()) {
-                        FileOutputStream os = new FileOutputStream(outputFile);
-                        writer = new OutputStreamWriter(os);
-                        println("Response resource written to file: " + outputFile);
-                    } else {
-                        writer = new OutputStreamWriter(console);
-                        println("Response resource:\n");
-                    }
-
-                    FHIRGenerator.generator( Format.JSON, false).generate(responseObj, writer);
-                }
-            }
-        }
-    }
-
-    /**
-     * Visits each "header" option and adds it to the InvocationContext.
-     */
-    private void collectHeaders(CommandLine cmdline, InvocationContext ic) {
-        for (Option option : cmdline.getOptions()) {
-            if (option.getOpt().equals(OptionNames.HEADER.getShortName())) {
-                List<String> values = option.getValuesList();
-                if (values != null && values.size() >= 2) {
-                    ic.addHeader(values.get(0), values.get(1));
-                }
-            }
-        }
-    }
-
-    /**
-     * Visits each "queryParameter" option and adds it to the InvocationContext.
-     */
-    private void collectQueryParameters(CommandLine cmdline, InvocationContext ic) {
-        for (Option option : cmdline.getOptions()) {
-            if (option.getOpt().equals(OptionNames.QUERYPARAMETER.getShortName())) {
-                List<String> values = option.getValuesList();
-                if (values != null && values.size() >= 2) {
-                    ic.addQueryParameter(values.get(0), values.get(1));
-                }
-            }
-        }
-    }
-
-    /**
-     * Determines the correct mimeType to use for the request, based on the command line options.
-     */
-    private String getMimetype(CommandLine cmdline) {
-        String mimeType = DEFAULT_MIMETYPE;
-//        if (cmdline.hasOption(OptionNames.XML.getShortName())) {
-//            mimeType = "application/fhir+xml";
-//        }
-        return mimeType;
-    }
-
-    /**
-     * Returns an Options object with the set of options supported by this tool.
-     */
-    private Options createOptions() {
-        Options options = new Options();
-        options
-            .addOption(Option.builder(OptionNames.HELP.getShortName()).longOpt(OptionNames.HELP.getLongName()).desc(OptionNames.HELP.getDesc()).build())
-            .addOption(Option.builder(OptionNames.VERBOSE.getShortName()).longOpt(OptionNames.VERBOSE.getLongName()).desc(OptionNames.VERBOSE.getDesc()).build())
-            .addOption(Option.builder(OptionNames.OPERATION.getShortName()).longOpt(OptionNames.OPERATION.getLongName()).desc(OptionNames.OPERATION.getDesc()).hasArg().argName(OptionNames.OPERATION.getArgName()).build())
-            .addOption(Option.builder(OptionNames.PROPERTIES.getShortName()).longOpt(OptionNames.PROPERTIES.getLongName()).desc(OptionNames.PROPERTIES.getDesc()).hasArg().argName(OptionNames.PROPERTIES.getArgName()).build())
-            .addOption(Option.builder(OptionNames.RESOURCE.getShortName()).longOpt(OptionNames.RESOURCE.getLongName()).desc(OptionNames.RESOURCE.getDesc()).hasArg().argName(OptionNames.RESOURCE.getArgName()).build())
-            .addOption(Option.builder(OptionNames.RESOURCETYPE.getShortName()).longOpt(OptionNames.RESOURCETYPE.getLongName()).desc(OptionNames.RESOURCETYPE.getDesc()).hasArg().argName(OptionNames.RESOURCETYPE.getArgName()).build())
-            .addOption(Option.builder(OptionNames.ID.getShortName()).longOpt(OptionNames.ID.getLongName()).desc(OptionNames.ID.getDesc()).hasArg().argName(OptionNames.ID.getArgName()).build())
-            .addOption(Option.builder(OptionNames.VERSIONID.getShortName()).longOpt(OptionNames.VERSIONID.getLongName()).desc(OptionNames.VERSIONID.getDesc()).hasArg().argName(OptionNames.VERSIONID.getArgName()).build())
-            .addOption(Option.builder(OptionNames.OUTPUT.getShortName()).longOpt(OptionNames.OUTPUT.getLongName()).desc(OptionNames.OUTPUT.getDesc()).hasArg().argName(OptionNames.OUTPUT.getArgName()).build())
-            .addOption(Option.builder(OptionNames.QUERYPARAMETER.getShortName()).longOpt(OptionNames.QUERYPARAMETER.getLongName()).desc(OptionNames.QUERYPARAMETER.getDesc()).numberOfArgs(2).argName(OptionNames.QUERYPARAMETER.getArgName()).valueSeparator().build())
-            .addOption(Option.builder(OptionNames.HEADER.getShortName()).longOpt(OptionNames.HEADER.getLongName()).desc(OptionNames.HEADER.getDesc()).numberOfArgs(2).argName(OptionNames.HEADER.getArgName()).valueSeparator().build());
-        
-        return options;
-    }
-
-    /**
-     * Displays the help text and usage syntax on the console.
-     */
-    private void displayHelp(Options options) {
-        StringWriter sw = new StringWriter();
-        PrintWriter pw = new PrintWriter(sw);
-        HelpFormatter helpFormatter = new HelpFormatter();
-        String footer = "\nOPERATION should be one of: " + Operations.validOperations() 
-            + "\n\nEach supported operation requires the following command-line options:\n" + Operations.operationsAndRequiredOptions();
-        helpFormatter.printHelp(pw, 100, syntax, header, options, 3, 3, footer);
-        println(sw.toString());
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/Operations.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/Operations.java
deleted file mode 100644
index f586298ee86..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/Operations.java
+++ /dev/null
@@ -1,93 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli;
-
-/**
- * This enum defines the valid operations that can be invoked via the command-line tool.
- * 
- * @author padams
- */
-public enum Operations {
-    BATCH("batch", OptionNames.RESOURCE),
-    CREATE("create", OptionNames.RESOURCE),
-    COND_CREATE("conditional-create", OptionNames.RESOURCE),
-    DELETE("delete", OptionNames.RESOURCETYPE, OptionNames.ID),
-    COND_DELETE("conditional-delete", OptionNames.RESOURCETYPE),
-    HISTORY("history", OptionNames.RESOURCETYPE, OptionNames.ID),
-    METADATA("metadata"),
-    READ("read", OptionNames.RESOURCETYPE, OptionNames.ID),
-    SEARCH("search", OptionNames.RESOURCETYPE),
-    SEARCHALL("search-all"),
-    SEARCH_POST("search-post", OptionNames.RESOURCETYPE),
-    TRANSACTION("transaction", OptionNames.RESOURCE),
-    UPDATE("update", OptionNames.RESOURCE),
-    COND_UPDATE("conditional-update", OptionNames.RESOURCE),
-    VALIDATE("validate", OptionNames.RESOURCE),
-    VREAD("vread", OptionNames.RESOURCETYPE, OptionNames.ID, OptionNames.VERSIONID);
-
-    private String opName;
-    private OptionNames[] requiredOptions;
-
-    private Operations(String opName, OptionNames... requiredOptions) {
-        this.opName = opName;
-        this.requiredOptions = requiredOptions;
-    }
-
-    public String getOpName() {
-        return this.opName;
-    }
-
-    public static Operations fromString(String s) {
-        for (Operations op : Operations.values()) {
-            if (op.getOpName().equals(s)) {
-                return op;
-            }
-        }
-        return null;
-    }
-
-    public static String validOperations() {
-        StringBuilder sb = new StringBuilder();
-        boolean needSep = false;
-        for (Operations op : Operations.values()) {
-            if (needSep) {
-                sb.append(" | ");
-            }
-            sb.append(op.getOpName());
-            needSep = true;
-        }
-        return sb.toString();
-    }
-    
-    public static String operationsAndRequiredOptions() {
-        StringBuilder sb = new StringBuilder();
-        for (Operations op : Operations.values()) {
-            sb.append("    ");
-            sb.append(op.getOpName() + ":  ");
-            OptionNames [] reqOptions = op.getRequiredOptions();
-            if (reqOptions != null && reqOptions.length != 0) {
-                boolean needSep = false;
-                for (OptionNames option : reqOptions) {
-                    if (needSep) {
-                        sb.append(", ");
-                    }
-                    needSep = true;
-                    sb.append("--" + option.getLongName());
-                }
-                
-            } else {
-                sb.append("No options required");
-            }
-            sb.append("\n");
-        }
-        return sb.toString();
-    }
-
-    public OptionNames[] getRequiredOptions() {
-        return requiredOptions;
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/OptionNames.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/OptionNames.java
deleted file mode 100644
index 7bb9fe64865..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/OptionNames.java
+++ /dev/null
@@ -1,63 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli;
-
-/**
- * This enum defines each of the command-line options, including the long name, short name, description and an optional
- * "argName" field for options which take an additional argument.
- * 
- * @author padams
- */
-public enum OptionNames {
-    
-    OPERATION("operation", "op", "The operation to be invoked", "OPERATION"),
-    RESOURCE("resource", "r", "Use FHIR resource contained in <FILE> for operation invocation (e.g. patient.json)", "FILE"),
-    RESOURCETYPE("type", "t", "Use resource type <TYPE> for the operation invocation (e.g. \"Patient\")", "TYPE"),
-    ID("resourceId", "id", "Use resource identifier <ID> for the operation invocation", "ID"),
-    VERSIONID("versionId", "vid", "Use version # <VID> for the operation invocation", "VID"),
-    PROPERTIES("properties", "p", "Use FHIR Client properties contained in <FILE> (e.g. fhir-cli.properties)", "FILE"),
-    QUERYPARAMETER("queryParameter", "qp", "Include query parameter NAME=VALUE with the operation invocation (e.g. _count=100).", "NAME=VALUE"),
-    HEADER("header", "H", "Include the specified request header NAME=VALUE with the operation invocation (e.g. If-Match=W/\"3\").", "NAME=VALUE"),
-    OUTPUT("output", "o", "Write output resource to <FILE> (e.g. searchresults.json)", "FILE"),
-    HELP("help", "h", "Display this help text"),
-    VERBOSE("verbose", "v", "Display detailed output");
-    // JSON("json", "j", "Use JSON format for requests and responses"),
-    // XML("xml", "x", "Use XML format for requests and responses");
-    // HEADER("header", "H", "Define a request header with the specified name and value", "HEADER=VALUE");
-    
-    private String longName;
-    private String shortName;
-    private String desc;
-    private String argName;
-    
-    private OptionNames(String longName, String shortName, String desc) {
-        this.longName = longName;
-        this.shortName = shortName;
-        this.desc = desc;
-    }
-    private OptionNames(String longName, String shortName, String desc, String argName) {
-        this(longName, shortName, desc);
-        this.argName = argName;
-    }
-    
-    public String getLongName() {
-        return this.longName;
-    }
-    
-    public String getShortName() {
-        return this.shortName;
-    }
-    
-    public String getDesc() {
-        return this.desc;
-    }
-    
-    public String getArgName() {
-        return this.argName;
-    }
-
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/BatchInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/BatchInvoker.java
deleted file mode 100644
index 22f6230d740..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/BatchInvoker.java
+++ /dev/null
@@ -1,30 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-import com.ibm.fhir.model.resource.Bundle;
-
-/**
- * This class is the OperationInvoker implementation for the 'batch' operation.
- * 
- * @author padams
- */
-public class BatchInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        Object resource = ic.getRequestResourceWithExcp();
-        if (resource instanceof Bundle) {
-            response = client.batch((Bundle)resource, requestHeaders);
-        } else {
-            throw new IllegalArgumentException("Input resource must be a Bundle.");
-        }
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ConditionalCreateInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ConditionalCreateInvoker.java
deleted file mode 100644
index 2021ad0b5c2..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ConditionalCreateInvoker.java
+++ /dev/null
@@ -1,32 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2017,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-import javax.json.JsonObject;
-
-import com.ibm.fhir.model.resource.Resource;
-
-/**
- * This class is the OperationInvoker implementation for the 'conditional create' operation.
- * 
- * @author padams
- */
-public class ConditionalCreateInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        Object resource = ic.getRequestResourceWithExcp();
-        if (resource instanceof Resource) {
-            response = client.conditionalCreate((Resource)resource, queryParameters, requestHeaders);
-        } else {
-            response = client.conditionalCreate((JsonObject)resource, queryParameters, requestHeaders);
-        }
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ConditionalDeleteInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ConditionalDeleteInvoker.java
deleted file mode 100644
index 2e53c05cca3..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ConditionalDeleteInvoker.java
+++ /dev/null
@@ -1,25 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2017,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-/**
- * This class is the OperationInvoker implementation for the 'conditional delete' operation.
- * 
- * @author padams
- */
-public class ConditionalDeleteInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        String resourceType = ic.getResourceTypeWithExcp();
-        
-        response = client.conditionalDelete(resourceType, queryParameters, requestHeaders);
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ConditionalUpdateInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ConditionalUpdateInvoker.java
deleted file mode 100644
index 355f0417b3a..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ConditionalUpdateInvoker.java
+++ /dev/null
@@ -1,32 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2017,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-import javax.json.JsonObject;
-
-import com.ibm.fhir.model.resource.Resource;
-
-/**
- * This class is the OperationInvoker implementation for the 'conditional update' operation.
- * 
- * @author padams
- */
-public class ConditionalUpdateInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        Object resource = ic.getRequestResourceWithExcp();
-        if (resource instanceof Resource) {
-            response = client.conditionalUpdate((Resource)resource, queryParameters, requestHeaders);
-        } else {
-            response = client.conditionalUpdate((JsonObject)resource, queryParameters, requestHeaders);
-        }
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/CreateInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/CreateInvoker.java
deleted file mode 100644
index be70d8ba4f1..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/CreateInvoker.java
+++ /dev/null
@@ -1,32 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-import javax.json.JsonObject;
-
-import com.ibm.fhir.model.resource.Resource;
-
-/**
- * This class is the OperationInvoker implementation for the 'create' operation.
- * 
- * @author padams
- */
-public class CreateInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        Object resource = ic.getRequestResourceWithExcp();
-        if (resource instanceof Resource) {
-            response = client.create((Resource)resource, requestHeaders);
-        } else {
-            response = client.create((JsonObject)resource, requestHeaders);
-        }
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/DeleteInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/DeleteInvoker.java
deleted file mode 100644
index e91dd78d521..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/DeleteInvoker.java
+++ /dev/null
@@ -1,26 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2017,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-/**
- * This class is the OperationInvoker implementation for the 'delete' operation.
- * 
- * @author padams
- */
-public class DeleteInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        String resourceType = ic.getResourceTypeWithExcp();
-        String resourceId = ic.getResourceIdWithExcp();
-        
-        response = client.delete(resourceType, resourceId, requestHeaders);
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/HistoryInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/HistoryInvoker.java
deleted file mode 100644
index d19e05a0d3f..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/HistoryInvoker.java
+++ /dev/null
@@ -1,26 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-/**
- * This class is the OperationInvoker implementation for the 'history' operation.
- * 
- * @author padams
- */
-public class HistoryInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        String resourceType = ic.getResourceTypeWithExcp();
-        String resourceId = ic.getResourceIdWithExcp();
-        
-        response = client.history(resourceType, resourceId, queryParameters, requestHeaders);
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/InvocationContext.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/InvocationContext.java
deleted file mode 100644
index 882ea16a1aa..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/InvocationContext.java
+++ /dev/null
@@ -1,218 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-import java.io.FileInputStream;
-import java.io.InputStream;
-import java.io.InputStreamReader;
-import java.io.Reader;
-import java.util.ArrayList;
-import java.util.List;
-import java.util.Properties;
-
-import com.ibm.fhir.cli.Operations;
-import com.ibm.fhir.client.FHIRResponse;
-import com.ibm.fhir.model.format.Format;
-import com.ibm.fhir.model.parser.FHIRParser;
-
-/**
- * This class serves as a holder of context information for a particular operation invocation.
- * 
- * @author padams
- */
-public class InvocationContext {
-
-    public class NameValuePair {
-        private String name;
-        private String value;
-
-        public NameValuePair(String name, String value) {
-            this.name = name;
-            this.value = value;
-        }
-
-        public String getName() {
-            return name;
-        }
-
-        public String getValue() {
-            return value;
-        }
-    }
-
-    private Operations operation;
-    private String mimeType;
-    private Properties clientProperties;
-    private String resourceType;
-    private String resourceId;
-    private String versionId;
-    private String outputFile;
-    private String propertiesFile;
-    private String resourceFile;
-    private boolean verbose;
-    private FHIRResponse response;
-    private List<NameValuePair> queryParameters = new ArrayList<>();
-    private List<NameValuePair> headers = new ArrayList<>();
-
-    public InvocationContext() {
-    }
-
-    public Operations getOperation() {
-        return operation;
-    }
-
-    public void setOperation(Operations operation) {
-        this.operation = operation;
-    }
-
-    public String getMimeType() {
-        return mimeType;
-    }
-
-    public void setMimeType(String mimeType) {
-        this.mimeType = mimeType;
-    }
-
-    public Properties getClientProperties() {
-        return clientProperties;
-    }
-
-    public void setClientProperties(Properties clientProperties) {
-        this.clientProperties = clientProperties;
-    }
-
-    public String getResourceType() {
-        return resourceType;
-    }
-
-    public void setResourceType(String resourceType) {
-        this.resourceType = resourceType;
-    }
-
-    public String getResourceId() {
-        return resourceId;
-    }
-
-    public void setResourceId(String resourceId) {
-        this.resourceId = resourceId;
-    }
-
-    public String getVersionId() {
-        return versionId;
-    }
-
-    public void setVersionId(String versionId) {
-        this.versionId = versionId;
-    }
-
-    public String getOutputFile() {
-        return outputFile;
-    }
-
-    public void setOutputFile(String outputFile) {
-        this.outputFile = outputFile;
-    }
-
-    public String getPropertiesFile() {
-        return propertiesFile;
-    }
-
-    public void setPropertiesFile(String propertiesFile) {
-        this.propertiesFile = propertiesFile;
-    }
-
-    public String getResourceFile() {
-        return resourceFile;
-    }
-
-    public void setResourceFile(String resourceFile) {
-        this.resourceFile = resourceFile;
-    }
-
-    public boolean isVerbose() {
-        return verbose;
-    }
-
-    public void setVerbose(boolean verbose) {
-        this.verbose = verbose;
-    }
-
-    public FHIRResponse getResponse() {
-        return response;
-    }
-
-    public void setResponse(FHIRResponse response) {
-        this.response = response;
-    }
-
-    public List<NameValuePair> getQueryParameters() {
-        return queryParameters;
-    }
-
-    public List<NameValuePair> getHeaders() {
-        return headers;
-    }
-
-    public void addQueryParameter(String name, String value) {
-        queryParameters.add(new NameValuePair(name, value));
-    }
-
-    public void addHeader(String name, String value) {
-        headers.add(new NameValuePair(name, value));
-    }
-
-    public String getResourceTypeWithExcp() throws Exception {
-        if (resourceType == null || resourceType.isEmpty()) {
-            throw new IllegalArgumentException("The 'type' parameter was missing.");
-        }
-
-        return resourceType;
-    }
-
-    public String getResourceIdWithExcp() throws Exception {
-        if (resourceId == null || resourceId.isEmpty()) {
-            throw new IllegalArgumentException("The 'id' parameter was missing.");
-        }
-
-        return resourceId;
-    }
-
-    public String getVersionIdWithExcp() throws Exception {
-        if (versionId == null || versionId.isEmpty()) {
-            throw new IllegalArgumentException("The 'versionId' parameter was missing.");
-        }
-
-        return versionId;
-    }
-
-    public Object getRequestResourceWithExcp() throws Exception {
-        Reader reader = null;
-        InputStream is = null;
-        
-        try {
-            // If the user specified the resource filename then we'll try to read
-            // the resource from there; otherwise, we'll get it from System.in.
-            if (resourceFile != null && !resourceFile.isEmpty()) {
-                is = new FileInputStream(resourceFile);
-                reader = new InputStreamReader(is);
-            } else {
-                reader = new InputStreamReader(System.in);
-            }
-            
-            return FHIRParser.parser(Format.JSON).parse(reader);
-        } catch (Throwable t) {
-            throw t;
-        } finally {
-            if (reader != null) {
-                reader.close();
-            }
-            if (is != null) {
-                is.close();
-            }
-        }
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/MetadataInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/MetadataInvoker.java
deleted file mode 100644
index 1878f40b05f..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/MetadataInvoker.java
+++ /dev/null
@@ -1,23 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-/**
- * This class is the OperationInvoker implementation for the 'metadata' operation.
- * 
- * @author padams
- */
-public class MetadataInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        response = client.metadata(requestHeaders);
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/OperationInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/OperationInvoker.java
deleted file mode 100644
index 925c74bfa4d..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/OperationInvoker.java
+++ /dev/null
@@ -1,116 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-import java.io.File;
-import java.io.FileInputStream;
-import java.io.FileNotFoundException;
-import java.io.InputStream;
-import java.util.List;
-import java.util.Properties;
-
-import com.ibm.fhir.cli.invoker.InvocationContext.NameValuePair;
-import com.ibm.fhir.client.FHIRClient;
-import com.ibm.fhir.client.FHIRClientFactory;
-import com.ibm.fhir.client.FHIRParameters;
-import com.ibm.fhir.client.FHIRRequestHeader;
-import com.ibm.fhir.client.FHIRResponse;
-
-/**
- * This is a base class for all of the various operation invoker classes.
- * 
- * @author padams
- */
-public abstract class OperationInvoker {
-    protected FHIRClient client;
-    protected FHIRResponse response;
-    protected FHIRParameters queryParameters;
-    protected FHIRRequestHeader[] requestHeaders;
-
-    public void invoke(InvocationContext ic) throws Exception {
-        preInvoke(ic);
-        doInvoke(ic);
-        postInvoke(ic);
-    }
-
-    /**
-     * Performs the necessary steps before the operation is invoked.
-     */
-    public void preInvoke(InvocationContext ic) throws Exception {
-        response = null;
-        queryParameters = null;
-        Properties properties = loadClientProperties(ic.getPropertiesFile());
-        client = getClient(properties);
-
-        // If query parameters were specified on the command line,
-        // then create a FHIRParameters object and store them in it.
-        List<NameValuePair> params = ic.getQueryParameters();
-        if (params != null && !params.isEmpty()) {
-            queryParameters = new FHIRParameters();
-            for (NameValuePair param : params) {
-                queryParameters.addMultivaluedParameter(param.getName(), param.getValue());
-            }
-        }
-
-        List<NameValuePair> headers = ic.getHeaders();
-        if (headers != null && !headers.isEmpty()) {
-            requestHeaders = new FHIRRequestHeader[headers.size()];
-            for (int i = 0; i < headers.size(); i++) {
-                NameValuePair header = headers.get(i);
-                requestHeaders[i] = new FHIRRequestHeader(header.getName(), header.getValue());
-            }
-        }
-    }
-
-    /**
-     * Each subclass will implement this method to invoke the appropriate FHIR Client API, based on the operation
-     * requested by the user.
-     */
-    public abstract void doInvoke(InvocationContext ic) throws Exception;
-
-    /**
-     * Saves off the relevant response information in the InvocationContext after the operation has been invoked.
-     */
-    public void postInvoke(InvocationContext ic) throws Exception {
-        ic.setResponse(response);
-    }
-
-    /**
-     * Loads the FHIRClient properties from the specified file.
-     */
-    protected Properties loadClientProperties(String filename) throws Exception {
-        InputStream is = null;
-        try {
-            Properties props = new Properties();
-
-            // Open the properties file specified by the user.
-            File f = new File(filename);
-            if (f.exists()) {
-                is = new FileInputStream(f);
-            } else {
-                throw new FileNotFoundException("Properties file '" + filename + "' not found.");
-            }
-
-            // Load the properties.
-            props.load(is);
-            is.close();
-
-            return props;
-        } finally {
-            if (is != null) {
-                is.close();
-            }
-        }
-    }
-
-    /**
-     * Retrieves a new FHIRClient instance using the specified properties.
-     */
-    protected FHIRClient getClient(Properties properties) throws Exception {
-        return FHIRClientFactory.getClient(properties);
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ReadInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ReadInvoker.java
deleted file mode 100644
index 0a20da74d17..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ReadInvoker.java
+++ /dev/null
@@ -1,26 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-/**
- * This class is the OperationInvoker implementation for the 'read' operation.
- * 
- * @author padams
- */
-public class ReadInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        String resourceType = ic.getResourceTypeWithExcp();
-        String resourceId = ic.getResourceIdWithExcp();
-        
-        response = client.read(resourceType, resourceId, requestHeaders);
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/SearchAllInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/SearchAllInvoker.java
deleted file mode 100644
index cc60374c0f4..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/SearchAllInvoker.java
+++ /dev/null
@@ -1,22 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-/**
- * This class is the OperationInvoker implementation for the 'search-all' operation.
- * 
- */
-public class SearchAllInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        response = client.searchAll(queryParameters, false, requestHeaders);
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/SearchInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/SearchInvoker.java
deleted file mode 100644
index 91e96240e0f..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/SearchInvoker.java
+++ /dev/null
@@ -1,25 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-/**
- * This class is the OperationInvoker implementation for the 'search' operation.
- * 
- * @author padams
- */
-public class SearchInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        String resourceType = ic.getResourceTypeWithExcp();
-        
-        response = client.search(resourceType, queryParameters, requestHeaders);
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/SearchPostInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/SearchPostInvoker.java
deleted file mode 100644
index 273cf9b2328..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/SearchPostInvoker.java
+++ /dev/null
@@ -1,25 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-/**
- * This class is the OperationInvoker implementation for the '_search' operation.
- * 
- * @author padams
- */
-public class SearchPostInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        String resourceType = ic.getResourceTypeWithExcp();
-        
-        response = client._search(resourceType, queryParameters, requestHeaders);
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/TransactionInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/TransactionInvoker.java
deleted file mode 100644
index f4d2e122e61..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/TransactionInvoker.java
+++ /dev/null
@@ -1,30 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-import com.ibm.fhir.model.resource.Bundle;
-
-/**
- * This class is the OperationInvoker implementation for the 'transaction' operation.
- * 
- * @author padams
- */
-public class TransactionInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        Object resource = ic.getRequestResourceWithExcp();
-        if (resource instanceof Bundle) {
-            response = client.transaction((Bundle)resource, requestHeaders);
-        } else {
-            throw new IllegalArgumentException("Input resource must be a Bundle.");
-        }
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/UpdateInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/UpdateInvoker.java
deleted file mode 100644
index e1e557cea84..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/UpdateInvoker.java
+++ /dev/null
@@ -1,32 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-import javax.json.JsonObject;
-
-import com.ibm.fhir.model.resource.Resource;
-
-/**
- * This class is the OperationInvoker implementation for the 'update' operation.
- * 
- * @author padams
- */
-public class UpdateInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        Object resource = ic.getRequestResourceWithExcp();
-        if (resource instanceof Resource) {
-            response = client.update((Resource)resource, requestHeaders);
-        } else {
-            response = client.update((JsonObject)resource, requestHeaders);
-        }
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ValidateInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ValidateInvoker.java
deleted file mode 100644
index de94bf075b9..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/ValidateInvoker.java
+++ /dev/null
@@ -1,32 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-import javax.json.JsonObject;
-
-import com.ibm.fhir.model.resource.Resource;
-
-/**
- * This class is the OperationInvoker implementation for the 'validate' operation.
- * 
- * @author padams
- */
-public class ValidateInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        Object resource = ic.getRequestResourceWithExcp();
-        if (resource instanceof Resource) {
-            response = client.validate((Resource)resource, requestHeaders);
-        } else {
-            response = client.validate((JsonObject)resource, requestHeaders);
-        }
-    }
-}
diff --git a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/VreadInvoker.java b/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/VreadInvoker.java
deleted file mode 100644
index c3877659aaa..00000000000
--- a/fhir-cli/src/main/java/com/ibm/fhir/cli/invoker/VreadInvoker.java
+++ /dev/null
@@ -1,27 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2016,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.invoker;
-
-/**
- * This class is the OperationInvoker implementation for the 'vread' operation.
- * 
- * @author padams
- */
-public class VreadInvoker extends OperationInvoker {
-
-    /* (non-Javadoc)
-     * @see com.ibm.fhir.cli.OperationInvoker#invoke(com.ibm.fhir.cli.InvocationContext)
-     */
-    @Override
-    public void doInvoke(InvocationContext ic) throws Exception {
-        String resourceType = ic.getResourceTypeWithExcp();
-        String resourceId = ic.getResourceIdWithExcp();
-        String versionId = ic.getVersionIdWithExcp();
-        
-        response = client.vread(resourceType, resourceId, versionId, requestHeaders);
-    }
-}
diff --git a/fhir-cli/src/main/resources/fhir-cli.properties b/fhir-cli/src/main/resources/fhir-cli.properties
deleted file mode 100644
index 3a0bc69e7ad..00000000000
--- a/fhir-cli/src/main/resources/fhir-cli.properties
+++ /dev/null
@@ -1,21 +0,0 @@
-# FHIR Client Properties
-
-fhirclient.rest.base.url = http://localhost:9080/fhir-server/api/v4
-
-fhirclient.default.mimetype = application/fhir+json
-
-fhirclient.basicauth.enabled = true
-fhirclient.basicauth.username = fhiruser
-fhirclient.basicauth.password = change-password
-
-fhirclient.clientauth.enabled = false
-fhirclient.keystore.location = fhirClientKeystore.jks
-fhirclient.keystore.password = change-password
-fhirclient.keystore.key.password = change-password
-fhirclient.truststore.location = fhirClientTruststore.jks
-fhirclient.truststore.password = change-password
-
-fhirclient.encryption.enabled = false
-fhirclient.encryption.keystore.location = fhirkeys.jceks
-fhirclient.encryption.keystore.password = change-password
-fhirclient.encryption.key.password = change-password
diff --git a/fhir-cli/src/main/resources/scripts/fhir-cli b/fhir-cli/src/main/resources/scripts/fhir-cli
deleted file mode 100644
index 106dcd7cda5..00000000000
--- a/fhir-cli/src/main/resources/scripts/fhir-cli
+++ /dev/null
@@ -1,22 +0,0 @@
-#!/usr/bin/env bash
-###############################################################################
-# (C) Copyright IBM Corp. 2016, 2017, 2019
-#
-# SPDX-License-Identifier: Apache-2.0
-###############################################################################
-
-# Determine the location of this script.
-dirname=`dirname "$0"`
-basedir=`unset CDPATH; cd $dirname && pwd`
-
-# build classpath from all jars in lib
-CP_SEP=":"
-CP=.
-for i in $basedir/lib/*.jar; do
-    CP="${CP}${CP_SEP}${i}"
-done
-
-# add any JVM options here
-#JAVA_OPTS=""
-
-java -cp "${CP}" ${JAVA_OPTS} com.ibm.fhir.cli.FHIRCLI ${1+"$@"}
diff --git a/fhir-cli/src/main/resources/scripts/fhir-cli.bat b/fhir-cli/src/main/resources/scripts/fhir-cli.bat
deleted file mode 100644
index 0f851cbae70..00000000000
--- a/fhir-cli/src/main/resources/scripts/fhir-cli.bat
+++ /dev/null
@@ -1,37 +0,0 @@
-@echo off
-@REM ----------------------------------------------------------------------------
-@REM (C) Copyright IBM Corp. 2016,2017,2019
-@REM
-@REM SPDX-License-Identifier: Apache-2.0
-@REM ----------------------------------------------------------------------------
-
-if "%OS%" == "Windows_NT" setlocal
-
-setlocal enabledelayedexpansion
-
-
-@REM Determine the location of this script.
-set BASEDIR=%~dp0
-
-@REM Remove any trailing \ from BASEDIR
-if %BASEDIR:~-1%==\ set BASEDIR=%BASEDIR:~0,-1%
-
-@REM build classpath from all jars in lib
-set CP=.
-for /R %BASEDIR%\lib %%f in (*.jar) do set CP=!CP!;%%f
-
-set CMD_LINE_ARGS=%1
-if ""%1""=="""" goto done
-shift
-:setup
-if ""%1""=="""" goto done
-set CMD_LINE_ARGS=%CMD_LINE_ARGS% %1
-shift
-goto setup
-:done
-
-IF NOT DEFINED JAVA_OPTS set JAVA_OPTS=
-@REM echo classpath: %CP%
-@REM echo arguments: %CMD_LINE_ARGS%
-
-java -cp "%CP%" %JAVA_OPTS% com.ibm.fhir.cli.FHIRCLI %CMD_LINE_ARGS%
diff --git a/fhir-cli/src/test/resources/.empty b/fhir-cli/src/test/resources/.empty
deleted file mode 100644
index e69de29bb2d..00000000000
diff --git a/fhir-client/pom.xml b/fhir-client/pom.xml
index 9cc3d42e57c..a7773de3f7a 100644
--- a/fhir-client/pom.xml
+++ b/fhir-client/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-client/src/main/java/com/ibm/fhir/client/FHIRClient.java b/fhir-client/src/main/java/com/ibm/fhir/client/FHIRClient.java
index 7c70919fec2..4f50439cfd2 100644
--- a/fhir-client/src/main/java/com/ibm/fhir/client/FHIRClient.java
+++ b/fhir-client/src/main/java/com/ibm/fhir/client/FHIRClient.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016,2021
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -8,7 +8,7 @@
 
 import java.security.KeyStore;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 import javax.ws.rs.client.WebTarget;
 
 import com.ibm.fhir.model.resource.Bundle;
@@ -140,13 +140,6 @@ public interface FHIRClient {
      */
     WebTarget getWebTarget(String baseURL) throws Exception;
 
-    /**
-     * Returns a JAX-RS 2.0 WebTarget object associated with a given REST API endpoint.
-     * @return a WebTarget instance that can be used to invoke REST APIs.
-     * @throws Exception
-     */
-    WebTarget getWebTargetUsingBasicAuth(String baseURL, String username, String pwd) throws Exception;
-
     /**
      * Sets the default mime-type to be used by the FHIRClient interface when invoking REST API operations.
      * @param mimeType a string containing the mime-type (e.g. "application/fhir+json")
@@ -486,5 +479,5 @@ public interface FHIRClient {
     /**
      * Allow the client consumer to be able to get and reuse the same TrustStore if necessary.
      */
-    public KeyStore getTrustStore();
+    KeyStore getTrustStore();
 }
diff --git a/fhir-client/src/main/java/com/ibm/fhir/client/FHIRParameters.java b/fhir-client/src/main/java/com/ibm/fhir/client/FHIRParameters.java
index 9bf37899ad5..f74df008c5d 100644
--- a/fhir-client/src/main/java/com/ibm/fhir/client/FHIRParameters.java
+++ b/fhir-client/src/main/java/com/ibm/fhir/client/FHIRParameters.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016,2019
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -12,6 +12,8 @@
 import javax.ws.rs.core.MultivaluedHashMap;
 import javax.ws.rs.core.MultivaluedMap;
 
+import com.ibm.fhir.model.type.code.ResourceType;
+
 /**
  * This class is used as a container for request parameters associated with a FHIR Client API request.
  */
@@ -27,18 +29,22 @@ public class FHIRParameters {
 
     /**
      * The valid set of modifiers that can be used when constructing the parameters for a search operation.
+     * @implNote please keep in sync with {@link com.ibm.fhir.search.SearchConstants.Modifier}
      */
     public enum Modifier {
-        MISSING("missing"), 
-        EXACT("exact"), 
-        CONTAINS("contains"), 
-        TEXT("text"), 
-        IN("in"), 
-        BELOW("below"), 
-        ABOVE("above"), 
-        NOT("not"), 
-        NOT_IN("not-in"), 
-        TYPE("[type]");
+        MISSING("missing"),
+        EXACT("exact"),
+        CONTAINS("contains"),
+        TEXT("text"),
+        IN("in"),
+        BELOW("below"),
+        ABOVE("above"),
+        NOT("not"),
+        NOT_IN("not-in"),
+        // For TYPE, the ResourceType class is used instead
+        IDENTIFIER("identifier"),
+        OF_TYPE("of-type"),
+        ITERATE("iterate");
 
         private String text;
 
@@ -53,16 +59,17 @@ public String text() {
 
     /**
      * The valid set of value prefixes that can be used when constructing the parameters for a search operation.
+     * @implNote please keep in sync with {@link com.ibm.fhir.search.SearchConstants.Prefix}
      */
     public static enum ValuePrefix {
-        EQ("eq"), 
-        NE("ne"), 
-        GT("gt"), 
-        LT("lt"), 
-        GE("ge"), 
-        LE("le"), 
-        SA("sa"), 
-        EB("eb"), 
+        EQ("eq"),
+        NE("ne"),
+        GT("gt"),
+        LT("lt"),
+        GE("ge"),
+        LE("le"),
+        SA("sa"),
+        EB("eb"),
         AP("ap");
 
         private String text;
@@ -83,7 +90,7 @@ public FHIRParameters() {
 
     /**
      * Convenience method which sets the "_format" query parameter.
-     * 
+     *
      * @param mimeType
      *            the mimeType to use for the request
      * @return a handle to the FHIRParameters object
@@ -94,7 +101,7 @@ public FHIRParameters format(String mimeType) {
 
     /**
      * Convenience method which sets the "_count" query parameter.
-     * 
+     *
      * @param count
      *            the count value to use for the request
      * @return a handle to the FHIRParameters object
@@ -105,7 +112,7 @@ public FHIRParameters count(int count) {
 
     /**
      * Convenience method which sets the "_page" query parameter.
-     * 
+     *
      * @param page
      *            the page number to use for the request
      * @return a handle to the FHIRParameters object
@@ -116,7 +123,7 @@ public FHIRParameters page(int page) {
 
     /**
      * Convenience method which sets the "_since" query parameter.
-     * 
+     *
      * @param since
      *            a string representing the "since" date value to use for the request
      * @return a handle to the FHIRParameters object
@@ -127,7 +134,7 @@ public FHIRParameters since(String since) {
 
     /**
      * Clears the set of parameters currently contained in the FHIRParameters object.
-     * 
+     *
      * @return a handle to the FHIRParameters object
      */
     public FHIRParameters clear() {
@@ -137,7 +144,7 @@ public FHIRParameters clear() {
 
     /**
      * Adds the specified query parameter name and value to 'this'.
-     * 
+     *
      * @param name
      *            the parameter name
      * @param value
@@ -151,7 +158,7 @@ public FHIRParameters queryParam(String name, String value) {
 
     /**
      * Adds the specified search parameter (name, modifier, values) to 'this'.
-     * 
+     *
      * @param name
      *            the parameter name
      * @param modifier
@@ -167,9 +174,27 @@ public FHIRParameters searchParam(String name, Modifier modifier, String... valu
         return this;
     }
 
+    /**
+     * Adds the specified search parameter (name, resourceType, values) to 'this'.
+     *
+     * @param name
+     *            the parameter name
+     * @param resourceType
+     *            a resource type (e.g. Patient) as a modifier
+     * @param values
+     *            one or more values associated with the search parameter
+     * @return a handle to the FHIRParameters object
+     */
+    public FHIRParameters searchParam(String name, ResourceType resourceType, String... values) {
+        String parameterName = name + ":" + resourceType.getValue();
+        String value = getValueString(values);
+        addMultivaluedParameter(parameterName, value);
+        return this;
+    }
+
     /**
      * Adds the specified search parameter (name, value-prefix, values) to 'this'.
-     * 
+     *
      * @param name
      *            the parameter name
      * @param prefix
@@ -186,7 +211,7 @@ public FHIRParameters searchParam(String name, ValuePrefix prefix, String... val
 
     /**
      * Returns a comma-separated string containing the elements of the 'values' array.
-     * 
+     *
      * @param values
      *            an array of strings containing parameter values
      */
@@ -205,7 +230,7 @@ private String getValueString(String[] values) {
 
     /**
      * Adds the specified search parameter name and values to 'this'.
-     * 
+     *
      * @param name
      *            the name of the search parameter
      * @param values
@@ -222,7 +247,7 @@ public FHIRParameters searchParam(String name, String... values) {
 
     /**
      * Returns the collection of parameters that have been added to 'this'.
-     * 
+     *
      * @return a MultivalueMap where the key (query parameter name) maps to a list of string values
      */
     public final MultivaluedMap<String, String> getParameterMap() {
@@ -248,7 +273,7 @@ public void addMultivaluedParameter(String name, String value) {
 
     /**
      * Adds a single-valued parameter to 'this'.
-     * 
+     *
      * @param name
      * @param value
      */
@@ -277,7 +302,7 @@ public String queryString(boolean includeSeparator) {
         }
         return sb.toString();
     }
-    
+
     public String queryString() {
         return queryString(true);
     }
@@ -285,6 +310,7 @@ public String queryString() {
     /**
      * This method returns a string representation of the FHIRParameters object.
      */
+    @Override
     public String toString() {
         return "FHIRParameters[parameters=" + (getParameters() != null ? getParameters().toString() : "<null>" + "]");
     }
diff --git a/fhir-client/src/main/java/com/ibm/fhir/client/impl/FHIRClientImpl.java b/fhir-client/src/main/java/com/ibm/fhir/client/impl/FHIRClientImpl.java
index 7d45494a4b0..b3edb44d63d 100644
--- a/fhir-client/src/main/java/com/ibm/fhir/client/impl/FHIRClientImpl.java
+++ b/fhir-client/src/main/java/com/ibm/fhir/client/impl/FHIRClientImpl.java
@@ -20,7 +20,7 @@
 import java.util.Map;
 import java.util.Properties;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 import javax.net.ssl.HostnameVerifier;
 import javax.net.ssl.SSLSession;
 import javax.ws.rs.RuntimeType;
@@ -93,11 +93,66 @@ public class FHIRClientImpl implements FHIRClient {
     // The tenantId to pass with the X-FHIR-TENANT-ID header
     private String tenantId;
 
-    protected FHIRClientImpl() {
-    }
-
     public FHIRClientImpl(Properties props) throws Exception {
         initProperties(props);
+
+        ClientBuilder cb =
+                ClientBuilder.newBuilder()
+                    .register(new FHIRProvider(RuntimeType.CLIENT))
+                    .register(new FHIRJsonProvider(RuntimeType.CLIENT))
+                    .register(new FHIRJsonPatchProvider(RuntimeType.CLIENT));
+
+        // Add support for basic auth if enabled.
+        if (isBasicAuthEnabled()) {
+            cb = cb.register(new FHIRBasicAuthenticator(getBasicAuthUsername(), getBasicAuthPassword()));
+        }
+
+        // Add support for OAuth 2.0 if enabled.
+        if (isOAuth2Enabled()) {
+            cb = cb.register(new FHIROAuth2Authenticator(getOAuth2AccessToken()));
+        }
+
+        // If using oAuth 2.0 or clientauth, then we need to attach our Keystore.
+        if (isOAuth2Enabled() || isClientAuthEnabled()) {
+            cb = cb.keyStore(getKeyStore(), getKeyStoreKeyPassword());
+        }
+
+        // If using oAuth 2.0 or clientauth or an https endpoint, then we need to attach our Truststore.
+        KeyStore ks = getTrustStore();
+        if (ks != null) {
+            cb = cb.trustStore(ks);
+        }
+
+        // Add a hostname verifier if we're using an ssl transport.
+        if (usingSSLTransport() && !isHostnameVerificationEnabled()) {
+            cb = cb.hostnameVerifier(new HostnameVerifier() {
+                @Override
+                public boolean verify(String s, SSLSession sslSession) {
+                    return true;
+                }
+            });
+        }
+
+        // Set the http client's receive timeout setting
+        cb.property("http.receive.timeout", getHttpTimeout()); // defaults to 60s
+
+        // true: If need, tell Apache CXF to use the Async HTTP conduit for PATCH operation as the
+        // default HTTP conduit does not support PATCH
+        // false(default): To avoid the http async client time out issue (http://mail-archives.apache.org
+        // /mod_mbox/hc-dev/201909.mbox/%3CJIRA.13256372.1568301069000.62179.1568450580088@Atlassian.JIRA%3E),
+        // please set this to false.
+        cb.property("use.async.http.conduit", false);
+
+        // Add request/response logging if enabled.
+        if (isLoggingEnabled()) {
+            cb.register(LoggingFeature.class);
+        }
+
+        cb.property("thread.safe.client", true);
+
+        // Save off our cached Client instance.
+        client = cb.build();
+
     }
 
     @Override
@@ -387,11 +442,6 @@ public FHIRResponse vread(String resourceType, String resourceId, String version
         return new FHIRResponseImpl(response);
     }
 
-    /*
-     * (non-Javadoc)
-     * @see com.ibm.fhir.client.FHIRClient#history(java.lang.String, java.lang.String,
-     * com.ibm.fhir.client.FHIRParameters)
-     */
     @Override
     public FHIRResponse history(String resourceType, String resourceId, FHIRParameters parameters, FHIRRequestHeader... headers) throws Exception {
         if (resourceType == null) {
@@ -746,92 +796,13 @@ private Builder addRequestHeaders(Builder builder, FHIRRequestHeader[] headers)
         return builder;
     }
 
-    /**
-     * Retrieves a jax-rs Client from the ClientBuilder object. The Client instance is created if necessary.
-     */
-    protected synchronized Client getClient() throws Exception {
-        if (client == null) {
-            ClientBuilder cb = ClientBuilder.newBuilder()
-                    .register(new FHIRProvider(RuntimeType.CLIENT))
-                    .register(new FHIRJsonProvider(RuntimeType.CLIENT))
-                    .register(new FHIRJsonPatchProvider(RuntimeType.CLIENT));
-
-            // Add support for basic auth if enabled.
-            if (isBasicAuthEnabled()) {
-                cb = cb.register(new FHIRBasicAuthenticator(getBasicAuthUsername(), getBasicAuthPassword()));
-            }
-
-            // Add support for OAuth 2.0 if enabled.
-            if (isOAuth2Enabled()) {
-                cb = cb.register(new FHIROAuth2Authenticator(getOAuth2AccessToken()));
-            }
-
-            // If using oAuth 2.0 or clientauth, then we need to attach our Keystore.
-            if (isOAuth2Enabled() || isClientAuthEnabled()) {
-                cb = cb.keyStore(getKeyStore(), getKeyStoreKeyPassword());
-            }
-
-            // If using oAuth 2.0 or clientauth or an https endpoint, then we need to attach our Truststore.
-            KeyStore ks = getTrustStore();
-            if (ks != null) {
-                cb = cb.trustStore(ks);
-            }
-
-            // Add a hostname verifier if we're using an ssl transport.
-            if (usingSSLTransport() && !isHostnameVerificationEnabled()) {
-                cb = cb.hostnameVerifier(new HostnameVerifier() {
-
-                    @Override
-                    public boolean verify(String s, SSLSession sslSession) {
-                        return true;
-                    }
-                });
-            }
-
-            // Set the http client's receive timeout setting
-            cb.property("http.receive.timeout", getHttpTimeout()); // defaults to 60s
-
-            // true: If need, tell Apache CXF to use the Async HTTP conduit for PATCH operation as the
-            // default HTTP conduit does not support PATCH
-            // false(default): To avoid the http async client time out issue (http://mail-archives.apache.org
-            // /mod_mbox/hc-dev/201909.mbox/%3CJIRA.13256372.1568301069000.62179.1568450580088@Atlassian.JIRA%3E),
-            // please set this to false.
-            cb.property("use.async.http.conduit", false);
-
-            // Add request/response logging if enabled.
-            if (isLoggingEnabled()) {
-                cb.register(LoggingFeature.class);
-            }
-
-            // Save off our cached Client instance.
-            client = cb.build();
-        }
-        return client;
-    }
-
     @Override
     public WebTarget getWebTarget() throws Exception {
-        return getClient().target(getBaseEndpointURL());
+        return client.target(getBaseEndpointURL());
     }
 
     @Override
     public WebTarget getWebTarget(String baseURL) throws Exception {
-        ClientBuilder cb =
-                ClientBuilder.newBuilder().register(new FHIRProvider(RuntimeType.CLIENT)).register(new FHIRJsonProvider(RuntimeType.CLIENT)).keyStore(getKeyStore(), getKeyStoreKeyPassword());
-
-        KeyStore ts = getTrustStore();
-
-        if (ts != null) {
-            cb = cb.trustStore(ts);
-        }
-        Client client = cb.build();
-        return client.target(baseURL);
-    }
-
-    @Override
-    public WebTarget getWebTargetUsingBasicAuth(String baseURL, String username, String pwd) throws Exception {
-        Client client =
-                ClientBuilder.newBuilder().register(new FHIRProvider(RuntimeType.CLIENT)).register(new FHIRJsonProvider(RuntimeType.CLIENT)).register(new FHIRBasicAuthenticator(username, pwd)).keyStore(getKeyStore(), getKeyStoreKeyPassword()).trustStore(getTrustStore()).build();
         return client.target(baseURL);
     }
 
@@ -1022,6 +993,7 @@ private void setTrustStorePassword(String trustStorePassword) {
         this.trustStorePassword = trustStorePassword;
     }
 
+    @Override
     public KeyStore getTrustStore() {
         return trustStore;
     }
diff --git a/fhir-client/src/main/java/com/ibm/fhir/client/impl/FHIRResponseImpl.java b/fhir-client/src/main/java/com/ibm/fhir/client/impl/FHIRResponseImpl.java
index 59e0b2039cd..a8f5ade8dbb 100644
--- a/fhir-client/src/main/java/com/ibm/fhir/client/impl/FHIRResponseImpl.java
+++ b/fhir-client/src/main/java/com/ibm/fhir/client/impl/FHIRResponseImpl.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -10,7 +10,7 @@
 import java.time.Instant;
 import java.util.Date;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 import javax.ws.rs.core.HttpHeaders;
 import javax.ws.rs.core.Response;
 
diff --git a/fhir-client/src/test/java/com/ibm/fhir/client/test/mains/FHIRClientSample.java b/fhir-client/src/test/java/com/ibm/fhir/client/test/mains/FHIRClientSample.java
index 53ec54fd46c..5c5167852cd 100644
--- a/fhir-client/src/test/java/com/ibm/fhir/client/test/mains/FHIRClientSample.java
+++ b/fhir-client/src/test/java/com/ibm/fhir/client/test/mains/FHIRClientSample.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -44,7 +44,6 @@
  */
 public class FHIRClientSample {
 
-
     public static void main(String[] args) throws Exception {
         FHIRClientSample sample = new FHIRClientSample();
         sample.run();
diff --git a/fhir-client/src/test/java/com/ibm/fhir/client/test/mains/JaxrsClientTestMain.java b/fhir-client/src/test/java/com/ibm/fhir/client/test/mains/JaxrsClientTestMain.java
index defc5bed513..ff5f95fc1ca 100644
--- a/fhir-client/src/test/java/com/ibm/fhir/client/test/mains/JaxrsClientTestMain.java
+++ b/fhir-client/src/test/java/com/ibm/fhir/client/test/mains/JaxrsClientTestMain.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016,2019
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -38,30 +38,30 @@
 import com.ibm.fhir.provider.FHIRProvider;
 
 public class JaxrsClientTestMain {
-    
+
     public static void main(String[] args) throws Exception {
         Patient patient = buildPatient();
         System.out.println("\nJSON:");
-        
+
         FHIRGenerator.generator( Format.JSON, false).generate(patient, System.out);
         System.out.println("\nXML:");
         FHIRGenerator.generator( Format.XML, false).generate(patient, System.out);
-        
+
         Client client = ClientBuilder.newBuilder()
                 .register(new FHIRProvider(RuntimeType.CLIENT))
                 .build();
-        
+
         WebTarget target = client.target("http://localhost:9080/fhir-server/api/v4");
         Entity<Patient> entity = Entity.entity(patient, FHIRMediaType.APPLICATION_FHIR_XML);
         Response response = target.path("Patient").request().post(entity, Response.class);
-        
+
         if (Response.Status.CREATED.getStatusCode() == response.getStatus()) {
             System.out.println("");
             System.out.println(response.getStatus());
             System.out.println(response.getStatusInfo().getReasonPhrase());
             String location = response.getLocation().toString();
             System.out.println("location: " + location);
-            
+
             String id = location.substring(location.lastIndexOf("/") + 1);
             response = target.path("Patient/" + id).request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
             patient = response.readEntity(Patient.class);
@@ -69,23 +69,23 @@ public static void main(String[] args) throws Exception {
             FHIRGenerator.generator( Format.JSON, false).generate(patient, System.out);
             System.out.println("\nXML:");
             FHIRGenerator.generator( Format.XML, false).generate(patient, System.out);
-                        
+
             Observation observation = buildObservation(id);
             System.out.println("\nJSON:");
             FHIRGenerator.generator( Format.JSON, false).generate(observation, System.out);
             System.out.println("\nXML:");
             FHIRGenerator.generator( Format.XML, false).generate(observation, System.out);
-            
+
             Entity<Observation> observationEntity = Entity.entity(observation, FHIRMediaType.APPLICATION_FHIR_JSON);
             response = target.path("Observation").request().post(observationEntity, Response.class);
-            
+
             if (Response.Status.CREATED.getStatusCode() == response.getStatus()) {
                 System.out.println("");
                 System.out.println(response.getStatus());
                 System.out.println(response.getStatusInfo().getReasonPhrase());
                 location = response.getLocation().toString();
                 System.out.println("location: " + location);
-                
+
                 response = target.path("Observation").queryParam("subject", "Patient/" + id).request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
                 Bundle bundle = response.readEntity(Bundle.class);
                 System.out.println("\nJSON:");
@@ -105,7 +105,7 @@ public static void main(String[] args) throws Exception {
             System.out.println(response.readEntity(String.class));
         }
     }
-    
+
     public static Patient buildPatient() {
         Patient patient = Patient.builder().name(HumanName.builder()
                         .family(string("Doe"))
@@ -114,12 +114,12 @@ public static Patient buildPatient() {
                 .telecom(ContactPoint.builder().system(ContactPointSystem.PHONE)
                         .use(ContactPointUse.HOME).value(string("555-1234")).build())
                 .extension(Extension.builder().url("http://ibm.com/fhir/extension/Patient/favorite-color")
-                        .value(string("blue")).build()).build();        
+                        .value(string("blue")).build()).build();
         return patient;
     }
-    
+
     public static Observation buildObservation(String patientId) {
-        Observation observation = Observation.builder().status(ObservationStatus.FINAL).bodySite( 
+        Observation observation = Observation.builder().status(ObservationStatus.FINAL).bodySite(
                 CodeableConcept.builder().coding(Coding.builder().code(Code.of("55284-4"))
                         .system(Uri.of("http://loinc.org")).build())
                         .text(string("Blood pressure systolic & diastolic")).build())
@@ -135,8 +135,8 @@ public static Observation buildObservation(String patientId) {
                         .system(Uri.of("http://loinc.org")).build())
                         .text(string("Diastolic")).build())
                         .value(Quantity.builder().value(Decimal.of(93.7)).unit(string("mmHg")).build()).build())
-             .build();           
+             .build();
 
         return observation;
-    } 
+    }
 }
diff --git a/fhir-client/src/test/java/com/ibm/fhir/client/test/testng/FHIRClientImplTest.java b/fhir-client/src/test/java/com/ibm/fhir/client/test/testng/FHIRClientImplTest.java
new file mode 100644
index 00000000000..304a70ef0e6
--- /dev/null
+++ b/fhir-client/src/test/java/com/ibm/fhir/client/test/testng/FHIRClientImplTest.java
@@ -0,0 +1,51 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.client.test.testng;
+
+import static org.testng.Assert.assertNotNull;
+
+import java.util.Properties;
+
+import javax.ws.rs.client.WebTarget;
+
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.client.FHIRClient;
+import com.ibm.fhir.client.FHIRClientFactory;
+
+/**
+ * Tests FHIR Client configurations.
+ */
+public class FHIRClientImplTest {
+
+    @Test
+    public void testClientImplWithoutKeyStore() throws Exception {
+        String baseURL = "http://localhost:9443/test";
+        Properties properties = new Properties();
+        properties.put(FHIRClient.PROPNAME_BASE_URL, baseURL);
+        FHIRClient client = FHIRClientFactory.getClient(properties);
+        WebTarget wt = client.getWebTarget(baseURL + "/Patient?_page=2");
+        assertNotNull(wt);
+    }
+
+    @Test(enabled = false)
+    public void testClientImplWithBasicAuth() throws Exception {
+        /*
+         * used during dev, it's handy test for basicauth, but not reliable for UT/IT.
+         */
+        String baseURL = "https://jigsaw.w3.org/HTTP/Basic/";
+        Properties properties = new Properties();
+        properties.put("fhirclient.basicauth.enabled", "true");
+        properties.put("fhirclient.basicauth.username", "guest");
+        properties.put("fhirclient.basicauth.password", "guest");
+        properties.put("fhirclient.logging.enabled", "true");
+        properties.put(FHIRClient.PROPNAME_BASE_URL, baseURL);
+        FHIRClient client = FHIRClientFactory.getClient(properties);
+        WebTarget wt = client.getWebTarget(baseURL);
+        assertNotNull(wt.request().get());
+    }
+}
\ No newline at end of file
diff --git a/fhir-client/src/test/java/com/ibm/fhir/client/test/testng/FHIRParametersTest.java b/fhir-client/src/test/java/com/ibm/fhir/client/test/testng/FHIRParametersTest.java
index 389dfc55d02..4c7f8223e0c 100644
--- a/fhir-client/src/test/java/com/ibm/fhir/client/test/testng/FHIRParametersTest.java
+++ b/fhir-client/src/test/java/com/ibm/fhir/client/test/testng/FHIRParametersTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016,2019
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -14,12 +14,13 @@
 import com.ibm.fhir.client.FHIRParameters;
 import com.ibm.fhir.client.FHIRParameters.Modifier;
 import com.ibm.fhir.client.FHIRParameters.ValuePrefix;
+import com.ibm.fhir.model.type.code.ResourceType;
 
 /**
  * Tests related to the FHIRParameters class.
  */
 public class FHIRParametersTest {
-    
+
     @Test
     public void testParameter1() {
         FHIRParameters p = new FHIRParameters();
@@ -31,7 +32,7 @@ public void testParameter1() {
         assertTrue(queryString.contains("_page=3"));
         assertTrue(queryString.contains("_since=2016-01-01"));
     }
-    
+
     @Test
     public void testParameter2() {
         FHIRParameters p = new FHIRParameters();
@@ -42,7 +43,7 @@ public void testParameter2() {
         assertTrue(queryString.contains("name:contains=Ortiz"));
         assertTrue(queryString.contains("favorite-color:in=red,green,blue"));
     }
-    
+
     @Test
     public void testParameter3() {
         FHIRParameters p = new FHIRParameters();
@@ -53,4 +54,17 @@ public void testParameter3() {
         assertTrue(queryString.contains("name=eqOrtiz"));
         assertTrue(queryString.contains("favorite-color=nered"));
     }
+
+    @Test
+    public void testParameter4() {
+        FHIRParameters p = new FHIRParameters();
+        p.searchParam("patient", Modifier.IDENTIFIER, "http://acme.org/fhir/identifier/mrn|123456")
+            .searchParam("identifier", Modifier.OF_TYPE, "http://terminology.hl7.org/CodeSystem/v2-0203|MR|446053")
+            .searchParam("subject", ResourceType.PATIENT, "Patient/23");
+        String queryString = p.queryString();
+        assertNotNull(queryString);
+        assertTrue(queryString.contains("patient:identifier=http://acme.org/fhir/identifier/mrn|123456"));
+        assertTrue(queryString.contains("identifier:of-type=http://terminology.hl7.org/CodeSystem/v2-0203|MR|446053"));
+        assertTrue(queryString.contains("subject:Patient=Patient/23"));
+    }
 }
diff --git a/fhir-client/src/test/resources/test.basic.properties b/fhir-client/src/test/resources/test.basic.properties
new file mode 100644
index 00000000000..0941a96675b
--- /dev/null
+++ b/fhir-client/src/test/resources/test.basic.properties
@@ -0,0 +1,23 @@
+# Properties file containing test-related properties
+
+fhirclient.rest.base.url = https://jigsaw.w3.org/HTTP/Basic/
+fhirclient.default.mimetype = application/fhir+json
+
+fhirclient.basicauth.enabled = true
+fhirclient.basicauth.username = guest
+fhirclient.basicauth.password = guest
+
+fhirclient.clientauth.enabled = false
+fhirclient.keystore.location = fhirClientKeyStore.p12
+fhirclient.keystore.password = change-password
+fhirclient.keystore.key.password = change-password
+fhirclient.truststore.location = fhirClientTrustStore.p12
+fhirclient.truststore.password = change-password
+
+fhirclient.oAuth2.enabled = false
+
+fhirclient.encryption.enabled = false
+
+fhirclient.logging.enabled = false
+
+fhirclient.hostnameVerification.enabled = false
\ No newline at end of file
diff --git a/fhir-config/pom.xml b/fhir-config/pom.xml
index b6586b669d3..421f3c63734 100644
--- a/fhir-config/pom.xml
+++ b/fhir-config/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-config</artifactId>
diff --git a/fhir-config/src/main/java/com/ibm/fhir/config/ConfigurationService.java b/fhir-config/src/main/java/com/ibm/fhir/config/ConfigurationService.java
index a8229833856..ab7d9866a87 100644
--- a/fhir-config/src/main/java/com/ibm/fhir/config/ConfigurationService.java
+++ b/fhir-config/src/main/java/com/ibm/fhir/config/ConfigurationService.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016,2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -18,10 +18,10 @@
 import java.nio.charset.StandardCharsets;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
 
 /**
  * The ConfigurationService is used by the FHIR Server to retrieve JSON-based configuration data.
diff --git a/fhir-config/src/main/java/com/ibm/fhir/config/FHIRConfigHelper.java b/fhir-config/src/main/java/com/ibm/fhir/config/FHIRConfigHelper.java
index 749e59c4076..8a86c4a06d0 100644
--- a/fhir-config/src/main/java/com/ibm/fhir/config/FHIRConfigHelper.java
+++ b/fhir-config/src/main/java/com/ibm/fhir/config/FHIRConfigHelper.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2017,2020
+ * (C) Copyright IBM Corp. 2017, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -10,7 +10,7 @@
 import java.util.logging.Level;
 import java.util.logging.Logger;
 
-import javax.json.JsonValue;
+import jakarta.json.JsonValue;
 
 /**
  * This class contains a set of static helper methods related to configuration parameters.
diff --git a/fhir-config/src/main/java/com/ibm/fhir/config/FHIRConfiguration.java b/fhir-config/src/main/java/com/ibm/fhir/config/FHIRConfiguration.java
index 67d044e3856..03666440726 100644
--- a/fhir-config/src/main/java/com/ibm/fhir/config/FHIRConfiguration.java
+++ b/fhir-config/src/main/java/com/ibm/fhir/config/FHIRConfiguration.java
@@ -40,8 +40,10 @@ public class FHIRConfiguration {
     public static final String PROPERTY_DEFAULT_PAGE_SIZE = "fhirServer/core/defaultPageSize";
     public static final String PROPERTY_MAX_PAGE_SIZE = "fhirServer/core/maxPageSize";
     public static final String PROPERTY_MAX_PAGE_INCLUDE_COUNT = "fhirServer/core/maxPageIncludeCount";
+    public static final String PROPERTY_CAPABILITIES_URL = "fhirServer/core/capabilitiesUrl";
 
     // Terminology service properties
+    public static final String PROPERTY_TERM_SERVICE_CAPABILITIES_URL = "fhirServer/term/capabilitiesUrl";
     public static final String PROPERTY_GRAPH_TERM_SERVICE_PROVIDER_ENABLED = "fhirServer/term/graphTermServiceProvider/enabled";
     public static final String PROPERTY_GRAPH_TERM_SERVICE_PROVIDER_TIME_LIMIT = "fhirServer/term/graphTermServiceProvider/timeLimit";
     public static final String PROPERTY_GRAPH_TERM_SERVICE_PROVIDER_CONFIGURATION = "fhirServer/term/graphTermServiceProvider/configuration";
@@ -83,10 +85,13 @@ public class FHIRConfiguration {
 
     // Notification config properties
     public static final String PROPERTY_NOTIFICATION_RESOURCE_TYPES = "fhirServer/notifications/common/includeResourceTypes";
+    public static final String PROPERTY_NOTIFICATION_NOTIFICATION_SIZE_BEHAVIOR = "fhirServer/notifications/common/maxNotificationSizeBehavior";
+    public static final String PROPERTY_NOTIFICATION_MAX_SIZE = "fhirServer/notifications/common/maxNotificationSizeBytes";
     public static final String PROPERTY_WEBSOCKET_ENABLED = "fhirServer/notifications/websocket/enabled";
     public static final String PROPERTY_KAFKA_ENABLED = "fhirServer/notifications/kafka/enabled";
     public static final String PROPERTY_KAFKA_TOPICNAME = "fhirServer/notifications/kafka/topicName";
     public static final String PROPERTY_KAFKA_CONNECTIONPROPS = "fhirServer/notifications/kafka/connectionProperties";
+    public static final String PROPERTY_KAFKA_SYNC = "fhirServer/notifications/kafka/sync";
     public static final String PROPERTY_NATS_ENABLED = "fhirServer/notifications/nats/enabled";
     public static final String PROPERTY_NATS_CLUSTER = "fhirServer/notifications/nats/cluster";
     public static final String PROPERTY_NATS_CHANNEL = "fhirServer/notifications/nats/channel";
@@ -133,7 +138,6 @@ public class FHIRConfiguration {
     public static final String PROPERTY_BULKDATA_BATCHJOB_BATCHUSERPWD = "fhirServer/bulkdata/batch-user-password";
     public static final String PROPERTY_BULKDATA_BATCHJOB_BATCHTRUSTSTORE = "fhirServer/bulkdata/batch-truststore";
     public static final String PROPERTY_BULKDATA_BATCHJOB_BATCHTRUSTSTOREPWD = "fhirServer/bulkdata/batch-truststore-password";
-    public static final String PROPERTY_BULKDATA_BATCHJOB_ISEXPORTPUBLIC = "fhirServer/bulkdata/isExportPublic";
     public static final String PROPERTY_BULKDATA_BATCHJOB_USEFHIRSERVERTRUSTSTORE = "fhirServer/bulkdata/useFhirServerTrustStore";
     public static final String PROPERTY_BULKDATA_BATCHJOB_ENABLEPARQUET = "fhirServer/bulkdata/enableParquet";
     public static final String PROPERTY_BULKDATA_BATCHJOB_SYSTEMEXPIMPL = "fhirServer/bulkdata/systemExportImpl";
diff --git a/fhir-config/src/main/java/com/ibm/fhir/config/PropertyGroup.java b/fhir-config/src/main/java/com/ibm/fhir/config/PropertyGroup.java
index 3a037bbf2a5..57d61636b49 100644
--- a/fhir-config/src/main/java/com/ibm/fhir/config/PropertyGroup.java
+++ b/fhir-config/src/main/java/com/ibm/fhir/config/PropertyGroup.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -11,11 +11,11 @@
 import java.util.List;
 import java.util.Map;
 
-import javax.json.JsonArray;
-import javax.json.JsonNumber;
-import javax.json.JsonObject;
-import javax.json.JsonString;
-import javax.json.JsonValue;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonNumber;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonString;
+import jakarta.json.JsonValue;
 
 import com.ibm.fhir.core.FHIRUtilities;
 
diff --git a/fhir-config/src/test/java/com/ibm/fhir/config/mock/MockPropertyGroup.java b/fhir-config/src/test/java/com/ibm/fhir/config/mock/MockPropertyGroup.java
index 3e1038a548d..aa813b17097 100644
--- a/fhir-config/src/test/java/com/ibm/fhir/config/mock/MockPropertyGroup.java
+++ b/fhir-config/src/test/java/com/ibm/fhir/config/mock/MockPropertyGroup.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016,2019
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -8,11 +8,11 @@
 
 import java.io.ByteArrayInputStream;
 
-import javax.json.Json;
-import javax.json.JsonException;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonException;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
 
 import com.google.gson.Gson;
 import com.ibm.fhir.config.PropertyGroup;
diff --git a/fhir-config/src/test/java/com/ibm/fhir/config/test/MockPropertyGroupTest.java b/fhir-config/src/test/java/com/ibm/fhir/config/test/MockPropertyGroupTest.java
index 6d3ec94f254..bc1d18a9360 100644
--- a/fhir-config/src/test/java/com/ibm/fhir/config/test/MockPropertyGroupTest.java
+++ b/fhir-config/src/test/java/com/ibm/fhir/config/test/MockPropertyGroupTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016,2019
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -10,9 +10,9 @@
 import static org.testng.AssertJUnit.assertNotNull;
 import static org.testng.AssertJUnit.assertNull;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
 
 import org.testng.annotations.BeforeClass;
 import org.testng.annotations.Test;
diff --git a/fhir-config/src/test/java/com/ibm/fhir/config/test/PropertyGroupTest.java b/fhir-config/src/test/java/com/ibm/fhir/config/test/PropertyGroupTest.java
index 13652f945db..f1899169fe0 100644
--- a/fhir-config/src/test/java/com/ibm/fhir/config/test/PropertyGroupTest.java
+++ b/fhir-config/src/test/java/com/ibm/fhir/config/test/PropertyGroupTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -14,9 +14,9 @@
 
 import java.util.List;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
 
 import org.testng.annotations.BeforeClass;
 import org.testng.annotations.Test;
diff --git a/fhir-config/src/test/java/com/ibm/fhir/config/test/TestMockPropertyGroup.java b/fhir-config/src/test/java/com/ibm/fhir/config/test/TestMockPropertyGroup.java
index 092e190a750..3b6e1632f5f 100644
--- a/fhir-config/src/test/java/com/ibm/fhir/config/test/TestMockPropertyGroup.java
+++ b/fhir-config/src/test/java/com/ibm/fhir/config/test/TestMockPropertyGroup.java
@@ -1,12 +1,12 @@
 /*
- * (C) Copyright IBM Corp. 2016,2019
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
 
 package com.ibm.fhir.config.test;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 
 import com.ibm.fhir.config.PropertyGroup;
 
diff --git a/fhir-core/pom.xml b/fhir-core/pom.xml
index f4d45819277..8d68a678405 100644
--- a/fhir-core/pom.xml
+++ b/fhir-core/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-core/src/main/java/com/ibm/fhir/core/FHIRConstants.java b/fhir-core/src/main/java/com/ibm/fhir/core/FHIRConstants.java
index 64f509e08c6..a99c6bda616 100644
--- a/fhir-core/src/main/java/com/ibm/fhir/core/FHIRConstants.java
+++ b/fhir-core/src/main/java/com/ibm/fhir/core/FHIRConstants.java
@@ -37,6 +37,8 @@ public class FHIRConstants {
 
     public static final String UPDATE_IF_MODIFIED_HEADER = "X-FHIR-UPDATE-IF-MODIFIED";
 
+    public static final String EXT_BASE = "http://ibm.com/fhir/extension/";
+
     /**
      * General parameter names that can be used with any FHIR interaction.
      *
diff --git a/fhir-core/src/main/java/com/ibm/fhir/core/FHIRMediaType.java b/fhir-core/src/main/java/com/ibm/fhir/core/FHIRMediaType.java
index cf733298f58..a1ab070ce23 100644
--- a/fhir-core/src/main/java/com/ibm/fhir/core/FHIRMediaType.java
+++ b/fhir-core/src/main/java/com/ibm/fhir/core/FHIRMediaType.java
@@ -1,17 +1,23 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
 
 package com.ibm.fhir.core;
 
+import java.util.Arrays;
+import java.util.Collections;
+import java.util.HashSet;
+import java.util.Set;
+
 import javax.ws.rs.core.MediaType;
 
 /**
  * This class contains definitions of some non-standard media types.
  */
 public class FHIRMediaType extends MediaType {
+
     public final static String SUBTYPE_FHIR_JSON = "fhir+json";
     public final static String APPLICATION_FHIR_JSON = "application/" + SUBTYPE_FHIR_JSON;
     public final static MediaType APPLICATION_FHIR_JSON_TYPE = new MediaType("application", SUBTYPE_FHIR_JSON);
@@ -29,6 +35,12 @@ public class FHIRMediaType extends MediaType {
     public final static MediaType APPLICATION_FHIR_NDJSON_TYPE = new MediaType("application", SUBTYPE_FHIR_NDJSON);
 
     public final static String SUBTYPE_FHIR_PARQUET = "fhir+parquet";
-    public static final String APPLICATION_PARQUET = "application/"  + SUBTYPE_FHIR_PARQUET;
+    public static final String APPLICATION_PARQUET = "application/" + SUBTYPE_FHIR_PARQUET;
     public final static MediaType APPLICATION_FHIR_PARQUET_TYPE = new MediaType("application", SUBTYPE_FHIR_PARQUET);
+
+    // Supported values for the MIME-type parameter fhirVersion.
+    // https://www.hl7.org/fhir/http.html#version-parameter
+    public static final String FHIR_VERSION_PARAMETER = "fhirVersion";
+    public static final Set<String> SUPPORTED_FHIR_VERSIONS =
+            Collections.unmodifiableSet(new HashSet<>(Arrays.asList("4.0","4.0.1")));
 }
diff --git a/fhir-database-utils/pom.xml b/fhir-database-utils/pom.xml
index fc03bb5e3ea..9059a429046 100644
--- a/fhir-database-utils/pom.xml
+++ b/fhir-database-utils/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/api/TableSpaceRemovalException.java b/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/api/TableSpaceRemovalException.java
new file mode 100644
index 00000000000..ee8088d8970
--- /dev/null
+++ b/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/api/TableSpaceRemovalException.java
@@ -0,0 +1,61 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.database.utils.api;
+
+/**
+ * When there is an issue removing the Tablespace
+ */
+public class TableSpaceRemovalException extends DataAccessException {
+
+    // All exceptions are serializable
+    private static final long serialVersionUID = -338568883070014498L;
+
+    private boolean transactionRetryable;
+
+    /**
+     * Public constructor
+     * @param msg
+     */
+    public TableSpaceRemovalException(String msg) {
+        super(msg);
+    }
+
+    /**
+     * Public constructor
+     * @param msg
+     * @param t
+     */
+    public TableSpaceRemovalException(String msg, Throwable t) {
+        super(msg, t);
+    }
+
+    /**
+     * Public constructor
+     * @param t
+     */
+    public TableSpaceRemovalException(Throwable t) {
+        super(t);
+    }
+
+    /**
+     * Setter for the transactionRetryable flag
+     * @param flag
+     */
+    @Override
+    public void setTransactionRetryable(boolean flag) {
+        this.transactionRetryable = flag;
+    }
+
+    /**
+     * Getter for the transactionRetryable flag
+     * @return true if the transaction could be retried
+     */
+    @Override
+    public boolean isTransactionRetryable() {
+        return this.transactionRetryable;
+    }
+}
diff --git a/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/model/BaseObject.java b/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/model/BaseObject.java
index c3cb00e9f9a..7d99f1af293 100644
--- a/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/model/BaseObject.java
+++ b/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/model/BaseObject.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -256,7 +256,8 @@ public void applyTx(IDatabaseAdapter target, ITransactionProvider tp, IVersionHi
     @Override
     public void applyVersion(IDatabaseAdapter target, IVersionHistoryService vhs) {
         // Only for Procedures do we skip the Version History Service check, and apply.
-        if (vhs.applies(getSchemaName(), getObjectType().name(), getObjectName(), version) || getObjectType().equals(DatabaseObjectType.PROCEDURE)) {
+        if (vhs.applies(getSchemaName(), getObjectType().name(), getObjectName(), version)
+                    || getObjectType() == DatabaseObjectType.PROCEDURE) {
             logger.fine("Applying change [v" + version + "]: " + this.getTypeNameVersion());
 
             // Apply this change to the target database
diff --git a/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/tenant/DeleteTenantKeyDAO.java b/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/tenant/DeleteTenantKeyDAO.java
new file mode 100644
index 00000000000..1fedfa6a46d
--- /dev/null
+++ b/fhir-database-utils/src/main/java/com/ibm/fhir/database/utils/tenant/DeleteTenantKeyDAO.java
@@ -0,0 +1,71 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.database.utils.tenant;
+
+import java.sql.Connection;
+import java.sql.PreparedStatement;
+import java.sql.SQLException;
+
+import com.ibm.fhir.database.utils.api.IDatabaseStatement;
+import com.ibm.fhir.database.utils.api.IDatabaseTranslator;
+import com.ibm.fhir.database.utils.common.DataDefinitionUtil;
+
+/**
+ * Db2-only DAO to delete a tenant key record
+ */
+public class DeleteTenantKeyDAO implements IDatabaseStatement {
+    private final String schemaName;
+    private final int tenantId;
+    private final String tenantKey;
+    private int count = 0;
+
+    /**
+     * Public constructor
+     *
+     * @param schemaName
+     * @param tenantId
+     * @param tenantKey
+     */
+    public DeleteTenantKeyDAO(String schemaName, int tenantId, String tenantKey) {
+        DataDefinitionUtil.assertValidName(schemaName);
+        this.schemaName = schemaName;
+        this.tenantId = tenantId;
+        this.tenantKey = tenantKey;
+    }
+
+    @Override
+    public void run(IDatabaseTranslator translator, Connection c) {
+        final String tableName = DataDefinitionUtil.getQualifiedName(schemaName, "TENANT_KEYS");
+        final String SQL;
+        if (tenantKey == null) {
+            SQL = "DELETE FROM " + tableName + "  WHERE mt_id = ?";
+        } else {
+            SQL = "DELETE FROM " + tableName + "  WHERE mt_id = ?"
+                    + " AND tenant_hash = sysibm.hash(tenant_salt || ?, 2)";
+        }
+
+        try (PreparedStatement ps = c.prepareStatement(SQL)) {
+            ps.setInt(1, tenantId);
+
+            if (tenantKey != null) {
+                ps.setString(2, tenantKey);
+            }
+            count = ps.executeUpdate();
+        } catch (SQLException x) {
+            // Translate the exception into something a little more meaningful
+            // for this database type and application
+            throw translator.translate(x);
+        }
+    }
+
+    /**
+     * @return total number of keys removed
+     */
+    public int getCount() {
+        return count;
+    }
+}
diff --git a/fhir-examples-generator/pom.xml b/fhir-examples-generator/pom.xml
index 148f5a46bdf..8feff6e52d8 100644
--- a/fhir-examples-generator/pom.xml
+++ b/fhir-examples-generator/pom.xml
@@ -9,7 +9,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-examples-generator/src/main/java/com/ibm/fhir/examples/CompleteMockDataCreator.java b/fhir-examples-generator/src/main/java/com/ibm/fhir/examples/CompleteMockDataCreator.java
index 9b10e6ce694..b492033505f 100644
--- a/fhir-examples-generator/src/main/java/com/ibm/fhir/examples/CompleteMockDataCreator.java
+++ b/fhir-examples-generator/src/main/java/com/ibm/fhir/examples/CompleteMockDataCreator.java
@@ -501,7 +501,7 @@ protected void handleCode(Code.Builder code) throws IllegalAccessException, Ille
         Class<?>[] classes = elementClass.getClasses();
         // If the element has a ValueSet, set one of the values randomly
         for (Class<?> clazz : classes) {
-            if ("ValueSet".equals(clazz.getSimpleName())) {
+            if ("Value".equals(clazz.getSimpleName())) {
                 Object[] enumConstants = clazz.getEnumConstants();
                 Object enumConstant = enumConstants[ThreadLocalRandom.current().nextInt(0, enumConstants.length)];
 
diff --git a/fhir-examples-generator/src/test/resources/examplesplugin/pom.xml b/fhir-examples-generator/src/test/resources/examplesplugin/pom.xml
index 5206a10896f..be3d0aeca1d 100644
--- a/fhir-examples-generator/src/test/resources/examplesplugin/pom.xml
+++ b/fhir-examples-generator/src/test/resources/examplesplugin/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-examples/pom.xml b/fhir-examples/pom.xml
index acc534afc15..061410f9339 100644
--- a/fhir-examples/pom.xml
+++ b/fhir-examples/pom.xml
@@ -4,7 +4,7 @@
     <modelVersion>4.0.0</modelVersion>
     <artifactId>fhir-examples</artifactId>
     <groupId>com.ibm.fhir</groupId>
-    <version>4.8.0-SNAPSHOT</version>
+    <version>4.9.0-SNAPSHOT</version>
 
     <name>IBM FHIR Server - Examples</name>
     <url>https://github.com/ibm/fhir</url>
diff --git a/fhir-examples/src/main/resources/json/ibm/basic/BasicDate.json b/fhir-examples/src/main/resources/json/ibm/basic/BasicDate.json
index b2ceeffbc28..e86d6130c1f 100644
--- a/fhir-examples/src/main/resources/json/ibm/basic/BasicDate.json
+++ b/fhir-examples/src/main/resources/json/ibm/basic/BasicDate.json
@@ -98,7 +98,7 @@
         "_start": {
           "extension": [{
             "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
-            "valueString": "masked"
+            "valueCode": "masked"
           }]
         }
       }
diff --git a/fhir-examples/src/main/resources/json/ibm/basic/BasicQuantity.json b/fhir-examples/src/main/resources/json/ibm/basic/BasicQuantity.json
index 97728b0565b..ee0b13354dd 100644
--- a/fhir-examples/src/main/resources/json/ibm/basic/BasicQuantity.json
+++ b/fhir-examples/src/main/resources/json/ibm/basic/BasicQuantity.json
@@ -34,6 +34,14 @@
         "value": 1
       }
     },
+    {
+      "url": "http://example.org/Quantity-unicodeLessThan",
+      "valueQuantity": {
+        "value": 3,
+        "unit": "ult",
+        "comparator": "\u003c"
+      }
+    },
     {
       "url": "http://example.org/Quantity-lessThan",
       "valueQuantity": {
@@ -83,6 +91,28 @@
         }
       }
     }, 
+    {
+      "url": "http://example.org/Range-noHigh",
+      "valueRange": {
+          "low": {
+          "value": 5,
+          "unit": "sec",
+          "system": "http://unitsofmeasure.org",
+          "code": "s"
+        }
+      }
+    }, 
+    {
+      "url": "http://example.org/Range-noLow",
+      "valueRange": {
+        "high": {
+          "value": 10,
+          "unit": "sec",
+          "system": "http://unitsofmeasure.org",
+          "code": "s"
+        }
+      }
+    }, 
     {
         "url": "http://example.org/Quantity-withExponent",
         "valueQuantity": {
diff --git a/fhir-install/Dockerfile b/fhir-install/Dockerfile
index 149e62341cb..acc89f02317 100644
--- a/fhir-install/Dockerfile
+++ b/fhir-install/Dockerfile
@@ -5,7 +5,7 @@
 # ----------------------------------------------------------------------------
 # Stage: Base
 
-FROM openliberty/open-liberty:21.0.0.3-kernel-slim-java11-openj9-ubi as base
+FROM openliberty/open-liberty:21.0.0.5-kernel-slim-java11-openj9-ubi as base
 
 USER root
 RUN yum install -y unzip
@@ -22,10 +22,10 @@ COPY src/main/docker/ibm-fhir-server/bootstrap.sh /opt/ibm-fhir-server/
 # ----------------------------------------------------------------------------
 # Stage: Runnable
 
-FROM openliberty/open-liberty:21.0.0.3-kernel-slim-java11-openj9-ubi
+FROM openliberty/open-liberty:21.0.0.5-kernel-slim-java11-openj9-ubi
 
 ARG VERBOSE=true
-ARG FHIR_VERSION=4.8.0-SNAPSHOT
+ARG FHIR_VERSION=4.9.0-SNAPSHOT
 
 # The following labels are required: 
 LABEL name='IBM FHIR Server'
@@ -52,7 +52,8 @@ RUN features.sh
 
 COPY --chown=1001:0 --from=base /opt/ol/wlp/usr /opt/ol/wlp/usr
 
-RUN configure.sh
+RUN configure.sh && \
+    mkdir -p /output/bulkdata
 
 COPY --chown=1001:0 --from=base /opt/ibm-fhir-server /opt/ibm-fhir-server
 
diff --git a/fhir-install/pom.xml b/fhir-install/pom.xml
index f16b5e95062..e55377911b9 100644
--- a/fhir-install/pom.xml
+++ b/fhir-install/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-install/src/main/resources/scripts/install.bat b/fhir-install/src/main/resources/scripts/install.bat
index b7c90550378..b698d2bfc1c 100644
--- a/fhir-install/src/main/resources/scripts/install.bat
+++ b/fhir-install/src/main/resources/scripts/install.bat
@@ -7,7 +7,7 @@
 
 SETLOCAL ENABLEDELAYEDEXPANSION
 
-set LIBERTY_VERSION=21.0.0.3
+set LIBERTY_VERSION=21.0.0.5
 
 echo Executing %0 to deploy the fhir-server web application...
 
diff --git a/fhir-install/src/main/resources/scripts/install.sh b/fhir-install/src/main/resources/scripts/install.sh
index 066296b1240..4be69d0804d 100644
--- a/fhir-install/src/main/resources/scripts/install.sh
+++ b/fhir-install/src/main/resources/scripts/install.sh
@@ -5,7 +5,7 @@
 # SPDX-License-Identifier: Apache-2.0
 ###############################################################################
 
-export LIBERTY_VERSION="21.0.0.3"
+export LIBERTY_VERSION="21.0.0.5"
 
 echo "
 Executing $0 to deploy the fhir-server web application...
diff --git a/fhir-model/pom.xml b/fhir-model/pom.xml
index b7fca1c6b94..f0c628abf9a 100644
--- a/fhir-model/pom.xml
+++ b/fhir-model/pom.xml
@@ -8,7 +8,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/builder/AbstractBuilder.java b/fhir-model/src/main/java/com/ibm/fhir/model/builder/AbstractBuilder.java
index 8e8eaccd46d..c05da37f170 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/builder/AbstractBuilder.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/builder/AbstractBuilder.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -7,6 +7,30 @@
 package com.ibm.fhir.model.builder;
 
 public abstract class AbstractBuilder<T> implements Builder<T> {
+    protected boolean validating = true;
+
+    /**
+     * Set the validating builder indicator for this builder
+     *
+     * <p>A validating builder may perform basic validation during object construction (e.g. cardinality checking, type checking, etc.)
+     *
+     * @param validating
+     *     the validating builder indicator
+     */
+    public void setValidating(boolean validating) {
+        this.validating = validating;
+    }
+
+    /**
+     * Indicates whether this builder is a validating builder
+     *
+     * @return
+     *     true if this builder is a validating builder, false otherwise
+     */
+    public boolean isValidating() {
+        return validating;
+    }
+
     @Override
     public abstract T build();
 }
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/generator/FHIRJsonGenerator.java b/fhir-model/src/main/java/com/ibm/fhir/model/generator/FHIRJsonGenerator.java
index 0cbf281f3e8..750d1b69f13 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/generator/FHIRJsonGenerator.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/generator/FHIRJsonGenerator.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -10,28 +10,15 @@
 import static com.ibm.fhir.model.util.JsonSupport.nonClosingWriter;
 import static com.ibm.fhir.model.util.ModelSupport.isPrimitiveType;
 
-import java.io.FilterOutputStream;
-import java.io.FilterWriter;
-import java.io.IOException;
 import java.io.OutputStream;
 import java.io.Writer;
 import java.math.BigDecimal;
 import java.nio.charset.StandardCharsets;
-import java.time.LocalDate;
-import java.time.ZoneOffset;
 import java.util.Base64;
-import java.util.HashMap;
+import java.util.Collections;
 import java.util.List;
-import java.util.Map;
-import java.util.UUID;
 
-import javax.json.Json;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
-
-import com.ibm.fhir.model.format.Format;
 import com.ibm.fhir.model.generator.exception.FHIRGeneratorException;
-import com.ibm.fhir.model.resource.Patient;
 import com.ibm.fhir.model.resource.Resource;
 import com.ibm.fhir.model.type.Base64Binary;
 import com.ibm.fhir.model.type.Boolean;
@@ -40,20 +27,21 @@
 import com.ibm.fhir.model.type.Decimal;
 import com.ibm.fhir.model.type.Element;
 import com.ibm.fhir.model.type.Extension;
-import com.ibm.fhir.model.type.HumanName;
-import com.ibm.fhir.model.type.Id;
 import com.ibm.fhir.model.type.Instant;
 import com.ibm.fhir.model.type.Integer;
-import com.ibm.fhir.model.type.Meta;
 import com.ibm.fhir.model.type.String;
 import com.ibm.fhir.model.type.Time;
 import com.ibm.fhir.model.type.Uri;
 import com.ibm.fhir.model.type.Xhtml;
 import com.ibm.fhir.model.visitor.Visitable;
 
+import jakarta.json.Json;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
+
 public class FHIRJsonGenerator extends FHIRAbstractGenerator {
     private static final JsonGeneratorFactory GENERATOR_FACTORY = Json.createGeneratorFactory(null);
-    private static final JsonGeneratorFactory PRETTY_PRINTING_GENERATOR_FACTORY = createPrettyPrintingGeneratorFactory();
+    private static final JsonGeneratorFactory PRETTY_PRINTING_GENERATOR_FACTORY = Json.createGeneratorFactory(Collections.singletonMap(JsonGenerator.PRETTY_PRINTING, true));
 
     private final boolean prettyPrinting;
 
@@ -68,7 +56,7 @@ protected FHIRJsonGenerator(boolean prettyPrinting) {
     @Override
     public void generate(Visitable visitable, OutputStream out) throws FHIRGeneratorException {
         GeneratingVisitor visitor = null;
-        try (JsonGenerator generator = getGeneratorFactory().createGenerator(prettyPrinting ? wrap(out) : nonClosingOutputStream(out), StandardCharsets.UTF_8)) {
+        try (JsonGenerator generator = getGeneratorFactory().createGenerator(nonClosingOutputStream(out), StandardCharsets.UTF_8)) {
             visitor = new JsonGeneratingVisitor(generator);
             visitable.accept(visitor);
             generator.flush();
@@ -80,7 +68,7 @@ public void generate(Visitable visitable, OutputStream out) throws FHIRGenerator
     @Override
     public void generate(Visitable visitable, Writer writer) throws FHIRGeneratorException {
         GeneratingVisitor visitor = null;
-        try (JsonGenerator generator = getGeneratorFactory().createGenerator(prettyPrinting ? wrap(writer) : nonClosingWriter(writer))) {
+        try (JsonGenerator generator = getGeneratorFactory().createGenerator(nonClosingWriter(writer))) {
             visitor = new JsonGeneratingVisitor(generator);
             visitable.accept(visitor);
             generator.flush();
@@ -94,60 +82,13 @@ public boolean isPrettyPrinting() {
         return prettyPrinting;
     }
 
-    /**
-     * Temporary workaround for: https://github.com/eclipse-ee4j/jsonp/issues/190
-     */
-    private OutputStream wrap(OutputStream out) {
-        return new FilterOutputStream(out) {
-            private boolean first = true;
-            
-            @Override
-            public void write(int b) throws IOException {
-                if (first && b == '\n') {
-                    first = false;
-                    return;
-                }
-                out.write(b);
-            }
-            
-            @Override
-            public void close() {
-                // do nothing
-            }
-        };
-    }
-    
-    /**
-     * Temporary workaround for: https://github.com/eclipse-ee4j/jsonp/issues/190
-     */
-    private Writer wrap(Writer writer) {
-        return new FilterWriter(writer) {
-            private boolean first = true;
-            
-            @Override
-            public void write(char[] cbuf, int off, int len) throws IOException {
-                if (first && cbuf.length > 1 && off == 0 && cbuf[0] == '\n') {
-                    first = false;
-                    out.write(cbuf, off + 1, len - 1);
-                    return;
-                }
-                out.write(cbuf, off, len);
-            }
-            
-            @Override
-            public void close() {
-                // do nothing
-            }
-        };
-    }
-
     private static class JsonGeneratingVisitor extends GeneratingVisitor {
         private final JsonGenerator generator;
-                
+
         private JsonGeneratingVisitor(JsonGenerator generator) {
             this.generator = generator;
         }
-        
+
         private void generate(Element element) {
             if (element.getId() != null) {
                 // visit id
@@ -167,7 +108,7 @@ private void generate(Element element) {
         private boolean hasIdOrExtension(Element element) {
             return element.getId() != null || !element.getExtension().isEmpty();
         }
-        
+
         private boolean hasIdOrExtension(java.util.List<? extends Visitable> visitables) {
             for (Visitable visitable : visitables) {
                 if (hasIdOrExtension((Element) visitable)) {
@@ -176,7 +117,7 @@ private boolean hasIdOrExtension(java.util.List<? extends Visitable> visitables)
             }
             return false;
         }
-        
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, Base64Binary base64Binary) {
             if (isChoiceElement(elementName)) {
@@ -189,7 +130,7 @@ public boolean visit(java.lang.String elementName, int elementIndex, Base64Binar
             }
             return false;
         }
-        
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, Boolean _boolean) {
             if (isChoiceElement(elementName)) {
@@ -202,12 +143,12 @@ public boolean visit(java.lang.String elementName, int elementIndex, Boolean _bo
             }
             return false;
         }
-        
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, Date date) {
             if (isChoiceElement(elementName)) {
                 elementName = getChoiceElementName(elementName, Date.class);
-            }            
+            }
             if (date.getValue() != null) {
                 writeValue(elementName, elementIndex, Date.PARSER_FORMATTER.format(date.getValue()));
             } else {
@@ -215,12 +156,12 @@ public boolean visit(java.lang.String elementName, int elementIndex, Date date)
             }
             return false;
         }
-    
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, DateTime dateTime) {
             if (isChoiceElement(elementName)) {
                 elementName = getChoiceElementName(elementName, DateTime.class);
-            }            
+            }
             if (dateTime.getValue() != null) {
                 writeValue(elementName, elementIndex, DateTime.PARSER_FORMATTER.format(dateTime.getValue()));
             } else {
@@ -228,12 +169,12 @@ public boolean visit(java.lang.String elementName, int elementIndex, DateTime da
             }
             return false;
         }
-        
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, Decimal decimal) {
             if (isChoiceElement(elementName)) {
                 elementName = getChoiceElementName(elementName, Decimal.class);
-            }            
+            }
             if (decimal.getValue() != null) {
                 writeValue(elementName, elementIndex, decimal.getValue());
             } else {
@@ -241,12 +182,12 @@ public boolean visit(java.lang.String elementName, int elementIndex, Decimal dec
             }
             return false;
         }
-        
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, Instant instant) {
             if (isChoiceElement(elementName)) {
                 elementName = getChoiceElementName(elementName, Instant.class);
-            }            
+            }
             if (instant.getValue() != null) {
                 writeValue(elementName, elementIndex, Instant.PARSER_FORMATTER.format(instant.getValue()));
             } else {
@@ -254,7 +195,7 @@ public boolean visit(java.lang.String elementName, int elementIndex, Instant ins
             }
             return false;
         }
-    
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, Integer integer) {
             if (isChoiceElement(elementName)) {
@@ -267,17 +208,17 @@ public boolean visit(java.lang.String elementName, int elementIndex, Integer int
             }
             return false;
         }
-        
+
         @Override
         public void doVisit(java.lang.String elementName, java.lang.String value) {
             writeValue(elementName, -1, value);
         }
-    
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, String string) {
             if (isChoiceElement(elementName)) {
                 elementName = getChoiceElementName(elementName, string.getClass());
-            }            
+            }
             if (string.getValue() != null) {
                 writeValue(elementName, elementIndex, string.getValue());
             } else {
@@ -285,12 +226,12 @@ public boolean visit(java.lang.String elementName, int elementIndex, String stri
             }
             return false;
         }
-        
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, Time time) {
             if (isChoiceElement(elementName)) {
                 elementName = getChoiceElementName(elementName, Time.class);
-            }            
+            }
             if (time.getValue() != null) {
                 writeValue(elementName, elementIndex, Time.PARSER_FORMATTER.format(time.getValue()));
             } else {
@@ -298,7 +239,7 @@ public boolean visit(java.lang.String elementName, int elementIndex, Time time)
             }
             return false;
         }
-        
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, Uri uri) {
             if (isChoiceElement(elementName)) {
@@ -311,13 +252,13 @@ public boolean visit(java.lang.String elementName, int elementIndex, Uri uri) {
             }
             return false;
         }
-        
+
         @Override
         public boolean visit(java.lang.String elementName, int elementIndex, Xhtml xhtml) {
             writeValue(elementName, elementIndex, xhtml.getValue());
             return false;
         }
-        
+
         @Override
         public void doVisitEnd(java.lang.String elementName, int elementIndex, Element element) {
             Class<?> elementType = element.getClass();
@@ -337,7 +278,7 @@ public void doVisitEnd(java.lang.String elementName, int elementIndex, Element e
                 generator.writeEnd();
             }
         }
-        
+
         @Override
         public void visitEnd(java.lang.String elementName, List<? extends Visitable> visitables, Class<?> type) {
             if (!visitables.isEmpty()) {
@@ -357,12 +298,12 @@ public void visitEnd(java.lang.String elementName, List<? extends Visitable> vis
                 }
             }
         }
-        
+
         @Override
         public void doVisitEnd(java.lang.String elementName, int elementIndex, Resource resource) {
             generator.writeEnd();
         }
-        
+
         @Override
         public void doVisitStart(java.lang.String elementName, int elementIndex, Element element) {
             Class<?> elementType = element.getClass();
@@ -375,14 +316,14 @@ public void doVisitStart(java.lang.String elementName, int elementIndex, Element
                 generator.writeStartObject();
             }
         }
-        
+
         @Override
         public void visitStart(java.lang.String elementName, List<? extends Visitable> visitables, Class<?> type) {
             if (!visitables.isEmpty()) {
                 writeStartArray(elementName);
             }
         }
-    
+
         @Override
         public void doVisitStart(java.lang.String elementName, int elementIndex, Resource resource) {
             writeStartObject(elementName, elementIndex);
@@ -390,17 +331,17 @@ public void doVisitStart(java.lang.String elementName, int elementIndex, Resourc
             java.lang.String resourceTypeName = resourceType.getSimpleName();
             generator.write("resourceType", resourceTypeName);
         }
-    
+
         private void writeNull(java.lang.String elementName, int elementIndex, Element element) {
             if (elementIndex != -1 && hasIdOrExtension(element)) {
                 generator.writeNull();
             }
         }
-    
+
         private void writeStartArray(java.lang.String elementName) {
             generator.writeStartArray(elementName);
         }
-    
+
         private void writeStartObject(java.lang.String elementName, int elementIndex) {
             if (getDepth() > 1 && elementIndex == -1) {
                 generator.writeStartObject(elementName);
@@ -408,7 +349,7 @@ private void writeStartObject(java.lang.String elementName, int elementIndex) {
                 generator.writeStartObject();
             }
         }
-    
+
         private void writeValue(java.lang.String elementName, int elementIndex, BigDecimal value) {
             if (elementIndex == -1) {
                 generator.write(elementName, value);
@@ -416,7 +357,7 @@ private void writeValue(java.lang.String elementName, int elementIndex, BigDecim
                 generator.write(value);
             }
         }
-    
+
         private void writeValue(java.lang.String elementName, int elementIndex, java.lang.Boolean value) {
             if (elementIndex == -1) {
                 generator.write(elementName, value);
@@ -424,7 +365,7 @@ private void writeValue(java.lang.String elementName, int elementIndex, java.lan
                 generator.write(value);
             }
         }
-    
+
         private void writeValue(java.lang.String elementName, int elementIndex, java.lang.Integer value) {
             if (elementIndex == -1) {
                 generator.write(elementName, value);
@@ -432,7 +373,7 @@ private void writeValue(java.lang.String elementName, int elementIndex, java.lan
                 generator.write(value);
             }
         }
-        
+
         private void writeValue(java.lang.String elementName, int elementIndex, java.lang.String value) {
             if (elementIndex == -1) {
                 generator.write(elementName, value);
@@ -442,56 +383,7 @@ private void writeValue(java.lang.String elementName, int elementIndex, java.lan
         }
     }
 
-    private static JsonGeneratorFactory createPrettyPrintingGeneratorFactory() {
-        Map<java.lang.String, Object> properties = new HashMap<>(1);
-        properties.put(JsonGenerator.PRETTY_PRINTING, true);
-        return Json.createGeneratorFactory(properties);
-    }
-
     private JsonGeneratorFactory getGeneratorFactory() {
         return prettyPrinting ? PRETTY_PRINTING_GENERATOR_FACTORY : GENERATOR_FACTORY;
     }
-
-    public static void main(java.lang.String[] args) throws Exception {
-        java.lang.String id = UUID.randomUUID().toString();
-        
-        Meta meta = Meta.builder().versionId(Id.of("1"))
-                .lastUpdated(Instant.now(ZoneOffset.UTC))
-                .build();
-        
-        String given = String.builder().value("John")
-                .extension(Extension.builder()
-                    .url("http://www.ibm.com/someExtension")
-                    .value(String.of("value and extension"))
-                    .build())
-                .build();
-        
-        String otherGiven = String.builder()
-                .id("someOtherId")
-                .extension(Extension.builder()
-                    .url("http://www.ibm.com/someExtension")
-                    .value(String.of("extension only"))
-                    .build())
-                .build();
-        
-        HumanName name = HumanName.builder()
-                .id("someId")
-                .given(given)
-                .given(otherGiven)
-                .given(String.of("value no extension"))
-                .family(String.of("Doe"))
-                .build();
-                
-        Patient patient = Patient.builder()
-                .id(id)
-                .active(Boolean.TRUE)
-                .multipleBirth(Integer.of(2))
-                .meta(meta)
-                .name(name)
-                .birthDate(Date.of(LocalDate.now()))
-                .build();
-    
-        FHIRGenerator generator = FHIRGenerator.generator(Format.JSON, true);
-        generator.generate(patient, System.out);
-    }
 }
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/generator/FHIRXMLGenerator.java b/fhir-model/src/main/java/com/ibm/fhir/model/generator/FHIRXMLGenerator.java
index dc106622d09..197e2099b6a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/generator/FHIRXMLGenerator.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/generator/FHIRXMLGenerator.java
@@ -1,12 +1,11 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
 
 package com.ibm.fhir.model.generator;
 
-import static com.ibm.fhir.model.type.Xhtml.xhtml;
 import static com.ibm.fhir.model.util.ModelSupport.isPrimitiveType;
 import static com.ibm.fhir.model.util.XMLSupport.FHIR_NS_URI;
 import static com.ibm.fhir.model.util.XMLSupport.createNonClosingStreamWriterDelegate;
@@ -16,10 +15,7 @@
 import java.io.OutputStream;
 import java.io.StringReader;
 import java.io.Writer;
-import java.time.LocalDate;
-import java.time.ZoneOffset;
 import java.util.Base64;
-import java.util.UUID;
 
 import javax.xml.stream.XMLStreamException;
 import javax.xml.stream.XMLStreamWriter;
@@ -28,9 +24,7 @@
 import javax.xml.transform.stax.StAXResult;
 import javax.xml.transform.stream.StreamSource;
 
-import com.ibm.fhir.model.format.Format;
 import com.ibm.fhir.model.generator.exception.FHIRGeneratorException;
-import com.ibm.fhir.model.resource.Patient;
 import com.ibm.fhir.model.resource.Resource;
 import com.ibm.fhir.model.type.Base64Binary;
 import com.ibm.fhir.model.type.Boolean;
@@ -39,17 +33,12 @@
 import com.ibm.fhir.model.type.Decimal;
 import com.ibm.fhir.model.type.Element;
 import com.ibm.fhir.model.type.Extension;
-import com.ibm.fhir.model.type.HumanName;
-import com.ibm.fhir.model.type.Id;
 import com.ibm.fhir.model.type.Instant;
 import com.ibm.fhir.model.type.Integer;
-import com.ibm.fhir.model.type.Meta;
-import com.ibm.fhir.model.type.Narrative;
 import com.ibm.fhir.model.type.String;
 import com.ibm.fhir.model.type.Time;
 import com.ibm.fhir.model.type.Uri;
 import com.ibm.fhir.model.type.Xhtml;
-import com.ibm.fhir.model.type.code.NarrativeStatus;
 import com.ibm.fhir.model.util.XMLSupport.StreamWriterDelegate;
 import com.ibm.fhir.model.visitor.Visitable;
 
@@ -330,60 +319,4 @@ public void doVisitStart(java.lang.String elementName, int elementIndex, Resourc
             }
         }
     }
-
-    public static void main(java.lang.String[] args) throws Exception {
-        java.lang.String div = "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p></div>";
-
-        java.lang.String id = UUID.randomUUID().toString();
-
-        Meta meta = Meta.builder().versionId(Id.of("1"))
-                .lastUpdated(Instant.now(ZoneOffset.UTC))
-                .build();
-
-        String given = String.builder().value("John")
-                .extension(Extension.builder()
-                    .url("http://www.ibm.com/someExtension")
-                    .value(String.of("value and extension"))
-                    .build())
-                .build();
-
-        String otherGiven = String.builder()
-                .extension(Extension.builder()
-                    .url("http://www.ibm.com/someExtension")
-                    .value(String.of("extension only"))
-                    .build())
-                .build();
-
-        HumanName name = HumanName.builder()
-                .id("someId")
-                .given(given)
-                .given(otherGiven)
-                .given(String.of("value no extension"))
-                .family(String.of("Doe"))
-                .build();
-
-        Narrative text = Narrative.builder().status(NarrativeStatus.GENERATED).div(xhtml(div)).build();
-
-        Patient patient = Patient.builder()
-                .id(id)
-                .text(text)
-                .active(Boolean.TRUE)
-                .multipleBirth(Integer.of(2))
-                .meta(meta)
-                .name(name)
-                .birthDate(Date.of(LocalDate.now()))
-                .build();
-
-        FHIRGenerator generator = FHIRGenerator.generator(Format.XML, true);
-        generator.generate(patient, System.out);
-
-        System.out.println("");
-
-        generator.setProperty(PROPERTY_INDENT_AMOUNT, 4);
-        generator.generate(patient, System.out);
-
-        System.out.println("");
-
-        System.out.println(patient.getMultipleBirth());
-    }
 }
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRAbstractParser.java b/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRAbstractParser.java
index 05d7613c223..dab7983338d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRAbstractParser.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRAbstractParser.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2020
+ * (C) Copyright IBM Corp. 2020, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -17,13 +17,35 @@
 
 public abstract class FHIRAbstractParser implements FHIRParser {
     protected Map<String, Object> properties = new HashMap<>();
-    
+    protected boolean validating = true;
+    protected boolean ignoringUnrecognizedElements = false;
+
     @Override
     public abstract <T extends Resource> T parse(InputStream in) throws FHIRParserException;
-    
+
     @Override
     public abstract <T extends Resource> T parse(Reader reader) throws FHIRParserException;
-    
+
+    @Override
+    public void setValidating(boolean validating) {
+        this.validating = validating;
+    }
+
+    @Override
+    public boolean isValidating() {
+        return validating;
+    }
+
+    @Override
+    public void setIgnoringUnrecognizedElements(boolean ignoringUnrecognizedElements) {
+        this.ignoringUnrecognizedElements = ignoringUnrecognizedElements;
+    }
+
+    @Override
+    public boolean isIgnoringUnrecognizedElements() {
+        return ignoringUnrecognizedElements;
+    }
+
     @Override
     public void setProperty(String name, Object value) {
         Objects.requireNonNull(name);
@@ -32,32 +54,32 @@ public void setProperty(String name, Object value) {
         }
         properties.put(name, Objects.requireNonNull(value));
     }
-    
+
     @Override
     public Object getProperty(String name) {
         return properties.get(Objects.requireNonNull(name));
     }
-    
+
     @Override
     public <T> T getProperty(String name, Class<T> type) {
         return Objects.requireNonNull(type).cast(getProperty(name));
     }
-    
+
     @Override
     public Object getPropertyOrDefault(String name, Object defaultValue) {
         return properties.getOrDefault(Objects.requireNonNull(name), Objects.requireNonNull(defaultValue));
     }
-    
+
     @Override
     public <T> T getPropertyOrDefault(String name, T defaultValue, Class<T> type) {
         return Objects.requireNonNull(type).cast(getPropertyOrDefault(name, defaultValue));
     }
-    
+
     @Override
     public boolean isPropertySupported(String name) {
         return false;
     }
-    
+
     @Override
     public <T extends FHIRParser> T as(Class<T> parserClass) {
         return parserClass.cast(this);
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRJsonParser.java b/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRJsonParser.java
index fb309e518dd..7b3c50f3f95 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRJsonParser.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRJsonParser.java
@@ -18,18 +18,22 @@
 import java.io.Reader;
 import java.nio.charset.StandardCharsets;
 import java.util.Collection;
+import java.util.Collections;
 import java.util.Stack;
 import java.util.StringJoiner;
 
 import javax.annotation.Generated;
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonNumber;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonString;
-import javax.json.JsonValue;
+
+import org.glassfish.json.api.JsonConfig;
+
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonNumber;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonString;
+import jakarta.json.JsonValue;
 
 import com.ibm.fhir.model.parser.exception.FHIRParserException;
 import com.ibm.fhir.model.resource.*;
@@ -39,14 +43,13 @@
 import com.ibm.fhir.model.type.Integer;
 import com.ibm.fhir.model.type.String;
 import com.ibm.fhir.model.util.ElementFilter;
-
 import net.jcip.annotations.NotThreadSafe;
 
 @NotThreadSafe
 @Generated("com.ibm.fhir.tools.CodeGenerator")
 public class FHIRJsonParser extends FHIRAbstractParser {
     public static boolean DEBUG = false;
-    private static final JsonReaderFactory JSON_READER_FACTORY = Json.createReaderFactory(null);
+    private static final JsonReaderFactory JSON_READER_FACTORY = Json.createReaderFactory(Collections.singletonMap(JsonConfig.REJECT_DUPLICATE_KEYS, true));
 
     private final Stack<java.lang.String> stack = new Stack<>();
 
@@ -109,14 +112,6 @@ private void reset() {
         stack.clear();
     }
 
-    @Override
-    public boolean isPropertySupported(java.lang.String name) {
-        if (FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS.equals(name)) {
-            return true;
-        }
-        return false;
-    }
-
     private Resource parseResource(java.lang.String elementName, JsonObject jsonObject, int elementIndex) {
         if (jsonObject == null) {
             return null;
@@ -424,10 +419,11 @@ private Account parseAccount(java.lang.String elementName, JsonObject jsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Account.class, jsonObject);
         }
         Account.Builder builder = Account.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -469,10 +465,11 @@ private Account.Coverage parseAccountCoverage(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Account.Coverage.class, jsonObject);
         }
         Account.Coverage.Builder builder = Account.Coverage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.coverage(parseReference("coverage", getJsonValue(jsonObject, "coverage", JsonObject.class), -1));
         builder.priority((PositiveInt) parseInteger(PositiveInt.builder(), "priority", getJsonValue(jsonObject, "priority", JsonNumber.class), jsonObject.get("_priority"), -1));
@@ -485,10 +482,11 @@ private Account.Guarantor parseAccountGuarantor(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Account.Guarantor.class, jsonObject);
         }
         Account.Guarantor.Builder builder = Account.Guarantor.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.party(parseReference("party", getJsonValue(jsonObject, "party", JsonObject.class), -1));
         builder.onHold(parseBoolean("onHold", getJsonValue(jsonObject, "onHold", JsonValue.class), jsonObject.get("_onHold"), -1));
@@ -502,10 +500,11 @@ private ActivityDefinition parseActivityDefinition(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ActivityDefinition.class, jsonObject);
         }
         ActivityDefinition.Builder builder = ActivityDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -653,10 +652,11 @@ private ActivityDefinition.DynamicValue parseActivityDefinitionDynamicValue(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ActivityDefinition.DynamicValue.class, jsonObject);
         }
         ActivityDefinition.DynamicValue.Builder builder = ActivityDefinition.DynamicValue.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.path(parseString("path", getJsonValue(jsonObject, "path", JsonString.class), jsonObject.get("_path"), -1));
         builder.expression(parseExpression("expression", getJsonValue(jsonObject, "expression", JsonObject.class), -1));
@@ -669,10 +669,11 @@ private ActivityDefinition.Participant parseActivityDefinitionParticipant(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ActivityDefinition.Participant.class, jsonObject);
         }
         ActivityDefinition.Participant.Builder builder = ActivityDefinition.Participant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((ActivityParticipantType) parseString(ActivityParticipantType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.role(parseCodeableConcept("role", getJsonValue(jsonObject, "role", JsonObject.class), -1));
@@ -685,10 +686,11 @@ private Address parseAddress(java.lang.String elementName, JsonObject jsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Address.class, jsonObject);
         }
         Address.Builder builder = Address.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.use((AddressUse) parseString(AddressUse.builder(), "use", getJsonValue(jsonObject, "use", JsonString.class), jsonObject.get("_use"), -1));
         builder.type((AddressType) parseString(AddressType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -715,10 +717,11 @@ private AdverseEvent parseAdverseEvent(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AdverseEvent.class, jsonObject);
         }
         AdverseEvent.Builder builder = AdverseEvent.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.actuality((AdverseEventActuality) parseString(AdverseEventActuality.builder(), "actuality", getJsonValue(jsonObject, "actuality", JsonString.class), jsonObject.get("_actuality"), -1));
@@ -784,10 +787,11 @@ private AdverseEvent.SuspectEntity parseAdverseEventSuspectEntity(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AdverseEvent.SuspectEntity.class, jsonObject);
         }
         AdverseEvent.SuspectEntity.Builder builder = AdverseEvent.SuspectEntity.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.instance(parseReference("instance", getJsonValue(jsonObject, "instance", JsonObject.class), -1));
         JsonArray causalityArray = getJsonArray(jsonObject, "causality");
@@ -805,10 +809,11 @@ private AdverseEvent.SuspectEntity.Causality parseAdverseEventSuspectEntityCausa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AdverseEvent.SuspectEntity.Causality.class, jsonObject);
         }
         AdverseEvent.SuspectEntity.Causality.Builder builder = AdverseEvent.SuspectEntity.Causality.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.assessment(parseCodeableConcept("assessment", getJsonValue(jsonObject, "assessment", JsonObject.class), -1));
         builder.productRelatedness(parseString("productRelatedness", getJsonValue(jsonObject, "productRelatedness", JsonString.class), jsonObject.get("_productRelatedness"), -1));
@@ -823,10 +828,11 @@ private AllergyIntolerance parseAllergyIntolerance(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AllergyIntolerance.class, jsonObject);
         }
         AllergyIntolerance.Builder builder = AllergyIntolerance.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -874,10 +880,11 @@ private AllergyIntolerance.Reaction parseAllergyIntoleranceReaction(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AllergyIntolerance.Reaction.class, jsonObject);
         }
         AllergyIntolerance.Reaction.Builder builder = AllergyIntolerance.Reaction.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.substance(parseCodeableConcept("substance", getJsonValue(jsonObject, "substance", JsonObject.class), -1));
         JsonArray manifestationArray = getJsonArray(jsonObject, "manifestation");
@@ -905,10 +912,11 @@ private Annotation parseAnnotation(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Annotation.class, jsonObject);
         }
         Annotation.Builder builder = Annotation.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.author(parseChoiceElement("author", jsonObject, Reference.class, String.class));
         builder.time(parseDateTime("time", getJsonValue(jsonObject, "time", JsonString.class), jsonObject.get("_time"), -1));
@@ -922,10 +930,11 @@ private Appointment parseAppointment(java.lang.String elementName, JsonObject js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Appointment.class, jsonObject);
         }
         Appointment.Builder builder = Appointment.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -1013,10 +1022,11 @@ private Appointment.Participant parseAppointmentParticipant(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Appointment.Participant.class, jsonObject);
         }
         Appointment.Participant.Builder builder = Appointment.Participant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray typeArray = getJsonArray(jsonObject, "type");
         if (typeArray != null) {
@@ -1037,10 +1047,11 @@ private AppointmentResponse parseAppointmentResponse(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AppointmentResponse.class, jsonObject);
         }
         AppointmentResponse.Builder builder = AppointmentResponse.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -1069,10 +1080,11 @@ private Attachment parseAttachment(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Attachment.class, jsonObject);
         }
         Attachment.Builder builder = Attachment.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.contentType((Code) parseString(Code.builder(), "contentType", getJsonValue(jsonObject, "contentType", JsonString.class), jsonObject.get("_contentType"), -1));
         builder.language((Code) parseString(Code.builder(), "language", getJsonValue(jsonObject, "language", JsonString.class), jsonObject.get("_language"), -1));
@@ -1091,10 +1103,11 @@ private AuditEvent parseAuditEvent(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AuditEvent.class, jsonObject);
         }
         AuditEvent.Builder builder = AuditEvent.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.type(parseCoding("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray subtypeArray = getJsonArray(jsonObject, "subtype");
@@ -1136,10 +1149,11 @@ private AuditEvent.Agent parseAuditEventAgent(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AuditEvent.Agent.class, jsonObject);
         }
         AuditEvent.Agent.Builder builder = AuditEvent.Agent.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray roleArray = getJsonArray(jsonObject, "role");
@@ -1177,10 +1191,11 @@ private AuditEvent.Agent.Network parseAuditEventAgentNetwork(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AuditEvent.Agent.Network.class, jsonObject);
         }
         AuditEvent.Agent.Network.Builder builder = AuditEvent.Agent.Network.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.address(parseString("address", getJsonValue(jsonObject, "address", JsonString.class), jsonObject.get("_address"), -1));
         builder.type((AuditEventAgentNetworkType) parseString(AuditEventAgentNetworkType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -1193,10 +1208,11 @@ private AuditEvent.Entity parseAuditEventEntity(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AuditEvent.Entity.class, jsonObject);
         }
         AuditEvent.Entity.Builder builder = AuditEvent.Entity.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.what(parseReference("what", getJsonValue(jsonObject, "what", JsonObject.class), -1));
         builder.type(parseCoding("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -1226,10 +1242,11 @@ private AuditEvent.Entity.Detail parseAuditEventEntityDetail(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AuditEvent.Entity.Detail.class, jsonObject);
         }
         AuditEvent.Entity.Detail.Builder builder = AuditEvent.Entity.Detail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseString("type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.value(parseChoiceElement("value", jsonObject, String.class, Base64Binary.class));
@@ -1242,10 +1259,11 @@ private AuditEvent.Source parseAuditEventSource(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(AuditEvent.Source.class, jsonObject);
         }
         AuditEvent.Source.Builder builder = AuditEvent.Source.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.site(parseString("site", getJsonValue(jsonObject, "site", JsonString.class), jsonObject.get("_site"), -1));
         builder.observer(parseReference("observer", getJsonValue(jsonObject, "observer", JsonObject.class), -1));
@@ -1260,6 +1278,7 @@ private AuditEvent.Source parseAuditEventSource(java.lang.String elementName, Js
     }
 
     private void parseBackboneElement(BackboneElement.Builder builder, JsonObject jsonObject) {
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         JsonArray modifierExtensionArray = getJsonArray(jsonObject, "modifierExtension");
         if (modifierExtensionArray != null) {
@@ -1275,9 +1294,10 @@ private Base64Binary parseBase64Binary(java.lang.String elementName, JsonValue j
         }
         stackPush(elementName, elementIndex);
         Base64Binary.Builder builder = Base64Binary.builder();
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -1299,10 +1319,11 @@ private Basic parseBasic(java.lang.String elementName, JsonObject jsonObject, in
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Basic.class, jsonObject);
         }
         Basic.Builder builder = Basic.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -1323,10 +1344,11 @@ private Binary parseBinary(java.lang.String elementName, JsonObject jsonObject,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Binary.class, jsonObject);
         }
         Binary.Builder builder = Binary.builder();
+        builder.setValidating(validating);
         parseResource(builder, jsonObject);
         builder.contentType((Code) parseString(Code.builder(), "contentType", getJsonValue(jsonObject, "contentType", JsonString.class), jsonObject.get("_contentType"), -1));
         builder.securityContext(parseReference("securityContext", getJsonValue(jsonObject, "securityContext", JsonObject.class), -1));
@@ -1340,10 +1362,11 @@ private BiologicallyDerivedProduct parseBiologicallyDerivedProduct(java.lang.Str
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(BiologicallyDerivedProduct.class, jsonObject);
         }
         BiologicallyDerivedProduct.Builder builder = BiologicallyDerivedProduct.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -1390,10 +1413,11 @@ private BiologicallyDerivedProduct.Collection parseBiologicallyDerivedProductCol
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(BiologicallyDerivedProduct.Collection.class, jsonObject);
         }
         BiologicallyDerivedProduct.Collection.Builder builder = BiologicallyDerivedProduct.Collection.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.collector(parseReference("collector", getJsonValue(jsonObject, "collector", JsonObject.class), -1));
         builder.source(parseReference("source", getJsonValue(jsonObject, "source", JsonObject.class), -1));
@@ -1407,10 +1431,11 @@ private BiologicallyDerivedProduct.Manipulation parseBiologicallyDerivedProductM
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(BiologicallyDerivedProduct.Manipulation.class, jsonObject);
         }
         BiologicallyDerivedProduct.Manipulation.Builder builder = BiologicallyDerivedProduct.Manipulation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.time(parseChoiceElement("time", jsonObject, DateTime.class, Period.class));
@@ -1423,10 +1448,11 @@ private BiologicallyDerivedProduct.Processing parseBiologicallyDerivedProductPro
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(BiologicallyDerivedProduct.Processing.class, jsonObject);
         }
         BiologicallyDerivedProduct.Processing.Builder builder = BiologicallyDerivedProduct.Processing.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.procedure(parseCodeableConcept("procedure", getJsonValue(jsonObject, "procedure", JsonObject.class), -1));
@@ -1441,10 +1467,11 @@ private BiologicallyDerivedProduct.Storage parseBiologicallyDerivedProductStorag
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(BiologicallyDerivedProduct.Storage.class, jsonObject);
         }
         BiologicallyDerivedProduct.Storage.Builder builder = BiologicallyDerivedProduct.Storage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.temperature(parseDecimal("temperature", getJsonValue(jsonObject, "temperature", JsonNumber.class), jsonObject.get("_temperature"), -1));
@@ -1459,10 +1486,11 @@ private BodyStructure parseBodyStructure(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(BodyStructure.class, jsonObject);
         }
         BodyStructure.Builder builder = BodyStructure.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -1497,9 +1525,10 @@ private Boolean parseBoolean(java.lang.String elementName, JsonValue jsonValue,
         }
         stackPush(elementName, elementIndex);
         Boolean.Builder builder = Boolean.builder();
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -1520,10 +1549,11 @@ private Bundle parseBundle(java.lang.String elementName, JsonObject jsonObject,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Bundle.class, jsonObject);
         }
         Bundle.Builder builder = Bundle.builder();
+        builder.setValidating(validating);
         parseResource(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.type((BundleType) parseString(BundleType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -1551,10 +1581,11 @@ private Bundle.Entry parseBundleEntry(java.lang.String elementName, JsonObject j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Bundle.Entry.class, jsonObject);
         }
         Bundle.Entry.Builder builder = Bundle.Entry.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray linkArray = getJsonArray(jsonObject, "link");
         if (linkArray != null) {
@@ -1576,10 +1607,11 @@ private Bundle.Entry.Request parseBundleEntryRequest(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Bundle.Entry.Request.class, jsonObject);
         }
         Bundle.Entry.Request.Builder builder = Bundle.Entry.Request.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.method((HTTPVerb) parseString(HTTPVerb.builder(), "method", getJsonValue(jsonObject, "method", JsonString.class), jsonObject.get("_method"), -1));
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
@@ -1596,10 +1628,11 @@ private Bundle.Entry.Response parseBundleEntryResponse(java.lang.String elementN
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Bundle.Entry.Response.class, jsonObject);
         }
         Bundle.Entry.Response.Builder builder = Bundle.Entry.Response.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.status(parseString("status", getJsonValue(jsonObject, "status", JsonString.class), jsonObject.get("_status"), -1));
         builder.location(parseUri("location", getJsonValue(jsonObject, "location", JsonString.class), jsonObject.get("_location"), -1));
@@ -1615,10 +1648,11 @@ private Bundle.Entry.Search parseBundleEntrySearch(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Bundle.Entry.Search.class, jsonObject);
         }
         Bundle.Entry.Search.Builder builder = Bundle.Entry.Search.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.mode((SearchEntryMode) parseString(SearchEntryMode.builder(), "mode", getJsonValue(jsonObject, "mode", JsonString.class), jsonObject.get("_mode"), -1));
         builder.score(parseDecimal("score", getJsonValue(jsonObject, "score", JsonNumber.class), jsonObject.get("_score"), -1));
@@ -1631,10 +1665,11 @@ private Bundle.Link parseBundleLink(java.lang.String elementName, JsonObject jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Bundle.Link.class, jsonObject);
         }
         Bundle.Link.Builder builder = Bundle.Link.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.relation(parseString("relation", getJsonValue(jsonObject, "relation", JsonString.class), jsonObject.get("_relation"), -1));
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
@@ -1647,10 +1682,11 @@ private CapabilityStatement parseCapabilityStatement(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.class, jsonObject);
         }
         CapabilityStatement.Builder builder = CapabilityStatement.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -1747,10 +1783,11 @@ private CapabilityStatement.Document parseCapabilityStatementDocument(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Document.class, jsonObject);
         }
         CapabilityStatement.Document.Builder builder = CapabilityStatement.Document.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.mode((DocumentMode) parseString(DocumentMode.builder(), "mode", getJsonValue(jsonObject, "mode", JsonString.class), jsonObject.get("_mode"), -1));
         builder.documentation((Markdown) parseString(Markdown.builder(), "documentation", getJsonValue(jsonObject, "documentation", JsonString.class), jsonObject.get("_documentation"), -1));
@@ -1764,10 +1801,11 @@ private CapabilityStatement.Implementation parseCapabilityStatementImplementatio
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Implementation.class, jsonObject);
         }
         CapabilityStatement.Implementation.Builder builder = CapabilityStatement.Implementation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.url((Url) parseUri(Url.builder(), "url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
@@ -1781,10 +1819,11 @@ private CapabilityStatement.Messaging parseCapabilityStatementMessaging(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Messaging.class, jsonObject);
         }
         CapabilityStatement.Messaging.Builder builder = CapabilityStatement.Messaging.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray endpointArray = getJsonArray(jsonObject, "endpoint");
         if (endpointArray != null) {
@@ -1809,10 +1848,11 @@ private CapabilityStatement.Messaging.Endpoint parseCapabilityStatementMessaging
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Messaging.Endpoint.class, jsonObject);
         }
         CapabilityStatement.Messaging.Endpoint.Builder builder = CapabilityStatement.Messaging.Endpoint.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.protocol(parseCoding("protocol", getJsonValue(jsonObject, "protocol", JsonObject.class), -1));
         builder.address((Url) parseUri(Url.builder(), "address", getJsonValue(jsonObject, "address", JsonString.class), jsonObject.get("_address"), -1));
@@ -1825,10 +1865,11 @@ private CapabilityStatement.Messaging.SupportedMessage parseCapabilityStatementM
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Messaging.SupportedMessage.class, jsonObject);
         }
         CapabilityStatement.Messaging.SupportedMessage.Builder builder = CapabilityStatement.Messaging.SupportedMessage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.mode((EventCapabilityMode) parseString(EventCapabilityMode.builder(), "mode", getJsonValue(jsonObject, "mode", JsonString.class), jsonObject.get("_mode"), -1));
         builder.definition((Canonical) parseUri(Canonical.builder(), "definition", getJsonValue(jsonObject, "definition", JsonString.class), jsonObject.get("_definition"), -1));
@@ -1841,10 +1882,11 @@ private CapabilityStatement.Rest parseCapabilityStatementRest(java.lang.String e
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Rest.class, jsonObject);
         }
         CapabilityStatement.Rest.Builder builder = CapabilityStatement.Rest.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.mode((RestfulCapabilityMode) parseString(RestfulCapabilityMode.builder(), "mode", getJsonValue(jsonObject, "mode", JsonString.class), jsonObject.get("_mode"), -1));
         builder.documentation((Markdown) parseString(Markdown.builder(), "documentation", getJsonValue(jsonObject, "documentation", JsonString.class), jsonObject.get("_documentation"), -1));
@@ -1889,10 +1931,11 @@ private CapabilityStatement.Rest.Interaction parseCapabilityStatementRestInterac
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Rest.Interaction.class, jsonObject);
         }
         CapabilityStatement.Rest.Interaction.Builder builder = CapabilityStatement.Rest.Interaction.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((SystemRestfulInteraction) parseString(SystemRestfulInteraction.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.documentation((Markdown) parseString(Markdown.builder(), "documentation", getJsonValue(jsonObject, "documentation", JsonString.class), jsonObject.get("_documentation"), -1));
@@ -1905,10 +1948,11 @@ private CapabilityStatement.Rest.Resource parseCapabilityStatementRestResource(j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Rest.Resource.class, jsonObject);
         }
         CapabilityStatement.Rest.Resource.Builder builder = CapabilityStatement.Rest.Resource.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((ResourceType) parseString(ResourceType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.profile((Canonical) parseUri(Canonical.builder(), "profile", getJsonValue(jsonObject, "profile", JsonString.class), jsonObject.get("_profile"), -1));
@@ -1975,10 +2019,11 @@ private CapabilityStatement.Rest.Resource.Interaction parseCapabilityStatementRe
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Rest.Resource.Interaction.class, jsonObject);
         }
         CapabilityStatement.Rest.Resource.Interaction.Builder builder = CapabilityStatement.Rest.Resource.Interaction.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((TypeRestfulInteraction) parseString(TypeRestfulInteraction.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.documentation((Markdown) parseString(Markdown.builder(), "documentation", getJsonValue(jsonObject, "documentation", JsonString.class), jsonObject.get("_documentation"), -1));
@@ -1991,10 +2036,11 @@ private CapabilityStatement.Rest.Resource.Operation parseCapabilityStatementRest
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Rest.Resource.Operation.class, jsonObject);
         }
         CapabilityStatement.Rest.Resource.Operation.Builder builder = CapabilityStatement.Rest.Resource.Operation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.definition((Canonical) parseUri(Canonical.builder(), "definition", getJsonValue(jsonObject, "definition", JsonString.class), jsonObject.get("_definition"), -1));
@@ -2008,10 +2054,11 @@ private CapabilityStatement.Rest.Resource.SearchParam parseCapabilityStatementRe
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Rest.Resource.SearchParam.class, jsonObject);
         }
         CapabilityStatement.Rest.Resource.SearchParam.Builder builder = CapabilityStatement.Rest.Resource.SearchParam.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.definition((Canonical) parseUri(Canonical.builder(), "definition", getJsonValue(jsonObject, "definition", JsonString.class), jsonObject.get("_definition"), -1));
@@ -2026,10 +2073,11 @@ private CapabilityStatement.Rest.Security parseCapabilityStatementRestSecurity(j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Rest.Security.class, jsonObject);
         }
         CapabilityStatement.Rest.Security.Builder builder = CapabilityStatement.Rest.Security.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.cors(parseBoolean("cors", getJsonValue(jsonObject, "cors", JsonValue.class), jsonObject.get("_cors"), -1));
         JsonArray serviceArray = getJsonArray(jsonObject, "service");
@@ -2048,10 +2096,11 @@ private CapabilityStatement.Software parseCapabilityStatementSoftware(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CapabilityStatement.Software.class, jsonObject);
         }
         CapabilityStatement.Software.Builder builder = CapabilityStatement.Software.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -2065,10 +2114,11 @@ private CarePlan parseCarePlan(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CarePlan.class, jsonObject);
         }
         CarePlan.Builder builder = CarePlan.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -2174,10 +2224,11 @@ private CarePlan.Activity parseCarePlanActivity(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CarePlan.Activity.class, jsonObject);
         }
         CarePlan.Activity.Builder builder = CarePlan.Activity.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray outcomeCodeableConceptArray = getJsonArray(jsonObject, "outcomeCodeableConcept");
         if (outcomeCodeableConceptArray != null) {
@@ -2208,10 +2259,11 @@ private CarePlan.Activity.Detail parseCarePlanActivityDetail(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CarePlan.Activity.Detail.class, jsonObject);
         }
         CarePlan.Activity.Detail.Builder builder = CarePlan.Activity.Detail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.kind((CarePlanActivityKind) parseString(CarePlanActivityKind.builder(), "kind", getJsonValue(jsonObject, "kind", JsonString.class), jsonObject.get("_kind"), -1));
         JsonArray instantiatesCanonicalArray = getJsonArray(jsonObject, "instantiatesCanonical", true);
@@ -2271,10 +2323,11 @@ private CareTeam parseCareTeam(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CareTeam.class, jsonObject);
         }
         CareTeam.Builder builder = CareTeam.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -2338,10 +2391,11 @@ private CareTeam.Participant parseCareTeamParticipant(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CareTeam.Participant.class, jsonObject);
         }
         CareTeam.Participant.Builder builder = CareTeam.Participant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray roleArray = getJsonArray(jsonObject, "role");
         if (roleArray != null) {
@@ -2361,10 +2415,11 @@ private CatalogEntry parseCatalogEntry(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CatalogEntry.class, jsonObject);
         }
         CatalogEntry.Builder builder = CatalogEntry.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -2418,10 +2473,11 @@ private CatalogEntry.RelatedEntry parseCatalogEntryRelatedEntry(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CatalogEntry.RelatedEntry.class, jsonObject);
         }
         CatalogEntry.RelatedEntry.Builder builder = CatalogEntry.RelatedEntry.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.relationtype((CatalogEntryRelationType) parseString(CatalogEntryRelationType.builder(), "relationtype", getJsonValue(jsonObject, "relationtype", JsonString.class), jsonObject.get("_relationtype"), -1));
         builder.item(parseReference("item", getJsonValue(jsonObject, "item", JsonObject.class), -1));
@@ -2434,10 +2490,11 @@ private ChargeItem parseChargeItem(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ChargeItem.class, jsonObject);
         }
         ChargeItem.Builder builder = ChargeItem.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -2531,10 +2588,11 @@ private ChargeItem.Performer parseChargeItemPerformer(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ChargeItem.Performer.class, jsonObject);
         }
         ChargeItem.Performer.Builder builder = ChargeItem.Performer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.function(parseCodeableConcept("function", getJsonValue(jsonObject, "function", JsonObject.class), -1));
         builder.actor(parseReference("actor", getJsonValue(jsonObject, "actor", JsonObject.class), -1));
@@ -2547,10 +2605,11 @@ private ChargeItemDefinition parseChargeItemDefinition(java.lang.String elementN
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ChargeItemDefinition.class, jsonObject);
         }
         ChargeItemDefinition.Builder builder = ChargeItemDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -2637,10 +2696,11 @@ private ChargeItemDefinition.Applicability parseChargeItemDefinitionApplicabilit
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ChargeItemDefinition.Applicability.class, jsonObject);
         }
         ChargeItemDefinition.Applicability.Builder builder = ChargeItemDefinition.Applicability.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.language(parseString("language", getJsonValue(jsonObject, "language", JsonString.class), jsonObject.get("_language"), -1));
@@ -2654,10 +2714,11 @@ private ChargeItemDefinition.PropertyGroup parseChargeItemDefinitionPropertyGrou
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ChargeItemDefinition.PropertyGroup.class, jsonObject);
         }
         ChargeItemDefinition.PropertyGroup.Builder builder = ChargeItemDefinition.PropertyGroup.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray applicabilityArray = getJsonArray(jsonObject, "applicability");
         if (applicabilityArray != null) {
@@ -2680,10 +2741,11 @@ private ChargeItemDefinition.PropertyGroup.PriceComponent parseChargeItemDefinit
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ChargeItemDefinition.PropertyGroup.PriceComponent.class, jsonObject);
         }
         ChargeItemDefinition.PropertyGroup.PriceComponent.Builder builder = ChargeItemDefinition.PropertyGroup.PriceComponent.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((ChargeItemDefinitionPriceComponentType) parseString(ChargeItemDefinitionPriceComponentType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
@@ -2698,10 +2760,11 @@ private Claim parseClaim(java.lang.String elementName, JsonObject jsonObject, in
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.class, jsonObject);
         }
         Claim.Builder builder = Claim.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -2779,10 +2842,11 @@ private Claim.Accident parseClaimAccident(java.lang.String elementName, JsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.Accident.class, jsonObject);
         }
         Claim.Accident.Builder builder = Claim.Accident.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.date(parseDate("date", getJsonValue(jsonObject, "date", JsonString.class), jsonObject.get("_date"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -2796,10 +2860,11 @@ private Claim.CareTeam parseClaimCareTeam(java.lang.String elementName, JsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.CareTeam.class, jsonObject);
         }
         Claim.CareTeam.Builder builder = Claim.CareTeam.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.provider(parseReference("provider", getJsonValue(jsonObject, "provider", JsonObject.class), -1));
@@ -2815,10 +2880,11 @@ private Claim.Diagnosis parseClaimDiagnosis(java.lang.String elementName, JsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.Diagnosis.class, jsonObject);
         }
         Claim.Diagnosis.Builder builder = Claim.Diagnosis.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.diagnosis(parseChoiceElement("diagnosis", jsonObject, CodeableConcept.class, Reference.class));
@@ -2839,10 +2905,11 @@ private Claim.Insurance parseClaimInsurance(java.lang.String elementName, JsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.Insurance.class, jsonObject);
         }
         Claim.Insurance.Builder builder = Claim.Insurance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.focal(parseBoolean("focal", getJsonValue(jsonObject, "focal", JsonValue.class), jsonObject.get("_focal"), -1));
@@ -2866,10 +2933,11 @@ private Claim.Item parseClaimItem(java.lang.String elementName, JsonObject jsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.Item.class, jsonObject);
         }
         Claim.Item.Builder builder = Claim.Item.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         JsonArray careTeamSequenceArray = getJsonArray(jsonObject, "careTeamSequence", true);
@@ -2955,10 +3023,11 @@ private Claim.Item.Detail parseClaimItemDetail(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.Item.Detail.class, jsonObject);
         }
         Claim.Item.Detail.Builder builder = Claim.Item.Detail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.revenue(parseCodeableConcept("revenue", getJsonValue(jsonObject, "revenue", JsonObject.class), -1));
@@ -3001,10 +3070,11 @@ private Claim.Item.Detail.SubDetail parseClaimItemDetailSubDetail(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.Item.Detail.SubDetail.class, jsonObject);
         }
         Claim.Item.Detail.SubDetail.Builder builder = Claim.Item.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.revenue(parseCodeableConcept("revenue", getJsonValue(jsonObject, "revenue", JsonObject.class), -1));
@@ -3041,10 +3111,11 @@ private Claim.Payee parseClaimPayee(java.lang.String elementName, JsonObject jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.Payee.class, jsonObject);
         }
         Claim.Payee.Builder builder = Claim.Payee.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.party(parseReference("party", getJsonValue(jsonObject, "party", JsonObject.class), -1));
@@ -3057,10 +3128,11 @@ private Claim.Procedure parseClaimProcedure(java.lang.String elementName, JsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.Procedure.class, jsonObject);
         }
         Claim.Procedure.Builder builder = Claim.Procedure.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         JsonArray typeArray = getJsonArray(jsonObject, "type");
@@ -3086,10 +3158,11 @@ private Claim.Related parseClaimRelated(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.Related.class, jsonObject);
         }
         Claim.Related.Builder builder = Claim.Related.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.claim(parseReference("claim", getJsonValue(jsonObject, "claim", JsonObject.class), -1));
         builder.relationship(parseCodeableConcept("relationship", getJsonValue(jsonObject, "relationship", JsonObject.class), -1));
@@ -3103,10 +3176,11 @@ private Claim.SupportingInfo parseClaimSupportingInfo(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Claim.SupportingInfo.class, jsonObject);
         }
         Claim.SupportingInfo.Builder builder = Claim.SupportingInfo.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
@@ -3123,10 +3197,11 @@ private ClaimResponse parseClaimResponse(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.class, jsonObject);
         }
         ClaimResponse.Builder builder = ClaimResponse.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -3209,10 +3284,11 @@ private ClaimResponse.AddItem parseClaimResponseAddItem(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.AddItem.class, jsonObject);
         }
         ClaimResponse.AddItem.Builder builder = ClaimResponse.AddItem.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray itemSequenceArray = getJsonArray(jsonObject, "itemSequence", true);
         if (itemSequenceArray != null) {
@@ -3295,10 +3371,11 @@ private ClaimResponse.AddItem.Detail parseClaimResponseAddItemDetail(java.lang.S
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.AddItem.Detail.class, jsonObject);
         }
         ClaimResponse.AddItem.Detail.Builder builder = ClaimResponse.AddItem.Detail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.productOrService(parseCodeableConcept("productOrService", getJsonValue(jsonObject, "productOrService", JsonObject.class), -1));
         JsonArray modifierArray = getJsonArray(jsonObject, "modifier");
@@ -3339,10 +3416,11 @@ private ClaimResponse.AddItem.Detail.SubDetail parseClaimResponseAddItemDetailSu
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.AddItem.Detail.SubDetail.class, jsonObject);
         }
         ClaimResponse.AddItem.Detail.SubDetail.Builder builder = ClaimResponse.AddItem.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.productOrService(parseCodeableConcept("productOrService", getJsonValue(jsonObject, "productOrService", JsonObject.class), -1));
         JsonArray modifierArray = getJsonArray(jsonObject, "modifier");
@@ -3377,10 +3455,11 @@ private ClaimResponse.Error parseClaimResponseError(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.Error.class, jsonObject);
         }
         ClaimResponse.Error.Builder builder = ClaimResponse.Error.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.itemSequence((PositiveInt) parseInteger(PositiveInt.builder(), "itemSequence", getJsonValue(jsonObject, "itemSequence", JsonNumber.class), jsonObject.get("_itemSequence"), -1));
         builder.detailSequence((PositiveInt) parseInteger(PositiveInt.builder(), "detailSequence", getJsonValue(jsonObject, "detailSequence", JsonNumber.class), jsonObject.get("_detailSequence"), -1));
@@ -3395,10 +3474,11 @@ private ClaimResponse.Insurance parseClaimResponseInsurance(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.Insurance.class, jsonObject);
         }
         ClaimResponse.Insurance.Builder builder = ClaimResponse.Insurance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.focal(parseBoolean("focal", getJsonValue(jsonObject, "focal", JsonValue.class), jsonObject.get("_focal"), -1));
@@ -3414,10 +3494,11 @@ private ClaimResponse.Item parseClaimResponseItem(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.Item.class, jsonObject);
         }
         ClaimResponse.Item.Builder builder = ClaimResponse.Item.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.itemSequence((PositiveInt) parseInteger(PositiveInt.builder(), "itemSequence", getJsonValue(jsonObject, "itemSequence", JsonNumber.class), jsonObject.get("_itemSequence"), -1));
         JsonArray noteNumberArray = getJsonArray(jsonObject, "noteNumber", true);
@@ -3448,10 +3529,11 @@ private ClaimResponse.Item.Adjudication parseClaimResponseItemAdjudication(java.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.Item.Adjudication.class, jsonObject);
         }
         ClaimResponse.Item.Adjudication.Builder builder = ClaimResponse.Item.Adjudication.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
         builder.reason(parseCodeableConcept("reason", getJsonValue(jsonObject, "reason", JsonObject.class), -1));
@@ -3466,10 +3548,11 @@ private ClaimResponse.Item.Detail parseClaimResponseItemDetail(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.Item.Detail.class, jsonObject);
         }
         ClaimResponse.Item.Detail.Builder builder = ClaimResponse.Item.Detail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.detailSequence((PositiveInt) parseInteger(PositiveInt.builder(), "detailSequence", getJsonValue(jsonObject, "detailSequence", JsonNumber.class), jsonObject.get("_detailSequence"), -1));
         JsonArray noteNumberArray = getJsonArray(jsonObject, "noteNumber", true);
@@ -3500,10 +3583,11 @@ private ClaimResponse.Item.Detail.SubDetail parseClaimResponseItemDetailSubDetai
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.Item.Detail.SubDetail.class, jsonObject);
         }
         ClaimResponse.Item.Detail.SubDetail.Builder builder = ClaimResponse.Item.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.subDetailSequence((PositiveInt) parseInteger(PositiveInt.builder(), "subDetailSequence", getJsonValue(jsonObject, "subDetailSequence", JsonNumber.class), jsonObject.get("_subDetailSequence"), -1));
         JsonArray noteNumberArray = getJsonArray(jsonObject, "noteNumber", true);
@@ -3528,10 +3612,11 @@ private ClaimResponse.Payment parseClaimResponsePayment(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.Payment.class, jsonObject);
         }
         ClaimResponse.Payment.Builder builder = ClaimResponse.Payment.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.adjustment(parseMoney("adjustment", getJsonValue(jsonObject, "adjustment", JsonObject.class), -1));
@@ -3548,10 +3633,11 @@ private ClaimResponse.ProcessNote parseClaimResponseProcessNote(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.ProcessNote.class, jsonObject);
         }
         ClaimResponse.ProcessNote.Builder builder = ClaimResponse.ProcessNote.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.number((PositiveInt) parseInteger(PositiveInt.builder(), "number", getJsonValue(jsonObject, "number", JsonNumber.class), jsonObject.get("_number"), -1));
         builder.type((NoteType) parseString(NoteType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -3566,10 +3652,11 @@ private ClaimResponse.Total parseClaimResponseTotal(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClaimResponse.Total.class, jsonObject);
         }
         ClaimResponse.Total.Builder builder = ClaimResponse.Total.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
         builder.amount(parseMoney("amount", getJsonValue(jsonObject, "amount", JsonObject.class), -1));
@@ -3582,10 +3669,11 @@ private ClinicalImpression parseClinicalImpression(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClinicalImpression.class, jsonObject);
         }
         ClinicalImpression.Builder builder = ClinicalImpression.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -3662,10 +3750,11 @@ private ClinicalImpression.Finding parseClinicalImpressionFinding(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClinicalImpression.Finding.class, jsonObject);
         }
         ClinicalImpression.Finding.Builder builder = ClinicalImpression.Finding.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.itemCodeableConcept(parseCodeableConcept("itemCodeableConcept", getJsonValue(jsonObject, "itemCodeableConcept", JsonObject.class), -1));
         builder.itemReference(parseReference("itemReference", getJsonValue(jsonObject, "itemReference", JsonObject.class), -1));
@@ -3679,10 +3768,11 @@ private ClinicalImpression.Investigation parseClinicalImpressionInvestigation(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ClinicalImpression.Investigation.class, jsonObject);
         }
         ClinicalImpression.Investigation.Builder builder = ClinicalImpression.Investigation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         JsonArray itemArray = getJsonArray(jsonObject, "item");
@@ -3700,10 +3790,11 @@ private CodeSystem parseCodeSystem(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CodeSystem.class, jsonObject);
         }
         CodeSystem.Builder builder = CodeSystem.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -3775,10 +3866,11 @@ private CodeSystem.Concept parseCodeSystemConcept(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CodeSystem.Concept.class, jsonObject);
         }
         CodeSystem.Concept.Builder builder = CodeSystem.Concept.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.display(parseString("display", getJsonValue(jsonObject, "display", JsonString.class), jsonObject.get("_display"), -1));
@@ -3810,10 +3902,11 @@ private CodeSystem.Concept.Designation parseCodeSystemConceptDesignation(java.la
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CodeSystem.Concept.Designation.class, jsonObject);
         }
         CodeSystem.Concept.Designation.Builder builder = CodeSystem.Concept.Designation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.language((Code) parseString(Code.builder(), "language", getJsonValue(jsonObject, "language", JsonString.class), jsonObject.get("_language"), -1));
         builder.use(parseCoding("use", getJsonValue(jsonObject, "use", JsonObject.class), -1));
@@ -3827,10 +3920,11 @@ private CodeSystem.Concept.Property parseCodeSystemConceptProperty(java.lang.Str
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CodeSystem.Concept.Property.class, jsonObject);
         }
         CodeSystem.Concept.Property.Builder builder = CodeSystem.Concept.Property.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.value(parseChoiceElement("value", jsonObject, Code.class, Coding.class, String.class, Integer.class, Boolean.class, DateTime.class, Decimal.class));
@@ -3843,10 +3937,11 @@ private CodeSystem.Filter parseCodeSystemFilter(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CodeSystem.Filter.class, jsonObject);
         }
         CodeSystem.Filter.Builder builder = CodeSystem.Filter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -3867,10 +3962,11 @@ private CodeSystem.Property parseCodeSystemProperty(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CodeSystem.Property.class, jsonObject);
         }
         CodeSystem.Property.Builder builder = CodeSystem.Property.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.uri(parseUri("uri", getJsonValue(jsonObject, "uri", JsonString.class), jsonObject.get("_uri"), -1));
@@ -3885,10 +3981,11 @@ private CodeableConcept parseCodeableConcept(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CodeableConcept.class, jsonObject);
         }
         CodeableConcept.Builder builder = CodeableConcept.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         JsonArray codingArray = getJsonArray(jsonObject, "coding");
         if (codingArray != null) {
@@ -3906,10 +4003,11 @@ private Coding parseCoding(java.lang.String elementName, JsonObject jsonObject,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Coding.class, jsonObject);
         }
         Coding.Builder builder = Coding.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.system(parseUri("system", getJsonValue(jsonObject, "system", JsonString.class), jsonObject.get("_system"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -3925,10 +4023,11 @@ private Communication parseCommunication(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Communication.class, jsonObject);
         }
         Communication.Builder builder = Communication.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -4034,10 +4133,11 @@ private Communication.Payload parseCommunicationPayload(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Communication.Payload.class, jsonObject);
         }
         Communication.Payload.Builder builder = Communication.Payload.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.content(parseChoiceElement("content", jsonObject, String.class, Attachment.class, Reference.class));
         stackPop();
@@ -4049,10 +4149,11 @@ private CommunicationRequest parseCommunicationRequest(java.lang.String elementN
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CommunicationRequest.class, jsonObject);
         }
         CommunicationRequest.Builder builder = CommunicationRequest.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -4140,10 +4241,11 @@ private CommunicationRequest.Payload parseCommunicationRequestPayload(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CommunicationRequest.Payload.class, jsonObject);
         }
         CommunicationRequest.Payload.Builder builder = CommunicationRequest.Payload.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.content(parseChoiceElement("content", jsonObject, String.class, Attachment.class, Reference.class));
         stackPop();
@@ -4155,10 +4257,11 @@ private CompartmentDefinition parseCompartmentDefinition(java.lang.String elemen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CompartmentDefinition.class, jsonObject);
         }
         CompartmentDefinition.Builder builder = CompartmentDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -4198,10 +4301,11 @@ private CompartmentDefinition.Resource parseCompartmentDefinitionResource(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CompartmentDefinition.Resource.class, jsonObject);
         }
         CompartmentDefinition.Resource.Builder builder = CompartmentDefinition.Resource.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((ResourceType) parseString(ResourceType.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         JsonArray paramArray = getJsonArray(jsonObject, "param", true);
@@ -4221,10 +4325,11 @@ private Composition parseComposition(java.lang.String elementName, JsonObject js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Composition.class, jsonObject);
         }
         Composition.Builder builder = Composition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.status((CompositionStatus) parseString(CompositionStatus.builder(), "status", getJsonValue(jsonObject, "status", JsonString.class), jsonObject.get("_status"), -1));
@@ -4280,10 +4385,11 @@ private Composition.Attester parseCompositionAttester(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Composition.Attester.class, jsonObject);
         }
         Composition.Attester.Builder builder = Composition.Attester.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.mode((CompositionAttestationMode) parseString(CompositionAttestationMode.builder(), "mode", getJsonValue(jsonObject, "mode", JsonString.class), jsonObject.get("_mode"), -1));
         builder.time(parseDateTime("time", getJsonValue(jsonObject, "time", JsonString.class), jsonObject.get("_time"), -1));
@@ -4297,10 +4403,11 @@ private Composition.Event parseCompositionEvent(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Composition.Event.class, jsonObject);
         }
         Composition.Event.Builder builder = Composition.Event.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray codeArray = getJsonArray(jsonObject, "code");
         if (codeArray != null) {
@@ -4324,10 +4431,11 @@ private Composition.RelatesTo parseCompositionRelatesTo(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Composition.RelatesTo.class, jsonObject);
         }
         Composition.RelatesTo.Builder builder = Composition.RelatesTo.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((DocumentRelationshipType) parseString(DocumentRelationshipType.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.target(parseChoiceElement("target", jsonObject, Identifier.class, Reference.class));
@@ -4340,10 +4448,11 @@ private Composition.Section parseCompositionSection(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Composition.Section.class, jsonObject);
         }
         Composition.Section.Builder builder = Composition.Section.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.title(parseString("title", getJsonValue(jsonObject, "title", JsonString.class), jsonObject.get("_title"), -1));
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
@@ -4379,10 +4488,11 @@ private ConceptMap parseConceptMap(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ConceptMap.class, jsonObject);
         }
         ConceptMap.Builder builder = ConceptMap.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
@@ -4431,10 +4541,11 @@ private ConceptMap.Group parseConceptMapGroup(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ConceptMap.Group.class, jsonObject);
         }
         ConceptMap.Group.Builder builder = ConceptMap.Group.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.source(parseUri("source", getJsonValue(jsonObject, "source", JsonString.class), jsonObject.get("_source"), -1));
         builder.sourceVersion(parseString("sourceVersion", getJsonValue(jsonObject, "sourceVersion", JsonString.class), jsonObject.get("_sourceVersion"), -1));
@@ -4456,10 +4567,11 @@ private ConceptMap.Group.Element parseConceptMapGroupElement(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ConceptMap.Group.Element.class, jsonObject);
         }
         ConceptMap.Group.Element.Builder builder = ConceptMap.Group.Element.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.display(parseString("display", getJsonValue(jsonObject, "display", JsonString.class), jsonObject.get("_display"), -1));
@@ -4478,10 +4590,11 @@ private ConceptMap.Group.Element.Target parseConceptMapGroupElementTarget(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ConceptMap.Group.Element.Target.class, jsonObject);
         }
         ConceptMap.Group.Element.Target.Builder builder = ConceptMap.Group.Element.Target.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.display(parseString("display", getJsonValue(jsonObject, "display", JsonString.class), jsonObject.get("_display"), -1));
@@ -4508,10 +4621,11 @@ private ConceptMap.Group.Element.Target.DependsOn parseConceptMapGroupElementTar
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ConceptMap.Group.Element.Target.DependsOn.class, jsonObject);
         }
         ConceptMap.Group.Element.Target.DependsOn.Builder builder = ConceptMap.Group.Element.Target.DependsOn.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.property(parseUri("property", getJsonValue(jsonObject, "property", JsonString.class), jsonObject.get("_property"), -1));
         builder.system((Canonical) parseUri(Canonical.builder(), "system", getJsonValue(jsonObject, "system", JsonString.class), jsonObject.get("_system"), -1));
@@ -4526,10 +4640,11 @@ private ConceptMap.Group.Unmapped parseConceptMapGroupUnmapped(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ConceptMap.Group.Unmapped.class, jsonObject);
         }
         ConceptMap.Group.Unmapped.Builder builder = ConceptMap.Group.Unmapped.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.mode((ConceptMapGroupUnmappedMode) parseString(ConceptMapGroupUnmappedMode.builder(), "mode", getJsonValue(jsonObject, "mode", JsonString.class), jsonObject.get("_mode"), -1));
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
@@ -4544,10 +4659,11 @@ private Condition parseCondition(java.lang.String elementName, JsonObject jsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Condition.class, jsonObject);
         }
         Condition.Builder builder = Condition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -4605,10 +4721,11 @@ private Condition.Evidence parseConditionEvidence(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Condition.Evidence.class, jsonObject);
         }
         Condition.Evidence.Builder builder = Condition.Evidence.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray codeArray = getJsonArray(jsonObject, "code");
         if (codeArray != null) {
@@ -4631,10 +4748,11 @@ private Condition.Stage parseConditionStage(java.lang.String elementName, JsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Condition.Stage.class, jsonObject);
         }
         Condition.Stage.Builder builder = Condition.Stage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.summary(parseCodeableConcept("summary", getJsonValue(jsonObject, "summary", JsonObject.class), -1));
         JsonArray assessmentArray = getJsonArray(jsonObject, "assessment");
@@ -4653,10 +4771,11 @@ private Consent parseConsent(java.lang.String elementName, JsonObject jsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Consent.class, jsonObject);
         }
         Consent.Builder builder = Consent.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -4710,10 +4829,11 @@ private Consent.Policy parseConsentPolicy(java.lang.String elementName, JsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Consent.Policy.class, jsonObject);
         }
         Consent.Policy.Builder builder = Consent.Policy.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.authority(parseUri("authority", getJsonValue(jsonObject, "authority", JsonString.class), jsonObject.get("_authority"), -1));
         builder.uri(parseUri("uri", getJsonValue(jsonObject, "uri", JsonString.class), jsonObject.get("_uri"), -1));
@@ -4726,10 +4846,11 @@ private Consent.Provision parseConsentProvision(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Consent.Provision.class, jsonObject);
         }
         Consent.Provision.Builder builder = Consent.Provision.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((ConsentProvisionType) parseString(ConsentProvisionType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.period(parsePeriod("period", getJsonValue(jsonObject, "period", JsonObject.class), -1));
@@ -4791,10 +4912,11 @@ private Consent.Provision.Actor parseConsentProvisionActor(java.lang.String elem
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Consent.Provision.Actor.class, jsonObject);
         }
         Consent.Provision.Actor.Builder builder = Consent.Provision.Actor.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.role(parseCodeableConcept("role", getJsonValue(jsonObject, "role", JsonObject.class), -1));
         builder.reference(parseReference("reference", getJsonValue(jsonObject, "reference", JsonObject.class), -1));
@@ -4807,10 +4929,11 @@ private Consent.Provision.Data parseConsentProvisionData(java.lang.String elemen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Consent.Provision.Data.class, jsonObject);
         }
         Consent.Provision.Data.Builder builder = Consent.Provision.Data.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.meaning((ConsentDataMeaning) parseString(ConsentDataMeaning.builder(), "meaning", getJsonValue(jsonObject, "meaning", JsonString.class), jsonObject.get("_meaning"), -1));
         builder.reference(parseReference("reference", getJsonValue(jsonObject, "reference", JsonObject.class), -1));
@@ -4823,10 +4946,11 @@ private Consent.Verification parseConsentVerification(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Consent.Verification.class, jsonObject);
         }
         Consent.Verification.Builder builder = Consent.Verification.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.verified(parseBoolean("verified", getJsonValue(jsonObject, "verified", JsonValue.class), jsonObject.get("_verified"), -1));
         builder.verifiedWith(parseReference("verifiedWith", getJsonValue(jsonObject, "verifiedWith", JsonObject.class), -1));
@@ -4840,10 +4964,11 @@ private ContactDetail parseContactDetail(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ContactDetail.class, jsonObject);
         }
         ContactDetail.Builder builder = ContactDetail.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         JsonArray telecomArray = getJsonArray(jsonObject, "telecom");
@@ -4861,10 +4986,11 @@ private ContactPoint parseContactPoint(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ContactPoint.class, jsonObject);
         }
         ContactPoint.Builder builder = ContactPoint.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.system((ContactPointSystem) parseString(ContactPointSystem.builder(), "system", getJsonValue(jsonObject, "system", JsonString.class), jsonObject.get("_system"), -1));
         builder.value(parseString("value", getJsonValue(jsonObject, "value", JsonString.class), jsonObject.get("_value"), -1));
@@ -4880,10 +5006,11 @@ private Contract parseContract(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.class, jsonObject);
         }
         Contract.Builder builder = Contract.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -4998,10 +5125,11 @@ private Contract.ContentDefinition parseContractContentDefinition(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.ContentDefinition.class, jsonObject);
         }
         Contract.ContentDefinition.Builder builder = Contract.ContentDefinition.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.subType(parseCodeableConcept("subType", getJsonValue(jsonObject, "subType", JsonObject.class), -1));
@@ -5018,10 +5146,11 @@ private Contract.Friendly parseContractFriendly(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Friendly.class, jsonObject);
         }
         Contract.Friendly.Builder builder = Contract.Friendly.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.content(parseChoiceElement("content", jsonObject, Attachment.class, Reference.class));
         stackPop();
@@ -5033,10 +5162,11 @@ private Contract.Legal parseContractLegal(java.lang.String elementName, JsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Legal.class, jsonObject);
         }
         Contract.Legal.Builder builder = Contract.Legal.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.content(parseChoiceElement("content", jsonObject, Attachment.class, Reference.class));
         stackPop();
@@ -5048,10 +5178,11 @@ private Contract.Rule parseContractRule(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Rule.class, jsonObject);
         }
         Contract.Rule.Builder builder = Contract.Rule.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.content(parseChoiceElement("content", jsonObject, Attachment.class, Reference.class));
         stackPop();
@@ -5063,10 +5194,11 @@ private Contract.Signer parseContractSigner(java.lang.String elementName, JsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Signer.class, jsonObject);
         }
         Contract.Signer.Builder builder = Contract.Signer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCoding("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.party(parseReference("party", getJsonValue(jsonObject, "party", JsonObject.class), -1));
@@ -5085,10 +5217,11 @@ private Contract.Term parseContractTerm(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.class, jsonObject);
         }
         Contract.Term.Builder builder = Contract.Term.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.issued(parseDateTime("issued", getJsonValue(jsonObject, "issued", JsonString.class), jsonObject.get("_issued"), -1));
@@ -5131,10 +5264,11 @@ private Contract.Term.Action parseContractTermAction(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.Action.class, jsonObject);
         }
         Contract.Term.Action.Builder builder = Contract.Term.Action.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.doNotPerform(parseBoolean("doNotPerform", getJsonValue(jsonObject, "doNotPerform", JsonValue.class), jsonObject.get("_doNotPerform"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -5238,10 +5372,11 @@ private Contract.Term.Action.Subject parseContractTermActionSubject(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.Action.Subject.class, jsonObject);
         }
         Contract.Term.Action.Subject.Builder builder = Contract.Term.Action.Subject.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray referenceArray = getJsonArray(jsonObject, "reference");
         if (referenceArray != null) {
@@ -5259,10 +5394,11 @@ private Contract.Term.Asset parseContractTermAsset(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.Asset.class, jsonObject);
         }
         Contract.Term.Asset.Builder builder = Contract.Term.Asset.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.scope(parseCodeableConcept("scope", getJsonValue(jsonObject, "scope", JsonObject.class), -1));
         JsonArray typeArray = getJsonArray(jsonObject, "type");
@@ -5345,10 +5481,11 @@ private Contract.Term.Asset.Context parseContractTermAssetContext(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.Asset.Context.class, jsonObject);
         }
         Contract.Term.Asset.Context.Builder builder = Contract.Term.Asset.Context.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.reference(parseReference("reference", getJsonValue(jsonObject, "reference", JsonObject.class), -1));
         JsonArray codeArray = getJsonArray(jsonObject, "code");
@@ -5367,10 +5504,11 @@ private Contract.Term.Asset.ValuedItem parseContractTermAssetValuedItem(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.Asset.ValuedItem.class, jsonObject);
         }
         Contract.Term.Asset.ValuedItem.Builder builder = Contract.Term.Asset.ValuedItem.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.entity(parseChoiceElement("entity", jsonObject, CodeableConcept.class, Reference.class));
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
@@ -5407,10 +5545,11 @@ private Contract.Term.Offer parseContractTermOffer(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.Offer.class, jsonObject);
         }
         Contract.Term.Offer.Builder builder = Contract.Term.Offer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -5463,10 +5602,11 @@ private Contract.Term.Offer.Answer parseContractTermOfferAnswer(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.Offer.Answer.class, jsonObject);
         }
         Contract.Term.Offer.Answer.Builder builder = Contract.Term.Offer.Answer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.value(parseChoiceElement("value", jsonObject, Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Uri.class, Attachment.class, Coding.class, Quantity.class, Reference.class));
         stackPop();
@@ -5478,10 +5618,11 @@ private Contract.Term.Offer.Party parseContractTermOfferParty(java.lang.String e
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.Offer.Party.class, jsonObject);
         }
         Contract.Term.Offer.Party.Builder builder = Contract.Term.Offer.Party.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray referenceArray = getJsonArray(jsonObject, "reference");
         if (referenceArray != null) {
@@ -5499,10 +5640,11 @@ private Contract.Term.SecurityLabel parseContractTermSecurityLabel(java.lang.Str
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contract.Term.SecurityLabel.class, jsonObject);
         }
         Contract.Term.SecurityLabel.Builder builder = Contract.Term.SecurityLabel.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray numberArray = getJsonArray(jsonObject, "number", true);
         if (numberArray != null) {
@@ -5533,10 +5675,11 @@ private Contributor parseContributor(java.lang.String elementName, JsonObject js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Contributor.class, jsonObject);
         }
         Contributor.Builder builder = Contributor.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.type((ContributorType) parseString(ContributorType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
@@ -5555,10 +5698,11 @@ private Coverage parseCoverage(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Coverage.class, jsonObject);
         }
         Coverage.Builder builder = Coverage.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -5611,10 +5755,11 @@ private Coverage.Class parseCoverageClass(java.lang.String elementName, JsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Coverage.Class.class, jsonObject);
         }
         Coverage.Class.Builder builder = Coverage.Class.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.value(parseString("value", getJsonValue(jsonObject, "value", JsonString.class), jsonObject.get("_value"), -1));
@@ -5628,10 +5773,11 @@ private Coverage.CostToBeneficiary parseCoverageCostToBeneficiary(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Coverage.CostToBeneficiary.class, jsonObject);
         }
         Coverage.CostToBeneficiary.Builder builder = Coverage.CostToBeneficiary.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, SimpleQuantity.class, Money.class));
@@ -5650,10 +5796,11 @@ private Coverage.CostToBeneficiary.Exception parseCoverageCostToBeneficiaryExcep
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Coverage.CostToBeneficiary.Exception.class, jsonObject);
         }
         Coverage.CostToBeneficiary.Exception.Builder builder = Coverage.CostToBeneficiary.Exception.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.period(parsePeriod("period", getJsonValue(jsonObject, "period", JsonObject.class), -1));
@@ -5666,10 +5813,11 @@ private CoverageEligibilityRequest parseCoverageEligibilityRequest(java.lang.Str
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityRequest.class, jsonObject);
         }
         CoverageEligibilityRequest.Builder builder = CoverageEligibilityRequest.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -5720,10 +5868,11 @@ private CoverageEligibilityRequest.Insurance parseCoverageEligibilityRequestInsu
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityRequest.Insurance.class, jsonObject);
         }
         CoverageEligibilityRequest.Insurance.Builder builder = CoverageEligibilityRequest.Insurance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.focal(parseBoolean("focal", getJsonValue(jsonObject, "focal", JsonValue.class), jsonObject.get("_focal"), -1));
         builder.coverage(parseReference("coverage", getJsonValue(jsonObject, "coverage", JsonObject.class), -1));
@@ -5737,10 +5886,11 @@ private CoverageEligibilityRequest.Item parseCoverageEligibilityRequestItem(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityRequest.Item.class, jsonObject);
         }
         CoverageEligibilityRequest.Item.Builder builder = CoverageEligibilityRequest.Item.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray supportingInfoSequenceArray = getJsonArray(jsonObject, "supportingInfoSequence", true);
         if (supportingInfoSequenceArray != null) {
@@ -5782,10 +5932,11 @@ private CoverageEligibilityRequest.Item.Diagnosis parseCoverageEligibilityReques
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityRequest.Item.Diagnosis.class, jsonObject);
         }
         CoverageEligibilityRequest.Item.Diagnosis.Builder builder = CoverageEligibilityRequest.Item.Diagnosis.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.diagnosis(parseChoiceElement("diagnosis", jsonObject, CodeableConcept.class, Reference.class));
         stackPop();
@@ -5797,10 +5948,11 @@ private CoverageEligibilityRequest.SupportingInfo parseCoverageEligibilityReques
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityRequest.SupportingInfo.class, jsonObject);
         }
         CoverageEligibilityRequest.SupportingInfo.Builder builder = CoverageEligibilityRequest.SupportingInfo.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.information(parseReference("information", getJsonValue(jsonObject, "information", JsonObject.class), -1));
@@ -5814,10 +5966,11 @@ private CoverageEligibilityResponse parseCoverageEligibilityResponse(java.lang.S
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityResponse.class, jsonObject);
         }
         CoverageEligibilityResponse.Builder builder = CoverageEligibilityResponse.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -5864,10 +6017,11 @@ private CoverageEligibilityResponse.Error parseCoverageEligibilityResponseError(
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityResponse.Error.class, jsonObject);
         }
         CoverageEligibilityResponse.Error.Builder builder = CoverageEligibilityResponse.Error.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         stackPop();
@@ -5879,10 +6033,11 @@ private CoverageEligibilityResponse.Insurance parseCoverageEligibilityResponseIn
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityResponse.Insurance.class, jsonObject);
         }
         CoverageEligibilityResponse.Insurance.Builder builder = CoverageEligibilityResponse.Insurance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.coverage(parseReference("coverage", getJsonValue(jsonObject, "coverage", JsonObject.class), -1));
         builder.inforce(parseBoolean("inforce", getJsonValue(jsonObject, "inforce", JsonValue.class), jsonObject.get("_inforce"), -1));
@@ -5902,10 +6057,11 @@ private CoverageEligibilityResponse.Insurance.Item parseCoverageEligibilityRespo
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityResponse.Insurance.Item.class, jsonObject);
         }
         CoverageEligibilityResponse.Insurance.Item.Builder builder = CoverageEligibilityResponse.Insurance.Item.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
         builder.productOrService(parseCodeableConcept("productOrService", getJsonValue(jsonObject, "productOrService", JsonObject.class), -1));
@@ -5945,10 +6101,11 @@ private CoverageEligibilityResponse.Insurance.Item.Benefit parseCoverageEligibil
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(CoverageEligibilityResponse.Insurance.Item.Benefit.class, jsonObject);
         }
         CoverageEligibilityResponse.Insurance.Item.Benefit.Builder builder = CoverageEligibilityResponse.Insurance.Item.Benefit.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.allowed(parseChoiceElement("allowed", jsonObject, UnsignedInt.class, String.class, Money.class));
@@ -5962,10 +6119,11 @@ private DataRequirement parseDataRequirement(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DataRequirement.class, jsonObject);
         }
         DataRequirement.Builder builder = DataRequirement.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.type((FHIRAllTypes) parseString(FHIRAllTypes.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         JsonArray profileArray = getJsonArray(jsonObject, "profile", true);
@@ -6011,10 +6169,11 @@ private DataRequirement.CodeFilter parseDataRequirementCodeFilter(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DataRequirement.CodeFilter.class, jsonObject);
         }
         DataRequirement.CodeFilter.Builder builder = DataRequirement.CodeFilter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.path(parseString("path", getJsonValue(jsonObject, "path", JsonString.class), jsonObject.get("_path"), -1));
         builder.searchParam(parseString("searchParam", getJsonValue(jsonObject, "searchParam", JsonString.class), jsonObject.get("_searchParam"), -1));
@@ -6034,10 +6193,11 @@ private DataRequirement.DateFilter parseDataRequirementDateFilter(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DataRequirement.DateFilter.class, jsonObject);
         }
         DataRequirement.DateFilter.Builder builder = DataRequirement.DateFilter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.path(parseString("path", getJsonValue(jsonObject, "path", JsonString.class), jsonObject.get("_path"), -1));
         builder.searchParam(parseString("searchParam", getJsonValue(jsonObject, "searchParam", JsonString.class), jsonObject.get("_searchParam"), -1));
@@ -6051,10 +6211,11 @@ private DataRequirement.Sort parseDataRequirementSort(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DataRequirement.Sort.class, jsonObject);
         }
         DataRequirement.Sort.Builder builder = DataRequirement.Sort.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.path(parseString("path", getJsonValue(jsonObject, "path", JsonString.class), jsonObject.get("_path"), -1));
         builder.direction((SortDirection) parseString(SortDirection.builder(), "direction", getJsonValue(jsonObject, "direction", JsonString.class), jsonObject.get("_direction"), -1));
@@ -6068,9 +6229,10 @@ private Date parseDate(java.lang.String elementName, JsonValue jsonValue, JsonVa
         }
         stackPush(elementName, elementIndex);
         Date.Builder builder = Date.builder();
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -6093,9 +6255,10 @@ private DateTime parseDateTime(java.lang.String elementName, JsonValue jsonValue
         }
         stackPush(elementName, elementIndex);
         DateTime.Builder builder = DateTime.builder();
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -6118,9 +6281,10 @@ private Decimal parseDecimal(java.lang.String elementName, JsonValue jsonValue,
         }
         stackPush(elementName, elementIndex);
         Decimal.Builder builder = Decimal.builder();
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -6142,10 +6306,11 @@ private DetectedIssue parseDetectedIssue(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DetectedIssue.class, jsonObject);
         }
         DetectedIssue.Builder builder = DetectedIssue.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -6188,10 +6353,11 @@ private DetectedIssue.Evidence parseDetectedIssueEvidence(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DetectedIssue.Evidence.class, jsonObject);
         }
         DetectedIssue.Evidence.Builder builder = DetectedIssue.Evidence.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray codeArray = getJsonArray(jsonObject, "code");
         if (codeArray != null) {
@@ -6214,10 +6380,11 @@ private DetectedIssue.Mitigation parseDetectedIssueMitigation(java.lang.String e
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DetectedIssue.Mitigation.class, jsonObject);
         }
         DetectedIssue.Mitigation.Builder builder = DetectedIssue.Mitigation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.action(parseCodeableConcept("action", getJsonValue(jsonObject, "action", JsonObject.class), -1));
         builder.date(parseDateTime("date", getJsonValue(jsonObject, "date", JsonString.class), jsonObject.get("_date"), -1));
@@ -6231,10 +6398,11 @@ private Device parseDevice(java.lang.String elementName, JsonObject jsonObject,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Device.class, jsonObject);
         }
         Device.Builder builder = Device.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -6321,10 +6489,11 @@ private Device.DeviceName parseDeviceDeviceName(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Device.DeviceName.class, jsonObject);
         }
         Device.DeviceName.Builder builder = Device.DeviceName.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.type((DeviceNameType) parseString(DeviceNameType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -6337,10 +6506,11 @@ private Device.Property parseDeviceProperty(java.lang.String elementName, JsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Device.Property.class, jsonObject);
         }
         Device.Property.Builder builder = Device.Property.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray valueQuantityArray = getJsonArray(jsonObject, "valueQuantity");
@@ -6364,10 +6534,11 @@ private Device.Specialization parseDeviceSpecialization(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Device.Specialization.class, jsonObject);
         }
         Device.Specialization.Builder builder = Device.Specialization.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.systemType(parseCodeableConcept("systemType", getJsonValue(jsonObject, "systemType", JsonObject.class), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -6380,10 +6551,11 @@ private Device.UdiCarrier parseDeviceUdiCarrier(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Device.UdiCarrier.class, jsonObject);
         }
         Device.UdiCarrier.Builder builder = Device.UdiCarrier.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.deviceIdentifier(parseString("deviceIdentifier", getJsonValue(jsonObject, "deviceIdentifier", JsonString.class), jsonObject.get("_deviceIdentifier"), -1));
         builder.issuer(parseUri("issuer", getJsonValue(jsonObject, "issuer", JsonString.class), jsonObject.get("_issuer"), -1));
@@ -6400,10 +6572,11 @@ private Device.Version parseDeviceVersion(java.lang.String elementName, JsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Device.Version.class, jsonObject);
         }
         Device.Version.Builder builder = Device.Version.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.component(parseIdentifier("component", getJsonValue(jsonObject, "component", JsonObject.class), -1));
@@ -6417,10 +6590,11 @@ private DeviceDefinition parseDeviceDefinition(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceDefinition.class, jsonObject);
         }
         DeviceDefinition.Builder builder = DeviceDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -6519,10 +6693,11 @@ private DeviceDefinition.Capability parseDeviceDefinitionCapability(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceDefinition.Capability.class, jsonObject);
         }
         DeviceDefinition.Capability.Builder builder = DeviceDefinition.Capability.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray descriptionArray = getJsonArray(jsonObject, "description");
@@ -6540,10 +6715,11 @@ private DeviceDefinition.DeviceName parseDeviceDefinitionDeviceName(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceDefinition.DeviceName.class, jsonObject);
         }
         DeviceDefinition.DeviceName.Builder builder = DeviceDefinition.DeviceName.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.type((DeviceNameType) parseString(DeviceNameType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -6556,10 +6732,11 @@ private DeviceDefinition.Material parseDeviceDefinitionMaterial(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceDefinition.Material.class, jsonObject);
         }
         DeviceDefinition.Material.Builder builder = DeviceDefinition.Material.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.substance(parseCodeableConcept("substance", getJsonValue(jsonObject, "substance", JsonObject.class), -1));
         builder.alternate(parseBoolean("alternate", getJsonValue(jsonObject, "alternate", JsonValue.class), jsonObject.get("_alternate"), -1));
@@ -6573,10 +6750,11 @@ private DeviceDefinition.Property parseDeviceDefinitionProperty(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceDefinition.Property.class, jsonObject);
         }
         DeviceDefinition.Property.Builder builder = DeviceDefinition.Property.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray valueQuantityArray = getJsonArray(jsonObject, "valueQuantity");
@@ -6600,10 +6778,11 @@ private DeviceDefinition.Specialization parseDeviceDefinitionSpecialization(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceDefinition.Specialization.class, jsonObject);
         }
         DeviceDefinition.Specialization.Builder builder = DeviceDefinition.Specialization.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.systemType(parseString("systemType", getJsonValue(jsonObject, "systemType", JsonString.class), jsonObject.get("_systemType"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -6616,10 +6795,11 @@ private DeviceDefinition.UdiDeviceIdentifier parseDeviceDefinitionUdiDeviceIdent
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceDefinition.UdiDeviceIdentifier.class, jsonObject);
         }
         DeviceDefinition.UdiDeviceIdentifier.Builder builder = DeviceDefinition.UdiDeviceIdentifier.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.deviceIdentifier(parseString("deviceIdentifier", getJsonValue(jsonObject, "deviceIdentifier", JsonString.class), jsonObject.get("_deviceIdentifier"), -1));
         builder.issuer(parseUri("issuer", getJsonValue(jsonObject, "issuer", JsonString.class), jsonObject.get("_issuer"), -1));
@@ -6633,10 +6813,11 @@ private DeviceMetric parseDeviceMetric(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceMetric.class, jsonObject);
         }
         DeviceMetric.Builder builder = DeviceMetric.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -6667,10 +6848,11 @@ private DeviceMetric.Calibration parseDeviceMetricCalibration(java.lang.String e
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceMetric.Calibration.class, jsonObject);
         }
         DeviceMetric.Calibration.Builder builder = DeviceMetric.Calibration.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((DeviceMetricCalibrationType) parseString(DeviceMetricCalibrationType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.state((DeviceMetricCalibrationState) parseString(DeviceMetricCalibrationState.builder(), "state", getJsonValue(jsonObject, "state", JsonString.class), jsonObject.get("_state"), -1));
@@ -6684,10 +6866,11 @@ private DeviceRequest parseDeviceRequest(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceRequest.class, jsonObject);
         }
         DeviceRequest.Builder builder = DeviceRequest.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -6784,10 +6967,11 @@ private DeviceRequest.Parameter parseDeviceRequestParameter(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceRequest.Parameter.class, jsonObject);
         }
         DeviceRequest.Parameter.Builder builder = DeviceRequest.Parameter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, CodeableConcept.class, Quantity.class, Range.class, Boolean.class));
@@ -6800,10 +6984,11 @@ private DeviceUseStatement parseDeviceUseStatement(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DeviceUseStatement.class, jsonObject);
         }
         DeviceUseStatement.Builder builder = DeviceUseStatement.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -6857,10 +7042,11 @@ private DiagnosticReport parseDiagnosticReport(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DiagnosticReport.class, jsonObject);
         }
         DiagnosticReport.Builder builder = DiagnosticReport.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -6944,10 +7130,11 @@ private DiagnosticReport.Media parseDiagnosticReportMedia(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DiagnosticReport.Media.class, jsonObject);
         }
         DiagnosticReport.Media.Builder builder = DiagnosticReport.Media.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.comment(parseString("comment", getJsonValue(jsonObject, "comment", JsonString.class), jsonObject.get("_comment"), -1));
         builder.link(parseReference("link", getJsonValue(jsonObject, "link", JsonObject.class), -1));
@@ -6960,10 +7147,11 @@ private DocumentManifest parseDocumentManifest(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DocumentManifest.class, jsonObject);
         }
         DocumentManifest.Builder builder = DocumentManifest.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.masterIdentifier(parseIdentifier("masterIdentifier", getJsonValue(jsonObject, "masterIdentifier", JsonObject.class), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -7011,10 +7199,11 @@ private DocumentManifest.Related parseDocumentManifestRelated(java.lang.String e
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DocumentManifest.Related.class, jsonObject);
         }
         DocumentManifest.Related.Builder builder = DocumentManifest.Related.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.ref(parseReference("ref", getJsonValue(jsonObject, "ref", JsonObject.class), -1));
@@ -7027,10 +7216,11 @@ private DocumentReference parseDocumentReference(java.lang.String elementName, J
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DocumentReference.class, jsonObject);
         }
         DocumentReference.Builder builder = DocumentReference.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.masterIdentifier(parseIdentifier("masterIdentifier", getJsonValue(jsonObject, "masterIdentifier", JsonObject.class), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -7087,10 +7277,11 @@ private DocumentReference.Content parseDocumentReferenceContent(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DocumentReference.Content.class, jsonObject);
         }
         DocumentReference.Content.Builder builder = DocumentReference.Content.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.attachment(parseAttachment("attachment", getJsonValue(jsonObject, "attachment", JsonObject.class), -1));
         builder.format(parseCoding("format", getJsonValue(jsonObject, "format", JsonObject.class), -1));
@@ -7103,10 +7294,11 @@ private DocumentReference.Context parseDocumentReferenceContext(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DocumentReference.Context.class, jsonObject);
         }
         DocumentReference.Context.Builder builder = DocumentReference.Context.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray encounterArray = getJsonArray(jsonObject, "encounter");
         if (encounterArray != null) {
@@ -7139,10 +7331,11 @@ private DocumentReference.RelatesTo parseDocumentReferenceRelatesTo(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(DocumentReference.RelatesTo.class, jsonObject);
         }
         DocumentReference.RelatesTo.Builder builder = DocumentReference.RelatesTo.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((DocumentRelationshipType) parseString(DocumentRelationshipType.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.target(parseReference("target", getJsonValue(jsonObject, "target", JsonObject.class), -1));
@@ -7151,6 +7344,7 @@ private DocumentReference.RelatesTo parseDocumentReferenceRelatesTo(java.lang.St
     }
 
     private void parseDomainResource(DomainResource.Builder builder, JsonObject jsonObject) {
+        builder.setValidating(validating);
         parseResource(builder, jsonObject);
         builder.text(parseNarrative("text", getJsonValue(jsonObject, "text", JsonObject.class), -1));
         JsonArray containedArray = getJsonArray(jsonObject, "contained");
@@ -7178,10 +7372,11 @@ private Dosage parseDosage(java.lang.String elementName, JsonObject jsonObject,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Dosage.class, jsonObject);
         }
         Dosage.Builder builder = Dosage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence(parseInteger("sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.text(parseString("text", getJsonValue(jsonObject, "text", JsonString.class), jsonObject.get("_text"), -1));
@@ -7215,10 +7410,11 @@ private Dosage.DoseAndRate parseDosageDoseAndRate(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Dosage.DoseAndRate.class, jsonObject);
         }
         Dosage.DoseAndRate.Builder builder = Dosage.DoseAndRate.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.dose(parseChoiceElement("dose", jsonObject, Range.class, SimpleQuantity.class));
@@ -7232,10 +7428,11 @@ private EffectEvidenceSynthesis parseEffectEvidenceSynthesis(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EffectEvidenceSynthesis.class, jsonObject);
         }
         EffectEvidenceSynthesis.Builder builder = EffectEvidenceSynthesis.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -7349,10 +7546,11 @@ private EffectEvidenceSynthesis.Certainty parseEffectEvidenceSynthesisCertainty(
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EffectEvidenceSynthesis.Certainty.class, jsonObject);
         }
         EffectEvidenceSynthesis.Certainty.Builder builder = EffectEvidenceSynthesis.Certainty.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray ratingArray = getJsonArray(jsonObject, "rating");
         if (ratingArray != null) {
@@ -7381,10 +7579,11 @@ private EffectEvidenceSynthesis.Certainty.CertaintySubcomponent parseEffectEvide
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EffectEvidenceSynthesis.Certainty.CertaintySubcomponent.class, jsonObject);
         }
         EffectEvidenceSynthesis.Certainty.CertaintySubcomponent.Builder builder = EffectEvidenceSynthesis.Certainty.CertaintySubcomponent.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray ratingArray = getJsonArray(jsonObject, "rating");
@@ -7408,10 +7607,11 @@ private EffectEvidenceSynthesis.EffectEstimate parseEffectEvidenceSynthesisEffec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EffectEvidenceSynthesis.EffectEstimate.class, jsonObject);
         }
         EffectEvidenceSynthesis.EffectEstimate.Builder builder = EffectEvidenceSynthesis.EffectEstimate.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -7433,10 +7633,11 @@ private EffectEvidenceSynthesis.EffectEstimate.PrecisionEstimate parseEffectEvid
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EffectEvidenceSynthesis.EffectEstimate.PrecisionEstimate.class, jsonObject);
         }
         EffectEvidenceSynthesis.EffectEstimate.PrecisionEstimate.Builder builder = EffectEvidenceSynthesis.EffectEstimate.PrecisionEstimate.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.level(parseDecimal("level", getJsonValue(jsonObject, "level", JsonNumber.class), jsonObject.get("_level"), -1));
@@ -7451,10 +7652,11 @@ private EffectEvidenceSynthesis.ResultsByExposure parseEffectEvidenceSynthesisRe
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EffectEvidenceSynthesis.ResultsByExposure.class, jsonObject);
         }
         EffectEvidenceSynthesis.ResultsByExposure.Builder builder = EffectEvidenceSynthesis.ResultsByExposure.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.exposureState((ExposureState) parseString(ExposureState.builder(), "exposureState", getJsonValue(jsonObject, "exposureState", JsonString.class), jsonObject.get("_exposureState"), -1));
@@ -7469,10 +7671,11 @@ private EffectEvidenceSynthesis.SampleSize parseEffectEvidenceSynthesisSampleSiz
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EffectEvidenceSynthesis.SampleSize.class, jsonObject);
         }
         EffectEvidenceSynthesis.SampleSize.Builder builder = EffectEvidenceSynthesis.SampleSize.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.numberOfStudies(parseInteger("numberOfStudies", getJsonValue(jsonObject, "numberOfStudies", JsonNumber.class), jsonObject.get("_numberOfStudies"), -1));
@@ -7482,6 +7685,7 @@ private EffectEvidenceSynthesis.SampleSize parseEffectEvidenceSynthesisSampleSiz
     }
 
     private void parseElement(Element.Builder builder, JsonObject jsonObject) {
+        builder.setValidating(validating);
         builder.id(parseJavaString("id", getJsonValue(jsonObject, "id", JsonString.class), -1));
         JsonArray extensionArray = getJsonArray(jsonObject, "extension");
         if (extensionArray != null) {
@@ -7496,10 +7700,11 @@ private ElementDefinition parseElementDefinition(java.lang.String elementName, J
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ElementDefinition.class, jsonObject);
         }
         ElementDefinition.Builder builder = ElementDefinition.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.path(parseString("path", getJsonValue(jsonObject, "path", JsonString.class), jsonObject.get("_path"), -1));
         JsonArray representationArray = getJsonArray(jsonObject, "representation", true);
@@ -7587,10 +7792,11 @@ private ElementDefinition.Base parseElementDefinitionBase(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ElementDefinition.Base.class, jsonObject);
         }
         ElementDefinition.Base.Builder builder = ElementDefinition.Base.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.path(parseString("path", getJsonValue(jsonObject, "path", JsonString.class), jsonObject.get("_path"), -1));
         builder.min((UnsignedInt) parseInteger(UnsignedInt.builder(), "min", getJsonValue(jsonObject, "min", JsonNumber.class), jsonObject.get("_min"), -1));
@@ -7604,10 +7810,11 @@ private ElementDefinition.Binding parseElementDefinitionBinding(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ElementDefinition.Binding.class, jsonObject);
         }
         ElementDefinition.Binding.Builder builder = ElementDefinition.Binding.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.strength((BindingStrength) parseString(BindingStrength.builder(), "strength", getJsonValue(jsonObject, "strength", JsonString.class), jsonObject.get("_strength"), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -7621,10 +7828,11 @@ private ElementDefinition.Constraint parseElementDefinitionConstraint(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ElementDefinition.Constraint.class, jsonObject);
         }
         ElementDefinition.Constraint.Builder builder = ElementDefinition.Constraint.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.key((Id) parseString(Id.builder(), "key", getJsonValue(jsonObject, "key", JsonString.class), jsonObject.get("_key"), -1));
         builder.requirements(parseString("requirements", getJsonValue(jsonObject, "requirements", JsonString.class), jsonObject.get("_requirements"), -1));
@@ -7642,10 +7850,11 @@ private ElementDefinition.Example parseElementDefinitionExample(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ElementDefinition.Example.class, jsonObject);
         }
         ElementDefinition.Example.Builder builder = ElementDefinition.Example.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.label(parseString("label", getJsonValue(jsonObject, "label", JsonString.class), jsonObject.get("_label"), -1));
         builder.value(parseChoiceElement("value", jsonObject, Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class));
@@ -7658,10 +7867,11 @@ private ElementDefinition.Mapping parseElementDefinitionMapping(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ElementDefinition.Mapping.class, jsonObject);
         }
         ElementDefinition.Mapping.Builder builder = ElementDefinition.Mapping.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identity((Id) parseString(Id.builder(), "identity", getJsonValue(jsonObject, "identity", JsonString.class), jsonObject.get("_identity"), -1));
         builder.language((Code) parseString(Code.builder(), "language", getJsonValue(jsonObject, "language", JsonString.class), jsonObject.get("_language"), -1));
@@ -7676,10 +7886,11 @@ private ElementDefinition.Slicing parseElementDefinitionSlicing(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ElementDefinition.Slicing.class, jsonObject);
         }
         ElementDefinition.Slicing.Builder builder = ElementDefinition.Slicing.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray discriminatorArray = getJsonArray(jsonObject, "discriminator");
         if (discriminatorArray != null) {
@@ -7699,10 +7910,11 @@ private ElementDefinition.Slicing.Discriminator parseElementDefinitionSlicingDis
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ElementDefinition.Slicing.Discriminator.class, jsonObject);
         }
         ElementDefinition.Slicing.Discriminator.Builder builder = ElementDefinition.Slicing.Discriminator.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((DiscriminatorType) parseString(DiscriminatorType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.path(parseString("path", getJsonValue(jsonObject, "path", JsonString.class), jsonObject.get("_path"), -1));
@@ -7715,10 +7927,11 @@ private ElementDefinition.Type parseElementDefinitionType(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ElementDefinition.Type.class, jsonObject);
         }
         ElementDefinition.Type.Builder builder = ElementDefinition.Type.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseUri("code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         JsonArray profileArray = getJsonArray(jsonObject, "profile", true);
@@ -7752,10 +7965,11 @@ private Encounter parseEncounter(java.lang.String elementName, JsonObject jsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Encounter.class, jsonObject);
         }
         Encounter.Builder builder = Encounter.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -7854,10 +8068,11 @@ private Encounter.ClassHistory parseEncounterClassHistory(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Encounter.ClassHistory.class, jsonObject);
         }
         Encounter.ClassHistory.Builder builder = Encounter.ClassHistory.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.clazz(parseCoding("class", getJsonValue(jsonObject, "class", JsonObject.class), -1));
         builder.period(parsePeriod("period", getJsonValue(jsonObject, "period", JsonObject.class), -1));
@@ -7870,10 +8085,11 @@ private Encounter.Diagnosis parseEncounterDiagnosis(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Encounter.Diagnosis.class, jsonObject);
         }
         Encounter.Diagnosis.Builder builder = Encounter.Diagnosis.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.condition(parseReference("condition", getJsonValue(jsonObject, "condition", JsonObject.class), -1));
         builder.use(parseCodeableConcept("use", getJsonValue(jsonObject, "use", JsonObject.class), -1));
@@ -7887,10 +8103,11 @@ private Encounter.Hospitalization parseEncounterHospitalization(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Encounter.Hospitalization.class, jsonObject);
         }
         Encounter.Hospitalization.Builder builder = Encounter.Hospitalization.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.preAdmissionIdentifier(parseIdentifier("preAdmissionIdentifier", getJsonValue(jsonObject, "preAdmissionIdentifier", JsonObject.class), -1));
         builder.origin(parseReference("origin", getJsonValue(jsonObject, "origin", JsonObject.class), -1));
@@ -7925,10 +8142,11 @@ private Encounter.Location parseEncounterLocation(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Encounter.Location.class, jsonObject);
         }
         Encounter.Location.Builder builder = Encounter.Location.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.location(parseReference("location", getJsonValue(jsonObject, "location", JsonObject.class), -1));
         builder.status((EncounterLocationStatus) parseString(EncounterLocationStatus.builder(), "status", getJsonValue(jsonObject, "status", JsonString.class), jsonObject.get("_status"), -1));
@@ -7943,10 +8161,11 @@ private Encounter.Participant parseEncounterParticipant(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Encounter.Participant.class, jsonObject);
         }
         Encounter.Participant.Builder builder = Encounter.Participant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray typeArray = getJsonArray(jsonObject, "type");
         if (typeArray != null) {
@@ -7965,10 +8184,11 @@ private Encounter.StatusHistory parseEncounterStatusHistory(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Encounter.StatusHistory.class, jsonObject);
         }
         Encounter.StatusHistory.Builder builder = Encounter.StatusHistory.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.status((EncounterStatus) parseString(EncounterStatus.builder(), "status", getJsonValue(jsonObject, "status", JsonString.class), jsonObject.get("_status"), -1));
         builder.period(parsePeriod("period", getJsonValue(jsonObject, "period", JsonObject.class), -1));
@@ -7981,10 +8201,11 @@ private Endpoint parseEndpoint(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Endpoint.class, jsonObject);
         }
         Endpoint.Builder builder = Endpoint.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -8033,10 +8254,11 @@ private EnrollmentRequest parseEnrollmentRequest(java.lang.String elementName, J
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EnrollmentRequest.class, jsonObject);
         }
         EnrollmentRequest.Builder builder = EnrollmentRequest.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -8059,10 +8281,11 @@ private EnrollmentResponse parseEnrollmentResponse(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EnrollmentResponse.class, jsonObject);
         }
         EnrollmentResponse.Builder builder = EnrollmentResponse.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -8086,10 +8309,11 @@ private EpisodeOfCare parseEpisodeOfCare(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EpisodeOfCare.class, jsonObject);
         }
         EpisodeOfCare.Builder builder = EpisodeOfCare.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -8147,10 +8371,11 @@ private EpisodeOfCare.Diagnosis parseEpisodeOfCareDiagnosis(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EpisodeOfCare.Diagnosis.class, jsonObject);
         }
         EpisodeOfCare.Diagnosis.Builder builder = EpisodeOfCare.Diagnosis.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.condition(parseReference("condition", getJsonValue(jsonObject, "condition", JsonObject.class), -1));
         builder.role(parseCodeableConcept("role", getJsonValue(jsonObject, "role", JsonObject.class), -1));
@@ -8164,10 +8389,11 @@ private EpisodeOfCare.StatusHistory parseEpisodeOfCareStatusHistory(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EpisodeOfCare.StatusHistory.class, jsonObject);
         }
         EpisodeOfCare.StatusHistory.Builder builder = EpisodeOfCare.StatusHistory.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.status((EpisodeOfCareStatus) parseString(EpisodeOfCareStatus.builder(), "status", getJsonValue(jsonObject, "status", JsonString.class), jsonObject.get("_status"), -1));
         builder.period(parsePeriod("period", getJsonValue(jsonObject, "period", JsonObject.class), -1));
@@ -8180,10 +8406,11 @@ private EventDefinition parseEventDefinition(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EventDefinition.class, jsonObject);
         }
         EventDefinition.Builder builder = EventDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -8277,10 +8504,11 @@ private Evidence parseEvidence(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Evidence.class, jsonObject);
         }
         Evidence.Builder builder = Evidence.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -8384,10 +8612,11 @@ private EvidenceVariable parseEvidenceVariable(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EvidenceVariable.class, jsonObject);
         }
         EvidenceVariable.Builder builder = EvidenceVariable.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -8485,10 +8714,11 @@ private EvidenceVariable.Characteristic parseEvidenceVariableCharacteristic(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(EvidenceVariable.Characteristic.class, jsonObject);
         }
         EvidenceVariable.Characteristic.Builder builder = EvidenceVariable.Characteristic.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.definition(parseChoiceElement("definition", jsonObject, Reference.class, Canonical.class, CodeableConcept.class, Expression.class, DataRequirement.class, TriggerDefinition.class));
@@ -8511,10 +8741,11 @@ private ExampleScenario parseExampleScenario(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExampleScenario.class, jsonObject);
         }
         ExampleScenario.Builder builder = ExampleScenario.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -8583,10 +8814,11 @@ private ExampleScenario.Actor parseExampleScenarioActor(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExampleScenario.Actor.class, jsonObject);
         }
         ExampleScenario.Actor.Builder builder = ExampleScenario.Actor.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.actorId(parseString("actorId", getJsonValue(jsonObject, "actorId", JsonString.class), jsonObject.get("_actorId"), -1));
         builder.type((ExampleScenarioActorType) parseString(ExampleScenarioActorType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -8601,10 +8833,11 @@ private ExampleScenario.Instance parseExampleScenarioInstance(java.lang.String e
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExampleScenario.Instance.class, jsonObject);
         }
         ExampleScenario.Instance.Builder builder = ExampleScenario.Instance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.resourceId(parseString("resourceId", getJsonValue(jsonObject, "resourceId", JsonString.class), jsonObject.get("_resourceId"), -1));
         builder.resourceType((FHIRResourceType) parseString(FHIRResourceType.builder(), "resourceType", getJsonValue(jsonObject, "resourceType", JsonString.class), jsonObject.get("_resourceType"), -1));
@@ -8631,10 +8864,11 @@ private ExampleScenario.Instance.ContainedInstance parseExampleScenarioInstanceC
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExampleScenario.Instance.ContainedInstance.class, jsonObject);
         }
         ExampleScenario.Instance.ContainedInstance.Builder builder = ExampleScenario.Instance.ContainedInstance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.resourceId(parseString("resourceId", getJsonValue(jsonObject, "resourceId", JsonString.class), jsonObject.get("_resourceId"), -1));
         builder.versionId(parseString("versionId", getJsonValue(jsonObject, "versionId", JsonString.class), jsonObject.get("_versionId"), -1));
@@ -8647,10 +8881,11 @@ private ExampleScenario.Instance.Version parseExampleScenarioInstanceVersion(jav
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExampleScenario.Instance.Version.class, jsonObject);
         }
         ExampleScenario.Instance.Version.Builder builder = ExampleScenario.Instance.Version.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.versionId(parseString("versionId", getJsonValue(jsonObject, "versionId", JsonString.class), jsonObject.get("_versionId"), -1));
         builder.description((Markdown) parseString(Markdown.builder(), "description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -8663,10 +8898,11 @@ private ExampleScenario.Process parseExampleScenarioProcess(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExampleScenario.Process.class, jsonObject);
         }
         ExampleScenario.Process.Builder builder = ExampleScenario.Process.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.title(parseString("title", getJsonValue(jsonObject, "title", JsonString.class), jsonObject.get("_title"), -1));
         builder.description((Markdown) parseString(Markdown.builder(), "description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -8687,10 +8923,11 @@ private ExampleScenario.Process.Step parseExampleScenarioProcessStep(java.lang.S
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExampleScenario.Process.Step.class, jsonObject);
         }
         ExampleScenario.Process.Step.Builder builder = ExampleScenario.Process.Step.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray processArray = getJsonArray(jsonObject, "process");
         if (processArray != null) {
@@ -8715,10 +8952,11 @@ private ExampleScenario.Process.Step.Alternative parseExampleScenarioProcessStep
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExampleScenario.Process.Step.Alternative.class, jsonObject);
         }
         ExampleScenario.Process.Step.Alternative.Builder builder = ExampleScenario.Process.Step.Alternative.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.title(parseString("title", getJsonValue(jsonObject, "title", JsonString.class), jsonObject.get("_title"), -1));
         builder.description((Markdown) parseString(Markdown.builder(), "description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -8737,10 +8975,11 @@ private ExampleScenario.Process.Step.Operation parseExampleScenarioProcessStepOp
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExampleScenario.Process.Step.Operation.class, jsonObject);
         }
         ExampleScenario.Process.Step.Operation.Builder builder = ExampleScenario.Process.Step.Operation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.number(parseString("number", getJsonValue(jsonObject, "number", JsonString.class), jsonObject.get("_number"), -1));
         builder.type(parseString("type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -8761,10 +9000,11 @@ private ExplanationOfBenefit parseExplanationOfBenefit(java.lang.String elementN
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.class, jsonObject);
         }
         ExplanationOfBenefit.Builder builder = ExplanationOfBenefit.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -8894,10 +9134,11 @@ private ExplanationOfBenefit.Accident parseExplanationOfBenefitAccident(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Accident.class, jsonObject);
         }
         ExplanationOfBenefit.Accident.Builder builder = ExplanationOfBenefit.Accident.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.date(parseDate("date", getJsonValue(jsonObject, "date", JsonString.class), jsonObject.get("_date"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -8911,10 +9152,11 @@ private ExplanationOfBenefit.AddItem parseExplanationOfBenefitAddItem(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.AddItem.class, jsonObject);
         }
         ExplanationOfBenefit.AddItem.Builder builder = ExplanationOfBenefit.AddItem.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray itemSequenceArray = getJsonArray(jsonObject, "itemSequence", true);
         if (itemSequenceArray != null) {
@@ -8997,10 +9239,11 @@ private ExplanationOfBenefit.AddItem.Detail parseExplanationOfBenefitAddItemDeta
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.AddItem.Detail.class, jsonObject);
         }
         ExplanationOfBenefit.AddItem.Detail.Builder builder = ExplanationOfBenefit.AddItem.Detail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.productOrService(parseCodeableConcept("productOrService", getJsonValue(jsonObject, "productOrService", JsonObject.class), -1));
         JsonArray modifierArray = getJsonArray(jsonObject, "modifier");
@@ -9041,10 +9284,11 @@ private ExplanationOfBenefit.AddItem.Detail.SubDetail parseExplanationOfBenefitA
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.AddItem.Detail.SubDetail.class, jsonObject);
         }
         ExplanationOfBenefit.AddItem.Detail.SubDetail.Builder builder = ExplanationOfBenefit.AddItem.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.productOrService(parseCodeableConcept("productOrService", getJsonValue(jsonObject, "productOrService", JsonObject.class), -1));
         JsonArray modifierArray = getJsonArray(jsonObject, "modifier");
@@ -9079,10 +9323,11 @@ private ExplanationOfBenefit.BenefitBalance parseExplanationOfBenefitBenefitBala
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.BenefitBalance.class, jsonObject);
         }
         ExplanationOfBenefit.BenefitBalance.Builder builder = ExplanationOfBenefit.BenefitBalance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
         builder.excluded(parseBoolean("excluded", getJsonValue(jsonObject, "excluded", JsonValue.class), jsonObject.get("_excluded"), -1));
@@ -9106,10 +9351,11 @@ private ExplanationOfBenefit.BenefitBalance.Financial parseExplanationOfBenefitB
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.BenefitBalance.Financial.class, jsonObject);
         }
         ExplanationOfBenefit.BenefitBalance.Financial.Builder builder = ExplanationOfBenefit.BenefitBalance.Financial.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.allowed(parseChoiceElement("allowed", jsonObject, UnsignedInt.class, String.class, Money.class));
@@ -9123,10 +9369,11 @@ private ExplanationOfBenefit.CareTeam parseExplanationOfBenefitCareTeam(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.CareTeam.class, jsonObject);
         }
         ExplanationOfBenefit.CareTeam.Builder builder = ExplanationOfBenefit.CareTeam.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.provider(parseReference("provider", getJsonValue(jsonObject, "provider", JsonObject.class), -1));
@@ -9142,10 +9389,11 @@ private ExplanationOfBenefit.Diagnosis parseExplanationOfBenefitDiagnosis(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Diagnosis.class, jsonObject);
         }
         ExplanationOfBenefit.Diagnosis.Builder builder = ExplanationOfBenefit.Diagnosis.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.diagnosis(parseChoiceElement("diagnosis", jsonObject, CodeableConcept.class, Reference.class));
@@ -9166,10 +9414,11 @@ private ExplanationOfBenefit.Insurance parseExplanationOfBenefitInsurance(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Insurance.class, jsonObject);
         }
         ExplanationOfBenefit.Insurance.Builder builder = ExplanationOfBenefit.Insurance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.focal(parseBoolean("focal", getJsonValue(jsonObject, "focal", JsonValue.class), jsonObject.get("_focal"), -1));
         builder.coverage(parseReference("coverage", getJsonValue(jsonObject, "coverage", JsonObject.class), -1));
@@ -9189,10 +9438,11 @@ private ExplanationOfBenefit.Item parseExplanationOfBenefitItem(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Item.class, jsonObject);
         }
         ExplanationOfBenefit.Item.Builder builder = ExplanationOfBenefit.Item.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         JsonArray careTeamSequenceArray = getJsonArray(jsonObject, "careTeamSequence", true);
@@ -9291,10 +9541,11 @@ private ExplanationOfBenefit.Item.Adjudication parseExplanationOfBenefitItemAdju
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Item.Adjudication.class, jsonObject);
         }
         ExplanationOfBenefit.Item.Adjudication.Builder builder = ExplanationOfBenefit.Item.Adjudication.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
         builder.reason(parseCodeableConcept("reason", getJsonValue(jsonObject, "reason", JsonObject.class), -1));
@@ -9309,10 +9560,11 @@ private ExplanationOfBenefit.Item.Detail parseExplanationOfBenefitItemDetail(jav
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Item.Detail.class, jsonObject);
         }
         ExplanationOfBenefit.Item.Detail.Builder builder = ExplanationOfBenefit.Item.Detail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.revenue(parseCodeableConcept("revenue", getJsonValue(jsonObject, "revenue", JsonObject.class), -1));
@@ -9368,10 +9620,11 @@ private ExplanationOfBenefit.Item.Detail.SubDetail parseExplanationOfBenefitItem
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Item.Detail.SubDetail.class, jsonObject);
         }
         ExplanationOfBenefit.Item.Detail.SubDetail.Builder builder = ExplanationOfBenefit.Item.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.revenue(parseCodeableConcept("revenue", getJsonValue(jsonObject, "revenue", JsonObject.class), -1));
@@ -9421,10 +9674,11 @@ private ExplanationOfBenefit.Payee parseExplanationOfBenefitPayee(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Payee.class, jsonObject);
         }
         ExplanationOfBenefit.Payee.Builder builder = ExplanationOfBenefit.Payee.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.party(parseReference("party", getJsonValue(jsonObject, "party", JsonObject.class), -1));
@@ -9437,10 +9691,11 @@ private ExplanationOfBenefit.Payment parseExplanationOfBenefitPayment(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Payment.class, jsonObject);
         }
         ExplanationOfBenefit.Payment.Builder builder = ExplanationOfBenefit.Payment.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.adjustment(parseMoney("adjustment", getJsonValue(jsonObject, "adjustment", JsonObject.class), -1));
@@ -9457,10 +9712,11 @@ private ExplanationOfBenefit.Procedure parseExplanationOfBenefitProcedure(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Procedure.class, jsonObject);
         }
         ExplanationOfBenefit.Procedure.Builder builder = ExplanationOfBenefit.Procedure.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         JsonArray typeArray = getJsonArray(jsonObject, "type");
@@ -9486,10 +9742,11 @@ private ExplanationOfBenefit.ProcessNote parseExplanationOfBenefitProcessNote(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.ProcessNote.class, jsonObject);
         }
         ExplanationOfBenefit.ProcessNote.Builder builder = ExplanationOfBenefit.ProcessNote.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.number((PositiveInt) parseInteger(PositiveInt.builder(), "number", getJsonValue(jsonObject, "number", JsonNumber.class), jsonObject.get("_number"), -1));
         builder.type((NoteType) parseString(NoteType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -9504,10 +9761,11 @@ private ExplanationOfBenefit.Related parseExplanationOfBenefitRelated(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Related.class, jsonObject);
         }
         ExplanationOfBenefit.Related.Builder builder = ExplanationOfBenefit.Related.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.claim(parseReference("claim", getJsonValue(jsonObject, "claim", JsonObject.class), -1));
         builder.relationship(parseCodeableConcept("relationship", getJsonValue(jsonObject, "relationship", JsonObject.class), -1));
@@ -9521,10 +9779,11 @@ private ExplanationOfBenefit.SupportingInfo parseExplanationOfBenefitSupportingI
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.SupportingInfo.class, jsonObject);
         }
         ExplanationOfBenefit.SupportingInfo.Builder builder = ExplanationOfBenefit.SupportingInfo.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
@@ -9541,10 +9800,11 @@ private ExplanationOfBenefit.Total parseExplanationOfBenefitTotal(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ExplanationOfBenefit.Total.class, jsonObject);
         }
         ExplanationOfBenefit.Total.Builder builder = ExplanationOfBenefit.Total.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
         builder.amount(parseMoney("amount", getJsonValue(jsonObject, "amount", JsonObject.class), -1));
@@ -9557,10 +9817,11 @@ private Expression parseExpression(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Expression.class, jsonObject);
         }
         Expression.Builder builder = Expression.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.name((Id) parseString(Id.builder(), "name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
@@ -9576,10 +9837,11 @@ private Extension parseExtension(java.lang.String elementName, JsonObject jsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Extension.class, jsonObject);
         }
         Extension.Builder builder = Extension.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.url(parseJavaString("url", getJsonValue(jsonObject, "url", JsonString.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class));
@@ -9592,10 +9854,11 @@ private FamilyMemberHistory parseFamilyMemberHistory(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(FamilyMemberHistory.class, jsonObject);
         }
         FamilyMemberHistory.Builder builder = FamilyMemberHistory.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -9661,10 +9924,11 @@ private FamilyMemberHistory.Condition parseFamilyMemberHistoryCondition(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(FamilyMemberHistory.Condition.class, jsonObject);
         }
         FamilyMemberHistory.Condition.Builder builder = FamilyMemberHistory.Condition.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.outcome(parseCodeableConcept("outcome", getJsonValue(jsonObject, "outcome", JsonObject.class), -1));
@@ -9685,10 +9949,11 @@ private Flag parseFlag(java.lang.String elementName, JsonObject jsonObject, int
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Flag.class, jsonObject);
         }
         Flag.Builder builder = Flag.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -9717,10 +9982,11 @@ private Goal parseGoal(java.lang.String elementName, JsonObject jsonObject, int
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Goal.class, jsonObject);
         }
         Goal.Builder builder = Goal.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -9782,10 +10048,11 @@ private Goal.Target parseGoalTarget(java.lang.String elementName, JsonObject jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Goal.Target.class, jsonObject);
         }
         Goal.Target.Builder builder = Goal.Target.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.measure(parseCodeableConcept("measure", getJsonValue(jsonObject, "measure", JsonObject.class), -1));
         builder.detail(parseChoiceElement("detail", jsonObject, Quantity.class, Range.class, CodeableConcept.class, String.class, Boolean.class, Integer.class, Ratio.class));
@@ -9799,10 +10066,11 @@ private GraphDefinition parseGraphDefinition(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(GraphDefinition.class, jsonObject);
         }
         GraphDefinition.Builder builder = GraphDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -9848,10 +10116,11 @@ private GraphDefinition.Link parseGraphDefinitionLink(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(GraphDefinition.Link.class, jsonObject);
         }
         GraphDefinition.Link.Builder builder = GraphDefinition.Link.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.path(parseString("path", getJsonValue(jsonObject, "path", JsonString.class), jsonObject.get("_path"), -1));
         builder.sliceName(parseString("sliceName", getJsonValue(jsonObject, "sliceName", JsonString.class), jsonObject.get("_sliceName"), -1));
@@ -9873,10 +10142,11 @@ private GraphDefinition.Link.Target parseGraphDefinitionLinkTarget(java.lang.Str
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(GraphDefinition.Link.Target.class, jsonObject);
         }
         GraphDefinition.Link.Target.Builder builder = GraphDefinition.Link.Target.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((ResourceType) parseString(ResourceType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.params(parseString("params", getJsonValue(jsonObject, "params", JsonString.class), jsonObject.get("_params"), -1));
@@ -9902,10 +10172,11 @@ private GraphDefinition.Link.Target.Compartment parseGraphDefinitionLinkTargetCo
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(GraphDefinition.Link.Target.Compartment.class, jsonObject);
         }
         GraphDefinition.Link.Target.Compartment.Builder builder = GraphDefinition.Link.Target.Compartment.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.use((GraphCompartmentUse) parseString(GraphCompartmentUse.builder(), "use", getJsonValue(jsonObject, "use", JsonString.class), jsonObject.get("_use"), -1));
         builder.code((CompartmentCode) parseString(CompartmentCode.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
@@ -9921,10 +10192,11 @@ private Group parseGroup(java.lang.String elementName, JsonObject jsonObject, in
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Group.class, jsonObject);
         }
         Group.Builder builder = Group.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -9960,10 +10232,11 @@ private Group.Characteristic parseGroupCharacteristic(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Group.Characteristic.class, jsonObject);
         }
         Group.Characteristic.Builder builder = Group.Characteristic.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, CodeableConcept.class, Boolean.class, Quantity.class, Range.class, Reference.class));
@@ -9978,10 +10251,11 @@ private Group.Member parseGroupMember(java.lang.String elementName, JsonObject j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Group.Member.class, jsonObject);
         }
         Group.Member.Builder builder = Group.Member.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.entity(parseReference("entity", getJsonValue(jsonObject, "entity", JsonObject.class), -1));
         builder.period(parsePeriod("period", getJsonValue(jsonObject, "period", JsonObject.class), -1));
@@ -9995,10 +10269,11 @@ private GuidanceResponse parseGuidanceResponse(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(GuidanceResponse.class, jsonObject);
         }
         GuidanceResponse.Builder builder = GuidanceResponse.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.requestIdentifier(parseIdentifier("requestIdentifier", getJsonValue(jsonObject, "requestIdentifier", JsonObject.class), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -10054,10 +10329,11 @@ private HealthcareService parseHealthcareService(java.lang.String elementName, J
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(HealthcareService.class, jsonObject);
         }
         HealthcareService.Builder builder = HealthcareService.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -10172,10 +10448,11 @@ private HealthcareService.AvailableTime parseHealthcareServiceAvailableTime(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(HealthcareService.AvailableTime.class, jsonObject);
         }
         HealthcareService.AvailableTime.Builder builder = HealthcareService.AvailableTime.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray daysOfWeekArray = getJsonArray(jsonObject, "daysOfWeek", true);
         if (daysOfWeekArray != null) {
@@ -10196,10 +10473,11 @@ private HealthcareService.Eligibility parseHealthcareServiceEligibility(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(HealthcareService.Eligibility.class, jsonObject);
         }
         HealthcareService.Eligibility.Builder builder = HealthcareService.Eligibility.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.comment((Markdown) parseString(Markdown.builder(), "comment", getJsonValue(jsonObject, "comment", JsonString.class), jsonObject.get("_comment"), -1));
@@ -10212,10 +10490,11 @@ private HealthcareService.NotAvailable parseHealthcareServiceNotAvailable(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(HealthcareService.NotAvailable.class, jsonObject);
         }
         HealthcareService.NotAvailable.Builder builder = HealthcareService.NotAvailable.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.during(parsePeriod("during", getJsonValue(jsonObject, "during", JsonObject.class), -1));
@@ -10228,10 +10507,11 @@ private HumanName parseHumanName(java.lang.String elementName, JsonObject jsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(HumanName.class, jsonObject);
         }
         HumanName.Builder builder = HumanName.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.use((NameUse) parseString(NameUse.builder(), "use", getJsonValue(jsonObject, "use", JsonString.class), jsonObject.get("_use"), -1));
         builder.text(parseString("text", getJsonValue(jsonObject, "text", JsonString.class), jsonObject.get("_text"), -1));
@@ -10267,10 +10547,11 @@ private Identifier parseIdentifier(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Identifier.class, jsonObject);
         }
         Identifier.Builder builder = Identifier.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.use((IdentifierUse) parseString(IdentifierUse.builder(), "use", getJsonValue(jsonObject, "use", JsonString.class), jsonObject.get("_use"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -10287,10 +10568,11 @@ private ImagingStudy parseImagingStudy(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImagingStudy.class, jsonObject);
         }
         ImagingStudy.Builder builder = ImagingStudy.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -10371,10 +10653,11 @@ private ImagingStudy.Series parseImagingStudySeries(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImagingStudy.Series.class, jsonObject);
         }
         ImagingStudy.Series.Builder builder = ImagingStudy.Series.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.uid((Id) parseString(Id.builder(), "uid", getJsonValue(jsonObject, "uid", JsonString.class), jsonObject.get("_uid"), -1));
         builder.number((UnsignedInt) parseInteger(UnsignedInt.builder(), "number", getJsonValue(jsonObject, "number", JsonNumber.class), jsonObject.get("_number"), -1));
@@ -10417,10 +10700,11 @@ private ImagingStudy.Series.Instance parseImagingStudySeriesInstance(java.lang.S
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImagingStudy.Series.Instance.class, jsonObject);
         }
         ImagingStudy.Series.Instance.Builder builder = ImagingStudy.Series.Instance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.uid((Id) parseString(Id.builder(), "uid", getJsonValue(jsonObject, "uid", JsonString.class), jsonObject.get("_uid"), -1));
         builder.sopClass(parseCoding("sopClass", getJsonValue(jsonObject, "sopClass", JsonObject.class), -1));
@@ -10435,10 +10719,11 @@ private ImagingStudy.Series.Performer parseImagingStudySeriesPerformer(java.lang
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImagingStudy.Series.Performer.class, jsonObject);
         }
         ImagingStudy.Series.Performer.Builder builder = ImagingStudy.Series.Performer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.function(parseCodeableConcept("function", getJsonValue(jsonObject, "function", JsonObject.class), -1));
         builder.actor(parseReference("actor", getJsonValue(jsonObject, "actor", JsonObject.class), -1));
@@ -10451,10 +10736,11 @@ private Immunization parseImmunization(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Immunization.class, jsonObject);
         }
         Immunization.Builder builder = Immunization.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -10543,10 +10829,11 @@ private Immunization.Education parseImmunizationEducation(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Immunization.Education.class, jsonObject);
         }
         Immunization.Education.Builder builder = Immunization.Education.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.documentType(parseString("documentType", getJsonValue(jsonObject, "documentType", JsonString.class), jsonObject.get("_documentType"), -1));
         builder.reference(parseUri("reference", getJsonValue(jsonObject, "reference", JsonString.class), jsonObject.get("_reference"), -1));
@@ -10561,10 +10848,11 @@ private Immunization.Performer parseImmunizationPerformer(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Immunization.Performer.class, jsonObject);
         }
         Immunization.Performer.Builder builder = Immunization.Performer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.function(parseCodeableConcept("function", getJsonValue(jsonObject, "function", JsonObject.class), -1));
         builder.actor(parseReference("actor", getJsonValue(jsonObject, "actor", JsonObject.class), -1));
@@ -10577,10 +10865,11 @@ private Immunization.ProtocolApplied parseImmunizationProtocolApplied(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Immunization.ProtocolApplied.class, jsonObject);
         }
         Immunization.ProtocolApplied.Builder builder = Immunization.ProtocolApplied.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.series(parseString("series", getJsonValue(jsonObject, "series", JsonString.class), jsonObject.get("_series"), -1));
         builder.authority(parseReference("authority", getJsonValue(jsonObject, "authority", JsonObject.class), -1));
@@ -10601,10 +10890,11 @@ private Immunization.Reaction parseImmunizationReaction(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Immunization.Reaction.class, jsonObject);
         }
         Immunization.Reaction.Builder builder = Immunization.Reaction.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.date(parseDateTime("date", getJsonValue(jsonObject, "date", JsonString.class), jsonObject.get("_date"), -1));
         builder.detail(parseReference("detail", getJsonValue(jsonObject, "detail", JsonObject.class), -1));
@@ -10618,10 +10908,11 @@ private ImmunizationEvaluation parseImmunizationEvaluation(java.lang.String elem
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImmunizationEvaluation.class, jsonObject);
         }
         ImmunizationEvaluation.Builder builder = ImmunizationEvaluation.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -10655,10 +10946,11 @@ private ImmunizationRecommendation parseImmunizationRecommendation(java.lang.Str
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImmunizationRecommendation.class, jsonObject);
         }
         ImmunizationRecommendation.Builder builder = ImmunizationRecommendation.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -10684,10 +10976,11 @@ private ImmunizationRecommendation.Recommendation parseImmunizationRecommendatio
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImmunizationRecommendation.Recommendation.class, jsonObject);
         }
         ImmunizationRecommendation.Recommendation.Builder builder = ImmunizationRecommendation.Recommendation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray vaccineCodeArray = getJsonArray(jsonObject, "vaccineCode");
         if (vaccineCodeArray != null) {
@@ -10740,10 +11033,11 @@ private ImmunizationRecommendation.Recommendation.DateCriterion parseImmunizatio
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImmunizationRecommendation.Recommendation.DateCriterion.class, jsonObject);
         }
         ImmunizationRecommendation.Recommendation.DateCriterion.Builder builder = ImmunizationRecommendation.Recommendation.DateCriterion.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.value(parseDateTime("value", getJsonValue(jsonObject, "value", JsonString.class), jsonObject.get("_value"), -1));
@@ -10756,10 +11050,11 @@ private ImplementationGuide parseImplementationGuide(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.class, jsonObject);
         }
         ImplementationGuide.Builder builder = ImplementationGuide.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -10821,10 +11116,11 @@ private ImplementationGuide.Definition parseImplementationGuideDefinition(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Definition.class, jsonObject);
         }
         ImplementationGuide.Definition.Builder builder = ImplementationGuide.Definition.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray groupingArray = getJsonArray(jsonObject, "grouping");
         if (groupingArray != null) {
@@ -10860,10 +11156,11 @@ private ImplementationGuide.Definition.Grouping parseImplementationGuideDefiniti
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Definition.Grouping.class, jsonObject);
         }
         ImplementationGuide.Definition.Grouping.Builder builder = ImplementationGuide.Definition.Grouping.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -10876,10 +11173,11 @@ private ImplementationGuide.Definition.Page parseImplementationGuideDefinitionPa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Definition.Page.class, jsonObject);
         }
         ImplementationGuide.Definition.Page.Builder builder = ImplementationGuide.Definition.Page.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseChoiceElement("name", jsonObject, Url.class, Reference.class));
         builder.title(parseString("title", getJsonValue(jsonObject, "title", JsonString.class), jsonObject.get("_title"), -1));
@@ -10899,10 +11197,11 @@ private ImplementationGuide.Definition.Parameter parseImplementationGuideDefinit
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Definition.Parameter.class, jsonObject);
         }
         ImplementationGuide.Definition.Parameter.Builder builder = ImplementationGuide.Definition.Parameter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((GuideParameterCode) parseString(GuideParameterCode.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.value(parseString("value", getJsonValue(jsonObject, "value", JsonString.class), jsonObject.get("_value"), -1));
@@ -10915,10 +11214,11 @@ private ImplementationGuide.Definition.Resource parseImplementationGuideDefiniti
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Definition.Resource.class, jsonObject);
         }
         ImplementationGuide.Definition.Resource.Builder builder = ImplementationGuide.Definition.Resource.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.reference(parseReference("reference", getJsonValue(jsonObject, "reference", JsonObject.class), -1));
         JsonArray fhirVersionArray = getJsonArray(jsonObject, "fhirVersion", true);
@@ -10941,10 +11241,11 @@ private ImplementationGuide.Definition.Template parseImplementationGuideDefiniti
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Definition.Template.class, jsonObject);
         }
         ImplementationGuide.Definition.Template.Builder builder = ImplementationGuide.Definition.Template.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.source(parseString("source", getJsonValue(jsonObject, "source", JsonString.class), jsonObject.get("_source"), -1));
@@ -10958,10 +11259,11 @@ private ImplementationGuide.DependsOn parseImplementationGuideDependsOn(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.DependsOn.class, jsonObject);
         }
         ImplementationGuide.DependsOn.Builder builder = ImplementationGuide.DependsOn.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.uri((Canonical) parseUri(Canonical.builder(), "uri", getJsonValue(jsonObject, "uri", JsonString.class), jsonObject.get("_uri"), -1));
         builder.packageId((Id) parseString(Id.builder(), "packageId", getJsonValue(jsonObject, "packageId", JsonString.class), jsonObject.get("_packageId"), -1));
@@ -10975,10 +11277,11 @@ private ImplementationGuide.Global parseImplementationGuideGlobal(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Global.class, jsonObject);
         }
         ImplementationGuide.Global.Builder builder = ImplementationGuide.Global.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((ResourceType) parseString(ResourceType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.profile((Canonical) parseUri(Canonical.builder(), "profile", getJsonValue(jsonObject, "profile", JsonString.class), jsonObject.get("_profile"), -1));
@@ -10991,10 +11294,11 @@ private ImplementationGuide.Manifest parseImplementationGuideManifest(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Manifest.class, jsonObject);
         }
         ImplementationGuide.Manifest.Builder builder = ImplementationGuide.Manifest.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.rendering((Url) parseUri(Url.builder(), "rendering", getJsonValue(jsonObject, "rendering", JsonString.class), jsonObject.get("_rendering"), -1));
         JsonArray resourceArray = getJsonArray(jsonObject, "resource");
@@ -11032,10 +11336,11 @@ private ImplementationGuide.Manifest.Page parseImplementationGuideManifestPage(j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Manifest.Page.class, jsonObject);
         }
         ImplementationGuide.Manifest.Page.Builder builder = ImplementationGuide.Manifest.Page.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.title(parseString("title", getJsonValue(jsonObject, "title", JsonString.class), jsonObject.get("_title"), -1));
@@ -11055,10 +11360,11 @@ private ImplementationGuide.Manifest.Resource parseImplementationGuideManifestRe
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ImplementationGuide.Manifest.Resource.class, jsonObject);
         }
         ImplementationGuide.Manifest.Resource.Builder builder = ImplementationGuide.Manifest.Resource.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.reference(parseReference("reference", getJsonValue(jsonObject, "reference", JsonObject.class), -1));
         builder.example(parseChoiceElement("example", jsonObject, Boolean.class, Canonical.class));
@@ -11073,9 +11379,10 @@ private Instant parseInstant(java.lang.String elementName, JsonValue jsonValue,
         }
         stackPush(elementName, elementIndex);
         Instant.Builder builder = Instant.builder();
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -11097,10 +11404,11 @@ private InsurancePlan parseInsurancePlan(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.class, jsonObject);
         }
         InsurancePlan.Builder builder = InsurancePlan.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -11171,10 +11479,11 @@ private InsurancePlan.Contact parseInsurancePlanContact(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.Contact.class, jsonObject);
         }
         InsurancePlan.Contact.Builder builder = InsurancePlan.Contact.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.purpose(parseCodeableConcept("purpose", getJsonValue(jsonObject, "purpose", JsonObject.class), -1));
         builder.name(parseHumanName("name", getJsonValue(jsonObject, "name", JsonObject.class), -1));
@@ -11194,10 +11503,11 @@ private InsurancePlan.Coverage parseInsurancePlanCoverage(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.Coverage.class, jsonObject);
         }
         InsurancePlan.Coverage.Builder builder = InsurancePlan.Coverage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray networkArray = getJsonArray(jsonObject, "network");
@@ -11221,10 +11531,11 @@ private InsurancePlan.Coverage.Benefit parseInsurancePlanCoverageBenefit(java.la
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.Coverage.Benefit.class, jsonObject);
         }
         InsurancePlan.Coverage.Benefit.Builder builder = InsurancePlan.Coverage.Benefit.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.requirement(parseString("requirement", getJsonValue(jsonObject, "requirement", JsonString.class), jsonObject.get("_requirement"), -1));
@@ -11243,10 +11554,11 @@ private InsurancePlan.Coverage.Benefit.Limit parseInsurancePlanCoverageBenefitLi
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.Coverage.Benefit.Limit.class, jsonObject);
         }
         InsurancePlan.Coverage.Benefit.Limit.Builder builder = InsurancePlan.Coverage.Benefit.Limit.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.value(parseQuantity("value", getJsonValue(jsonObject, "value", JsonObject.class), -1));
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
@@ -11259,10 +11571,11 @@ private InsurancePlan.Plan parseInsurancePlanPlan(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.Plan.class, jsonObject);
         }
         InsurancePlan.Plan.Builder builder = InsurancePlan.Plan.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -11304,10 +11617,11 @@ private InsurancePlan.Plan.GeneralCost parseInsurancePlanPlanGeneralCost(java.la
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.Plan.GeneralCost.class, jsonObject);
         }
         InsurancePlan.Plan.GeneralCost.Builder builder = InsurancePlan.Plan.GeneralCost.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.groupSize((PositiveInt) parseInteger(PositiveInt.builder(), "groupSize", getJsonValue(jsonObject, "groupSize", JsonNumber.class), jsonObject.get("_groupSize"), -1));
@@ -11322,10 +11636,11 @@ private InsurancePlan.Plan.SpecificCost parseInsurancePlanPlanSpecificCost(java.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.Plan.SpecificCost.class, jsonObject);
         }
         InsurancePlan.Plan.SpecificCost.Builder builder = InsurancePlan.Plan.SpecificCost.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
         JsonArray benefitArray = getJsonArray(jsonObject, "benefit");
@@ -11343,10 +11658,11 @@ private InsurancePlan.Plan.SpecificCost.Benefit parseInsurancePlanPlanSpecificCo
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.Plan.SpecificCost.Benefit.class, jsonObject);
         }
         InsurancePlan.Plan.SpecificCost.Benefit.Builder builder = InsurancePlan.Plan.SpecificCost.Benefit.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray costArray = getJsonArray(jsonObject, "cost");
@@ -11364,10 +11680,11 @@ private InsurancePlan.Plan.SpecificCost.Benefit.Cost parseInsurancePlanPlanSpeci
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(InsurancePlan.Plan.SpecificCost.Benefit.Cost.class, jsonObject);
         }
         InsurancePlan.Plan.SpecificCost.Benefit.Cost.Builder builder = InsurancePlan.Plan.SpecificCost.Benefit.Cost.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.applicability(parseCodeableConcept("applicability", getJsonValue(jsonObject, "applicability", JsonObject.class), -1));
@@ -11387,9 +11704,10 @@ private Integer parseInteger(Integer.Builder builder, java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -11415,10 +11733,11 @@ private Invoice parseInvoice(java.lang.String elementName, JsonObject jsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Invoice.class, jsonObject);
         }
         Invoice.Builder builder = Invoice.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -11470,10 +11789,11 @@ private Invoice.LineItem parseInvoiceLineItem(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Invoice.LineItem.class, jsonObject);
         }
         Invoice.LineItem.Builder builder = Invoice.LineItem.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.sequence((PositiveInt) parseInteger(PositiveInt.builder(), "sequence", getJsonValue(jsonObject, "sequence", JsonNumber.class), jsonObject.get("_sequence"), -1));
         builder.chargeItem(parseChoiceElement("chargeItem", jsonObject, Reference.class, CodeableConcept.class));
@@ -11492,10 +11812,11 @@ private Invoice.LineItem.PriceComponent parseInvoiceLineItemPriceComponent(java.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Invoice.LineItem.PriceComponent.class, jsonObject);
         }
         Invoice.LineItem.PriceComponent.Builder builder = Invoice.LineItem.PriceComponent.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((InvoicePriceComponentType) parseString(InvoicePriceComponentType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
@@ -11510,10 +11831,11 @@ private Invoice.Participant parseInvoiceParticipant(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Invoice.Participant.class, jsonObject);
         }
         Invoice.Participant.Builder builder = Invoice.Participant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.role(parseCodeableConcept("role", getJsonValue(jsonObject, "role", JsonObject.class), -1));
         builder.actor(parseReference("actor", getJsonValue(jsonObject, "actor", JsonObject.class), -1));
@@ -11526,10 +11848,11 @@ private Library parseLibrary(java.lang.String elementName, JsonObject jsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Library.class, jsonObject);
         }
         Library.Builder builder = Library.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -11636,10 +11959,11 @@ private Linkage parseLinkage(java.lang.String elementName, JsonObject jsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Linkage.class, jsonObject);
         }
         Linkage.Builder builder = Linkage.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.active(parseBoolean("active", getJsonValue(jsonObject, "active", JsonValue.class), jsonObject.get("_active"), -1));
         builder.author(parseReference("author", getJsonValue(jsonObject, "author", JsonObject.class), -1));
@@ -11658,10 +11982,11 @@ private Linkage.Item parseLinkageItem(java.lang.String elementName, JsonObject j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Linkage.Item.class, jsonObject);
         }
         Linkage.Item.Builder builder = Linkage.Item.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((LinkageType) parseString(LinkageType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.resource(parseReference("resource", getJsonValue(jsonObject, "resource", JsonObject.class), -1));
@@ -11674,10 +11999,11 @@ private List parseList(java.lang.String elementName, JsonObject jsonObject, int
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(List.class, jsonObject);
         }
         List.Builder builder = List.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -11716,10 +12042,11 @@ private List.Entry parseListEntry(java.lang.String elementName, JsonObject jsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(List.Entry.class, jsonObject);
         }
         List.Entry.Builder builder = List.Entry.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.flag(parseCodeableConcept("flag", getJsonValue(jsonObject, "flag", JsonObject.class), -1));
         builder.deleted(parseBoolean("deleted", getJsonValue(jsonObject, "deleted", JsonValue.class), jsonObject.get("_deleted"), -1));
@@ -11734,10 +12061,11 @@ private Location parseLocation(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Location.class, jsonObject);
         }
         Location.Builder builder = Location.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -11796,10 +12124,11 @@ private Location.HoursOfOperation parseLocationHoursOfOperation(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Location.HoursOfOperation.class, jsonObject);
         }
         Location.HoursOfOperation.Builder builder = Location.HoursOfOperation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray daysOfWeekArray = getJsonArray(jsonObject, "daysOfWeek", true);
         if (daysOfWeekArray != null) {
@@ -11820,10 +12149,11 @@ private Location.Position parseLocationPosition(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Location.Position.class, jsonObject);
         }
         Location.Position.Builder builder = Location.Position.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.longitude(parseDecimal("longitude", getJsonValue(jsonObject, "longitude", JsonNumber.class), jsonObject.get("_longitude"), -1));
         builder.latitude(parseDecimal("latitude", getJsonValue(jsonObject, "latitude", JsonNumber.class), jsonObject.get("_latitude"), -1));
@@ -11837,10 +12167,11 @@ private MarketingStatus parseMarketingStatus(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MarketingStatus.class, jsonObject);
         }
         MarketingStatus.Builder builder = MarketingStatus.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.country(parseCodeableConcept("country", getJsonValue(jsonObject, "country", JsonObject.class), -1));
         builder.jurisdiction(parseCodeableConcept("jurisdiction", getJsonValue(jsonObject, "jurisdiction", JsonObject.class), -1));
@@ -11856,10 +12187,11 @@ private Measure parseMeasure(java.lang.String elementName, JsonObject jsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Measure.class, jsonObject);
         }
         Measure.Builder builder = Measure.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -11988,10 +12320,11 @@ private Measure.Group parseMeasureGroup(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Measure.Group.class, jsonObject);
         }
         Measure.Group.Builder builder = Measure.Group.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -12016,10 +12349,11 @@ private Measure.Group.Population parseMeasureGroupPopulation(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Measure.Group.Population.class, jsonObject);
         }
         Measure.Group.Population.Builder builder = Measure.Group.Population.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -12033,10 +12367,11 @@ private Measure.Group.Stratifier parseMeasureGroupStratifier(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Measure.Group.Stratifier.class, jsonObject);
         }
         Measure.Group.Stratifier.Builder builder = Measure.Group.Stratifier.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -12056,10 +12391,11 @@ private Measure.Group.Stratifier.Component parseMeasureGroupStratifierComponent(
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Measure.Group.Stratifier.Component.class, jsonObject);
         }
         Measure.Group.Stratifier.Component.Builder builder = Measure.Group.Stratifier.Component.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -12073,10 +12409,11 @@ private Measure.SupplementalData parseMeasureSupplementalData(java.lang.String e
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Measure.SupplementalData.class, jsonObject);
         }
         Measure.SupplementalData.Builder builder = Measure.SupplementalData.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         JsonArray usageArray = getJsonArray(jsonObject, "usage");
@@ -12096,10 +12433,11 @@ private MeasureReport parseMeasureReport(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MeasureReport.class, jsonObject);
         }
         MeasureReport.Builder builder = MeasureReport.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -12136,10 +12474,11 @@ private MeasureReport.Group parseMeasureReportGroup(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MeasureReport.Group.class, jsonObject);
         }
         MeasureReport.Group.Builder builder = MeasureReport.Group.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         JsonArray populationArray = getJsonArray(jsonObject, "population");
@@ -12164,10 +12503,11 @@ private MeasureReport.Group.Population parseMeasureReportGroupPopulation(java.la
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MeasureReport.Group.Population.class, jsonObject);
         }
         MeasureReport.Group.Population.Builder builder = MeasureReport.Group.Population.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.count(parseInteger("count", getJsonValue(jsonObject, "count", JsonNumber.class), jsonObject.get("_count"), -1));
@@ -12181,10 +12521,11 @@ private MeasureReport.Group.Stratifier parseMeasureReportGroupStratifier(java.la
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MeasureReport.Group.Stratifier.class, jsonObject);
         }
         MeasureReport.Group.Stratifier.Builder builder = MeasureReport.Group.Stratifier.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray codeArray = getJsonArray(jsonObject, "code");
         if (codeArray != null) {
@@ -12207,10 +12548,11 @@ private MeasureReport.Group.Stratifier.Stratum parseMeasureReportGroupStratifier
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MeasureReport.Group.Stratifier.Stratum.class, jsonObject);
         }
         MeasureReport.Group.Stratifier.Stratum.Builder builder = MeasureReport.Group.Stratifier.Stratum.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.value(parseCodeableConcept("value", getJsonValue(jsonObject, "value", JsonObject.class), -1));
         JsonArray componentArray = getJsonArray(jsonObject, "component");
@@ -12235,10 +12577,11 @@ private MeasureReport.Group.Stratifier.Stratum.Component parseMeasureReportGroup
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MeasureReport.Group.Stratifier.Stratum.Component.class, jsonObject);
         }
         MeasureReport.Group.Stratifier.Stratum.Component.Builder builder = MeasureReport.Group.Stratifier.Stratum.Component.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.value(parseCodeableConcept("value", getJsonValue(jsonObject, "value", JsonObject.class), -1));
@@ -12251,10 +12594,11 @@ private MeasureReport.Group.Stratifier.Stratum.Population parseMeasureReportGrou
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MeasureReport.Group.Stratifier.Stratum.Population.class, jsonObject);
         }
         MeasureReport.Group.Stratifier.Stratum.Population.Builder builder = MeasureReport.Group.Stratifier.Stratum.Population.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.count(parseInteger("count", getJsonValue(jsonObject, "count", JsonNumber.class), jsonObject.get("_count"), -1));
@@ -12268,10 +12612,11 @@ private Media parseMedia(java.lang.String elementName, JsonObject jsonObject, in
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Media.class, jsonObject);
         }
         Media.Builder builder = Media.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -12329,10 +12674,11 @@ private Medication parseMedication(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Medication.class, jsonObject);
         }
         Medication.Builder builder = Medication.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -12361,10 +12707,11 @@ private Medication.Batch parseMedicationBatch(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Medication.Batch.class, jsonObject);
         }
         Medication.Batch.Builder builder = Medication.Batch.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.lotNumber(parseString("lotNumber", getJsonValue(jsonObject, "lotNumber", JsonString.class), jsonObject.get("_lotNumber"), -1));
         builder.expirationDate(parseDateTime("expirationDate", getJsonValue(jsonObject, "expirationDate", JsonString.class), jsonObject.get("_expirationDate"), -1));
@@ -12377,10 +12724,11 @@ private Medication.Ingredient parseMedicationIngredient(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Medication.Ingredient.class, jsonObject);
         }
         Medication.Ingredient.Builder builder = Medication.Ingredient.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.item(parseChoiceElement("item", jsonObject, CodeableConcept.class, Reference.class));
         builder.isActive(parseBoolean("isActive", getJsonValue(jsonObject, "isActive", JsonValue.class), jsonObject.get("_isActive"), -1));
@@ -12394,10 +12742,11 @@ private MedicationAdministration parseMedicationAdministration(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationAdministration.class, jsonObject);
         }
         MedicationAdministration.Builder builder = MedicationAdministration.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -12483,10 +12832,11 @@ private MedicationAdministration.Dosage parseMedicationAdministrationDosage(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationAdministration.Dosage.class, jsonObject);
         }
         MedicationAdministration.Dosage.Builder builder = MedicationAdministration.Dosage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.text(parseString("text", getJsonValue(jsonObject, "text", JsonString.class), jsonObject.get("_text"), -1));
         builder.site(parseCodeableConcept("site", getJsonValue(jsonObject, "site", JsonObject.class), -1));
@@ -12503,10 +12853,11 @@ private MedicationAdministration.Performer parseMedicationAdministrationPerforme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationAdministration.Performer.class, jsonObject);
         }
         MedicationAdministration.Performer.Builder builder = MedicationAdministration.Performer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.function(parseCodeableConcept("function", getJsonValue(jsonObject, "function", JsonObject.class), -1));
         builder.actor(parseReference("actor", getJsonValue(jsonObject, "actor", JsonObject.class), -1));
@@ -12519,10 +12870,11 @@ private MedicationDispense parseMedicationDispense(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationDispense.class, jsonObject);
         }
         MedicationDispense.Builder builder = MedicationDispense.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -12607,10 +12959,11 @@ private MedicationDispense.Performer parseMedicationDispensePerformer(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationDispense.Performer.class, jsonObject);
         }
         MedicationDispense.Performer.Builder builder = MedicationDispense.Performer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.function(parseCodeableConcept("function", getJsonValue(jsonObject, "function", JsonObject.class), -1));
         builder.actor(parseReference("actor", getJsonValue(jsonObject, "actor", JsonObject.class), -1));
@@ -12623,10 +12976,11 @@ private MedicationDispense.Substitution parseMedicationDispenseSubstitution(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationDispense.Substitution.class, jsonObject);
         }
         MedicationDispense.Substitution.Builder builder = MedicationDispense.Substitution.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.wasSubstituted(parseBoolean("wasSubstituted", getJsonValue(jsonObject, "wasSubstituted", JsonValue.class), jsonObject.get("_wasSubstituted"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -12651,10 +13005,11 @@ private MedicationKnowledge parseMedicationKnowledge(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.class, jsonObject);
         }
         MedicationKnowledge.Builder builder = MedicationKnowledge.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.status((MedicationKnowledgeStatus) parseString(MedicationKnowledgeStatus.builder(), "status", getJsonValue(jsonObject, "status", JsonString.class), jsonObject.get("_status"), -1));
@@ -12763,10 +13118,11 @@ private MedicationKnowledge.AdministrationGuidelines parseMedicationKnowledgeAdm
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.AdministrationGuidelines.class, jsonObject);
         }
         MedicationKnowledge.AdministrationGuidelines.Builder builder = MedicationKnowledge.AdministrationGuidelines.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray dosageArray = getJsonArray(jsonObject, "dosage");
         if (dosageArray != null) {
@@ -12790,10 +13146,11 @@ private MedicationKnowledge.AdministrationGuidelines.Dosage parseMedicationKnowl
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.AdministrationGuidelines.Dosage.class, jsonObject);
         }
         MedicationKnowledge.AdministrationGuidelines.Dosage.Builder builder = MedicationKnowledge.AdministrationGuidelines.Dosage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray dosageArray = getJsonArray(jsonObject, "dosage");
@@ -12811,10 +13168,11 @@ private MedicationKnowledge.AdministrationGuidelines.PatientCharacteristics pars
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.AdministrationGuidelines.PatientCharacteristics.class, jsonObject);
         }
         MedicationKnowledge.AdministrationGuidelines.PatientCharacteristics.Builder builder = MedicationKnowledge.AdministrationGuidelines.PatientCharacteristics.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.characteristic(parseChoiceElement("characteristic", jsonObject, CodeableConcept.class, SimpleQuantity.class));
         JsonArray valueArray = getJsonArray(jsonObject, "value", true);
@@ -12833,10 +13191,11 @@ private MedicationKnowledge.Cost parseMedicationKnowledgeCost(java.lang.String e
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.Cost.class, jsonObject);
         }
         MedicationKnowledge.Cost.Builder builder = MedicationKnowledge.Cost.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.source(parseString("source", getJsonValue(jsonObject, "source", JsonString.class), jsonObject.get("_source"), -1));
@@ -12850,10 +13209,11 @@ private MedicationKnowledge.DrugCharacteristic parseMedicationKnowledgeDrugChara
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.DrugCharacteristic.class, jsonObject);
         }
         MedicationKnowledge.DrugCharacteristic.Builder builder = MedicationKnowledge.DrugCharacteristic.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, CodeableConcept.class, String.class, SimpleQuantity.class, Base64Binary.class));
@@ -12866,10 +13226,11 @@ private MedicationKnowledge.Ingredient parseMedicationKnowledgeIngredient(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.Ingredient.class, jsonObject);
         }
         MedicationKnowledge.Ingredient.Builder builder = MedicationKnowledge.Ingredient.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.item(parseChoiceElement("item", jsonObject, CodeableConcept.class, Reference.class));
         builder.isActive(parseBoolean("isActive", getJsonValue(jsonObject, "isActive", JsonValue.class), jsonObject.get("_isActive"), -1));
@@ -12883,10 +13244,11 @@ private MedicationKnowledge.Kinetics parseMedicationKnowledgeKinetics(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.Kinetics.class, jsonObject);
         }
         MedicationKnowledge.Kinetics.Builder builder = MedicationKnowledge.Kinetics.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray areaUnderCurveArray = getJsonArray(jsonObject, "areaUnderCurve");
         if (areaUnderCurveArray != null) {
@@ -12910,10 +13272,11 @@ private MedicationKnowledge.MedicineClassification parseMedicationKnowledgeMedic
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.MedicineClassification.class, jsonObject);
         }
         MedicationKnowledge.MedicineClassification.Builder builder = MedicationKnowledge.MedicineClassification.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray classificationArray = getJsonArray(jsonObject, "classification");
@@ -12931,10 +13294,11 @@ private MedicationKnowledge.MonitoringProgram parseMedicationKnowledgeMonitoring
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.MonitoringProgram.class, jsonObject);
         }
         MedicationKnowledge.MonitoringProgram.Builder builder = MedicationKnowledge.MonitoringProgram.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
@@ -12947,10 +13311,11 @@ private MedicationKnowledge.Monograph parseMedicationKnowledgeMonograph(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.Monograph.class, jsonObject);
         }
         MedicationKnowledge.Monograph.Builder builder = MedicationKnowledge.Monograph.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.source(parseReference("source", getJsonValue(jsonObject, "source", JsonObject.class), -1));
@@ -12963,10 +13328,11 @@ private MedicationKnowledge.Packaging parseMedicationKnowledgePackaging(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.Packaging.class, jsonObject);
         }
         MedicationKnowledge.Packaging.Builder builder = MedicationKnowledge.Packaging.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.quantity((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "quantity", getJsonValue(jsonObject, "quantity", JsonObject.class), -1));
@@ -12979,10 +13345,11 @@ private MedicationKnowledge.Regulatory parseMedicationKnowledgeRegulatory(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.Regulatory.class, jsonObject);
         }
         MedicationKnowledge.Regulatory.Builder builder = MedicationKnowledge.Regulatory.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.regulatoryAuthority(parseReference("regulatoryAuthority", getJsonValue(jsonObject, "regulatoryAuthority", JsonObject.class), -1));
         JsonArray substitutionArray = getJsonArray(jsonObject, "substitution");
@@ -13007,10 +13374,11 @@ private MedicationKnowledge.Regulatory.MaxDispense parseMedicationKnowledgeRegul
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.Regulatory.MaxDispense.class, jsonObject);
         }
         MedicationKnowledge.Regulatory.MaxDispense.Builder builder = MedicationKnowledge.Regulatory.MaxDispense.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.quantity((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "quantity", getJsonValue(jsonObject, "quantity", JsonObject.class), -1));
         builder.period((Duration) parseQuantity(Duration.builder(), "period", getJsonValue(jsonObject, "period", JsonObject.class), -1));
@@ -13023,10 +13391,11 @@ private MedicationKnowledge.Regulatory.Schedule parseMedicationKnowledgeRegulato
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.Regulatory.Schedule.class, jsonObject);
         }
         MedicationKnowledge.Regulatory.Schedule.Builder builder = MedicationKnowledge.Regulatory.Schedule.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.schedule(parseCodeableConcept("schedule", getJsonValue(jsonObject, "schedule", JsonObject.class), -1));
         stackPop();
@@ -13038,10 +13407,11 @@ private MedicationKnowledge.Regulatory.Substitution parseMedicationKnowledgeRegu
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.Regulatory.Substitution.class, jsonObject);
         }
         MedicationKnowledge.Regulatory.Substitution.Builder builder = MedicationKnowledge.Regulatory.Substitution.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.allowed(parseBoolean("allowed", getJsonValue(jsonObject, "allowed", JsonValue.class), jsonObject.get("_allowed"), -1));
@@ -13054,10 +13424,11 @@ private MedicationKnowledge.RelatedMedicationKnowledge parseMedicationKnowledgeR
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationKnowledge.RelatedMedicationKnowledge.class, jsonObject);
         }
         MedicationKnowledge.RelatedMedicationKnowledge.Builder builder = MedicationKnowledge.RelatedMedicationKnowledge.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray referenceArray = getJsonArray(jsonObject, "reference");
@@ -13075,10 +13446,11 @@ private MedicationRequest parseMedicationRequest(java.lang.String elementName, J
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationRequest.class, jsonObject);
         }
         MedicationRequest.Builder builder = MedicationRequest.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -13188,10 +13560,11 @@ private MedicationRequest.DispenseRequest parseMedicationRequestDispenseRequest(
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationRequest.DispenseRequest.class, jsonObject);
         }
         MedicationRequest.DispenseRequest.Builder builder = MedicationRequest.DispenseRequest.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.initialFill(parseMedicationRequestDispenseRequestInitialFill("initialFill", getJsonValue(jsonObject, "initialFill", JsonObject.class), -1));
         builder.dispenseInterval((Duration) parseQuantity(Duration.builder(), "dispenseInterval", getJsonValue(jsonObject, "dispenseInterval", JsonObject.class), -1));
@@ -13209,10 +13582,11 @@ private MedicationRequest.DispenseRequest.InitialFill parseMedicationRequestDisp
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationRequest.DispenseRequest.InitialFill.class, jsonObject);
         }
         MedicationRequest.DispenseRequest.InitialFill.Builder builder = MedicationRequest.DispenseRequest.InitialFill.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.quantity((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "quantity", getJsonValue(jsonObject, "quantity", JsonObject.class), -1));
         builder.duration((Duration) parseQuantity(Duration.builder(), "duration", getJsonValue(jsonObject, "duration", JsonObject.class), -1));
@@ -13225,10 +13599,11 @@ private MedicationRequest.Substitution parseMedicationRequestSubstitution(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationRequest.Substitution.class, jsonObject);
         }
         MedicationRequest.Substitution.Builder builder = MedicationRequest.Substitution.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.allowed(parseChoiceElement("allowed", jsonObject, Boolean.class, CodeableConcept.class));
         builder.reason(parseCodeableConcept("reason", getJsonValue(jsonObject, "reason", JsonObject.class), -1));
@@ -13241,10 +13616,11 @@ private MedicationStatement parseMedicationStatement(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicationStatement.class, jsonObject);
         }
         MedicationStatement.Builder builder = MedicationStatement.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -13317,10 +13693,11 @@ private MedicinalProduct parseMedicinalProduct(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProduct.class, jsonObject);
         }
         MedicinalProduct.Builder builder = MedicinalProduct.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -13422,10 +13799,11 @@ private MedicinalProduct.ManufacturingBusinessOperation parseMedicinalProductMan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProduct.ManufacturingBusinessOperation.class, jsonObject);
         }
         MedicinalProduct.ManufacturingBusinessOperation.Builder builder = MedicinalProduct.ManufacturingBusinessOperation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.operationType(parseCodeableConcept("operationType", getJsonValue(jsonObject, "operationType", JsonObject.class), -1));
         builder.authorisationReferenceNumber(parseIdentifier("authorisationReferenceNumber", getJsonValue(jsonObject, "authorisationReferenceNumber", JsonObject.class), -1));
@@ -13447,10 +13825,11 @@ private MedicinalProduct.Name parseMedicinalProductName(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProduct.Name.class, jsonObject);
         }
         MedicinalProduct.Name.Builder builder = MedicinalProduct.Name.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.productName(parseString("productName", getJsonValue(jsonObject, "productName", JsonString.class), jsonObject.get("_productName"), -1));
         JsonArray namePartArray = getJsonArray(jsonObject, "namePart");
@@ -13474,10 +13853,11 @@ private MedicinalProduct.Name.CountryLanguage parseMedicinalProductNameCountryLa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProduct.Name.CountryLanguage.class, jsonObject);
         }
         MedicinalProduct.Name.CountryLanguage.Builder builder = MedicinalProduct.Name.CountryLanguage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.country(parseCodeableConcept("country", getJsonValue(jsonObject, "country", JsonObject.class), -1));
         builder.jurisdiction(parseCodeableConcept("jurisdiction", getJsonValue(jsonObject, "jurisdiction", JsonObject.class), -1));
@@ -13491,10 +13871,11 @@ private MedicinalProduct.Name.NamePart parseMedicinalProductNameNamePart(java.la
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProduct.Name.NamePart.class, jsonObject);
         }
         MedicinalProduct.Name.NamePart.Builder builder = MedicinalProduct.Name.NamePart.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.part(parseString("part", getJsonValue(jsonObject, "part", JsonString.class), jsonObject.get("_part"), -1));
         builder.type(parseCoding("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -13507,10 +13888,11 @@ private MedicinalProduct.SpecialDesignation parseMedicinalProductSpecialDesignat
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProduct.SpecialDesignation.class, jsonObject);
         }
         MedicinalProduct.SpecialDesignation.Builder builder = MedicinalProduct.SpecialDesignation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -13533,10 +13915,11 @@ private MedicinalProductAuthorization parseMedicinalProductAuthorization(java.la
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductAuthorization.class, jsonObject);
         }
         MedicinalProductAuthorization.Builder builder = MedicinalProductAuthorization.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -13583,10 +13966,11 @@ private MedicinalProductAuthorization.JurisdictionalAuthorization parseMedicinal
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductAuthorization.JurisdictionalAuthorization.class, jsonObject);
         }
         MedicinalProductAuthorization.JurisdictionalAuthorization.Builder builder = MedicinalProductAuthorization.JurisdictionalAuthorization.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -13612,10 +13996,11 @@ private MedicinalProductAuthorization.Procedure parseMedicinalProductAuthorizati
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductAuthorization.Procedure.class, jsonObject);
         }
         MedicinalProductAuthorization.Procedure.Builder builder = MedicinalProductAuthorization.Procedure.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -13635,10 +14020,11 @@ private MedicinalProductContraindication parseMedicinalProductContraindication(j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductContraindication.class, jsonObject);
         }
         MedicinalProductContraindication.Builder builder = MedicinalProductContraindication.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray subjectArray = getJsonArray(jsonObject, "subject");
         if (subjectArray != null) {
@@ -13681,10 +14067,11 @@ private MedicinalProductContraindication.OtherTherapy parseMedicinalProductContr
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductContraindication.OtherTherapy.class, jsonObject);
         }
         MedicinalProductContraindication.OtherTherapy.Builder builder = MedicinalProductContraindication.OtherTherapy.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.therapyRelationshipType(parseCodeableConcept("therapyRelationshipType", getJsonValue(jsonObject, "therapyRelationshipType", JsonObject.class), -1));
         builder.medication(parseChoiceElement("medication", jsonObject, CodeableConcept.class, Reference.class));
@@ -13697,10 +14084,11 @@ private MedicinalProductIndication parseMedicinalProductIndication(java.lang.Str
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductIndication.class, jsonObject);
         }
         MedicinalProductIndication.Builder builder = MedicinalProductIndication.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray subjectArray = getJsonArray(jsonObject, "subject");
         if (subjectArray != null) {
@@ -13745,10 +14133,11 @@ private MedicinalProductIndication.OtherTherapy parseMedicinalProductIndicationO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductIndication.OtherTherapy.class, jsonObject);
         }
         MedicinalProductIndication.OtherTherapy.Builder builder = MedicinalProductIndication.OtherTherapy.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.therapyRelationshipType(parseCodeableConcept("therapyRelationshipType", getJsonValue(jsonObject, "therapyRelationshipType", JsonObject.class), -1));
         builder.medication(parseChoiceElement("medication", jsonObject, CodeableConcept.class, Reference.class));
@@ -13761,10 +14150,11 @@ private MedicinalProductIngredient parseMedicinalProductIngredient(java.lang.Str
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductIngredient.class, jsonObject);
         }
         MedicinalProductIngredient.Builder builder = MedicinalProductIngredient.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.role(parseCodeableConcept("role", getJsonValue(jsonObject, "role", JsonObject.class), -1));
@@ -13791,10 +14181,11 @@ private MedicinalProductIngredient.SpecifiedSubstance parseMedicinalProductIngre
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductIngredient.SpecifiedSubstance.class, jsonObject);
         }
         MedicinalProductIngredient.SpecifiedSubstance.Builder builder = MedicinalProductIngredient.SpecifiedSubstance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.group(parseCodeableConcept("group", getJsonValue(jsonObject, "group", JsonObject.class), -1));
@@ -13814,10 +14205,11 @@ private MedicinalProductIngredient.SpecifiedSubstance.Strength parseMedicinalPro
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductIngredient.SpecifiedSubstance.Strength.class, jsonObject);
         }
         MedicinalProductIngredient.SpecifiedSubstance.Strength.Builder builder = MedicinalProductIngredient.SpecifiedSubstance.Strength.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.presentation(parseRatio("presentation", getJsonValue(jsonObject, "presentation", JsonObject.class), -1));
         builder.presentationLowLimit(parseRatio("presentationLowLimit", getJsonValue(jsonObject, "presentationLowLimit", JsonObject.class), -1));
@@ -13845,10 +14237,11 @@ private MedicinalProductIngredient.SpecifiedSubstance.Strength.ReferenceStrength
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductIngredient.SpecifiedSubstance.Strength.ReferenceStrength.class, jsonObject);
         }
         MedicinalProductIngredient.SpecifiedSubstance.Strength.ReferenceStrength.Builder builder = MedicinalProductIngredient.SpecifiedSubstance.Strength.ReferenceStrength.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.substance(parseCodeableConcept("substance", getJsonValue(jsonObject, "substance", JsonObject.class), -1));
         builder.strength(parseRatio("strength", getJsonValue(jsonObject, "strength", JsonObject.class), -1));
@@ -13869,10 +14262,11 @@ private MedicinalProductIngredient.Substance parseMedicinalProductIngredientSubs
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductIngredient.Substance.class, jsonObject);
         }
         MedicinalProductIngredient.Substance.Builder builder = MedicinalProductIngredient.Substance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         JsonArray strengthArray = getJsonArray(jsonObject, "strength");
@@ -13890,10 +14284,11 @@ private MedicinalProductInteraction parseMedicinalProductInteraction(java.lang.S
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductInteraction.class, jsonObject);
         }
         MedicinalProductInteraction.Builder builder = MedicinalProductInteraction.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray subjectArray = getJsonArray(jsonObject, "subject");
         if (subjectArray != null) {
@@ -13921,10 +14316,11 @@ private MedicinalProductInteraction.Interactant parseMedicinalProductInteraction
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductInteraction.Interactant.class, jsonObject);
         }
         MedicinalProductInteraction.Interactant.Builder builder = MedicinalProductInteraction.Interactant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.item(parseChoiceElement("item", jsonObject, Reference.class, CodeableConcept.class));
         stackPop();
@@ -13936,10 +14332,11 @@ private MedicinalProductManufactured parseMedicinalProductManufactured(java.lang
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductManufactured.class, jsonObject);
         }
         MedicinalProductManufactured.Builder builder = MedicinalProductManufactured.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.manufacturedDoseForm(parseCodeableConcept("manufacturedDoseForm", getJsonValue(jsonObject, "manufacturedDoseForm", JsonObject.class), -1));
         builder.unitOfPresentation(parseCodeableConcept("unitOfPresentation", getJsonValue(jsonObject, "unitOfPresentation", JsonObject.class), -1));
@@ -13972,10 +14369,11 @@ private MedicinalProductPackaged parseMedicinalProductPackaged(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductPackaged.class, jsonObject);
         }
         MedicinalProductPackaged.Builder builder = MedicinalProductPackaged.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -14025,10 +14423,11 @@ private MedicinalProductPackaged.BatchIdentifier parseMedicinalProductPackagedBa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductPackaged.BatchIdentifier.class, jsonObject);
         }
         MedicinalProductPackaged.BatchIdentifier.Builder builder = MedicinalProductPackaged.BatchIdentifier.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.outerPackaging(parseIdentifier("outerPackaging", getJsonValue(jsonObject, "outerPackaging", JsonObject.class), -1));
         builder.immediatePackaging(parseIdentifier("immediatePackaging", getJsonValue(jsonObject, "immediatePackaging", JsonObject.class), -1));
@@ -14041,10 +14440,11 @@ private MedicinalProductPackaged.PackageItem parseMedicinalProductPackagedPackag
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductPackaged.PackageItem.class, jsonObject);
         }
         MedicinalProductPackaged.PackageItem.Builder builder = MedicinalProductPackaged.PackageItem.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -14112,10 +14512,11 @@ private MedicinalProductPharmaceutical parseMedicinalProductPharmaceutical(java.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductPharmaceutical.class, jsonObject);
         }
         MedicinalProductPharmaceutical.Builder builder = MedicinalProductPharmaceutical.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -14158,10 +14559,11 @@ private MedicinalProductPharmaceutical.Characteristics parseMedicinalProductPhar
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductPharmaceutical.Characteristics.class, jsonObject);
         }
         MedicinalProductPharmaceutical.Characteristics.Builder builder = MedicinalProductPharmaceutical.Characteristics.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.status(parseCodeableConcept("status", getJsonValue(jsonObject, "status", JsonObject.class), -1));
@@ -14174,10 +14576,11 @@ private MedicinalProductPharmaceutical.RouteOfAdministration parseMedicinalProdu
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductPharmaceutical.RouteOfAdministration.class, jsonObject);
         }
         MedicinalProductPharmaceutical.RouteOfAdministration.Builder builder = MedicinalProductPharmaceutical.RouteOfAdministration.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.firstDose(parseQuantity("firstDose", getJsonValue(jsonObject, "firstDose", JsonObject.class), -1));
@@ -14200,10 +14603,11 @@ private MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies parse
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.class, jsonObject);
         }
         MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.Builder builder = MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         JsonArray withdrawalPeriodArray = getJsonArray(jsonObject, "withdrawalPeriod");
@@ -14221,10 +14625,11 @@ private MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.Withd
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.WithdrawalPeriod.class, jsonObject);
         }
         MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.WithdrawalPeriod.Builder builder = MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.WithdrawalPeriod.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.tissue(parseCodeableConcept("tissue", getJsonValue(jsonObject, "tissue", JsonObject.class), -1));
         builder.value(parseQuantity("value", getJsonValue(jsonObject, "value", JsonObject.class), -1));
@@ -14238,10 +14643,11 @@ private MedicinalProductUndesirableEffect parseMedicinalProductUndesirableEffect
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MedicinalProductUndesirableEffect.class, jsonObject);
         }
         MedicinalProductUndesirableEffect.Builder builder = MedicinalProductUndesirableEffect.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray subjectArray = getJsonArray(jsonObject, "subject");
         if (subjectArray != null) {
@@ -14267,10 +14673,11 @@ private MessageDefinition parseMessageDefinition(java.lang.String elementName, J
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MessageDefinition.class, jsonObject);
         }
         MessageDefinition.Builder builder = MessageDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -14353,10 +14760,11 @@ private MessageDefinition.AllowedResponse parseMessageDefinitionAllowedResponse(
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MessageDefinition.AllowedResponse.class, jsonObject);
         }
         MessageDefinition.AllowedResponse.Builder builder = MessageDefinition.AllowedResponse.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.message((Canonical) parseUri(Canonical.builder(), "message", getJsonValue(jsonObject, "message", JsonString.class), jsonObject.get("_message"), -1));
         builder.situation((Markdown) parseString(Markdown.builder(), "situation", getJsonValue(jsonObject, "situation", JsonString.class), jsonObject.get("_situation"), -1));
@@ -14369,10 +14777,11 @@ private MessageDefinition.Focus parseMessageDefinitionFocus(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MessageDefinition.Focus.class, jsonObject);
         }
         MessageDefinition.Focus.Builder builder = MessageDefinition.Focus.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((ResourceType) parseString(ResourceType.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.profile((Canonical) parseUri(Canonical.builder(), "profile", getJsonValue(jsonObject, "profile", JsonString.class), jsonObject.get("_profile"), -1));
@@ -14387,10 +14796,11 @@ private MessageHeader parseMessageHeader(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MessageHeader.class, jsonObject);
         }
         MessageHeader.Builder builder = MessageHeader.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.event(parseChoiceElement("event", jsonObject, Coding.class, Uri.class));
         JsonArray destinationArray = getJsonArray(jsonObject, "destination");
@@ -14422,10 +14832,11 @@ private MessageHeader.Destination parseMessageHeaderDestination(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MessageHeader.Destination.class, jsonObject);
         }
         MessageHeader.Destination.Builder builder = MessageHeader.Destination.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.target(parseReference("target", getJsonValue(jsonObject, "target", JsonObject.class), -1));
@@ -14440,10 +14851,11 @@ private MessageHeader.Response parseMessageHeaderResponse(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MessageHeader.Response.class, jsonObject);
         }
         MessageHeader.Response.Builder builder = MessageHeader.Response.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier((Id) parseString(Id.builder(), "identifier", getJsonValue(jsonObject, "identifier", JsonString.class), jsonObject.get("_identifier"), -1));
         builder.code((ResponseType) parseString(ResponseType.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
@@ -14457,10 +14869,11 @@ private MessageHeader.Source parseMessageHeaderSource(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MessageHeader.Source.class, jsonObject);
         }
         MessageHeader.Source.Builder builder = MessageHeader.Source.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.software(parseString("software", getJsonValue(jsonObject, "software", JsonString.class), jsonObject.get("_software"), -1));
@@ -14476,10 +14889,11 @@ private Meta parseMeta(java.lang.String elementName, JsonObject jsonObject, int
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Meta.class, jsonObject);
         }
         Meta.Builder builder = Meta.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.versionId((Id) parseString(Id.builder(), "versionId", getJsonValue(jsonObject, "versionId", JsonString.class), jsonObject.get("_versionId"), -1));
         builder.lastUpdated(parseInstant("lastUpdated", getJsonValue(jsonObject, "lastUpdated", JsonString.class), jsonObject.get("_lastUpdated"), -1));
@@ -14512,10 +14926,11 @@ private MolecularSequence parseMolecularSequence(java.lang.String elementName, J
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MolecularSequence.class, jsonObject);
         }
         MolecularSequence.Builder builder = MolecularSequence.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -14572,10 +14987,11 @@ private MolecularSequence.Quality parseMolecularSequenceQuality(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MolecularSequence.Quality.class, jsonObject);
         }
         MolecularSequence.Quality.Builder builder = MolecularSequence.Quality.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((QualityType) parseString(QualityType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.standardSequence(parseCodeableConcept("standardSequence", getJsonValue(jsonObject, "standardSequence", JsonObject.class), -1));
@@ -14601,10 +15017,11 @@ private MolecularSequence.Quality.Roc parseMolecularSequenceQualityRoc(java.lang
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MolecularSequence.Quality.Roc.class, jsonObject);
         }
         MolecularSequence.Quality.Roc.Builder builder = MolecularSequence.Quality.Roc.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray scoreArray = getJsonArray(jsonObject, "score", true);
         if (scoreArray != null) {
@@ -14664,10 +15081,11 @@ private MolecularSequence.ReferenceSeq parseMolecularSequenceReferenceSeq(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MolecularSequence.ReferenceSeq.class, jsonObject);
         }
         MolecularSequence.ReferenceSeq.Builder builder = MolecularSequence.ReferenceSeq.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.chromosome(parseCodeableConcept("chromosome", getJsonValue(jsonObject, "chromosome", JsonObject.class), -1));
         builder.genomeBuild(parseString("genomeBuild", getJsonValue(jsonObject, "genomeBuild", JsonString.class), jsonObject.get("_genomeBuild"), -1));
@@ -14687,10 +15105,11 @@ private MolecularSequence.Repository parseMolecularSequenceRepository(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MolecularSequence.Repository.class, jsonObject);
         }
         MolecularSequence.Repository.Builder builder = MolecularSequence.Repository.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((RepositoryType) parseString(RepositoryType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
@@ -14707,10 +15126,11 @@ private MolecularSequence.StructureVariant parseMolecularSequenceStructureVarian
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MolecularSequence.StructureVariant.class, jsonObject);
         }
         MolecularSequence.StructureVariant.Builder builder = MolecularSequence.StructureVariant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.variantType(parseCodeableConcept("variantType", getJsonValue(jsonObject, "variantType", JsonObject.class), -1));
         builder.exact(parseBoolean("exact", getJsonValue(jsonObject, "exact", JsonValue.class), jsonObject.get("_exact"), -1));
@@ -14726,10 +15146,11 @@ private MolecularSequence.StructureVariant.Inner parseMolecularSequenceStructure
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MolecularSequence.StructureVariant.Inner.class, jsonObject);
         }
         MolecularSequence.StructureVariant.Inner.Builder builder = MolecularSequence.StructureVariant.Inner.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.start(parseInteger("start", getJsonValue(jsonObject, "start", JsonNumber.class), jsonObject.get("_start"), -1));
         builder.end(parseInteger("end", getJsonValue(jsonObject, "end", JsonNumber.class), jsonObject.get("_end"), -1));
@@ -14742,10 +15163,11 @@ private MolecularSequence.StructureVariant.Outer parseMolecularSequenceStructure
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MolecularSequence.StructureVariant.Outer.class, jsonObject);
         }
         MolecularSequence.StructureVariant.Outer.Builder builder = MolecularSequence.StructureVariant.Outer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.start(parseInteger("start", getJsonValue(jsonObject, "start", JsonNumber.class), jsonObject.get("_start"), -1));
         builder.end(parseInteger("end", getJsonValue(jsonObject, "end", JsonNumber.class), jsonObject.get("_end"), -1));
@@ -14758,10 +15180,11 @@ private MolecularSequence.Variant parseMolecularSequenceVariant(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(MolecularSequence.Variant.class, jsonObject);
         }
         MolecularSequence.Variant.Builder builder = MolecularSequence.Variant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.start(parseInteger("start", getJsonValue(jsonObject, "start", JsonNumber.class), jsonObject.get("_start"), -1));
         builder.end(parseInteger("end", getJsonValue(jsonObject, "end", JsonNumber.class), jsonObject.get("_end"), -1));
@@ -14778,10 +15201,11 @@ private Money parseMoney(java.lang.String elementName, JsonObject jsonObject, in
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Money.class, jsonObject);
         }
         Money.Builder builder = Money.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.value(parseDecimal("value", getJsonValue(jsonObject, "value", JsonNumber.class), jsonObject.get("_value"), -1));
         builder.currency((Code) parseString(Code.builder(), "currency", getJsonValue(jsonObject, "currency", JsonString.class), jsonObject.get("_currency"), -1));
@@ -14794,10 +15218,11 @@ private NamingSystem parseNamingSystem(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(NamingSystem.class, jsonObject);
         }
         NamingSystem.Builder builder = NamingSystem.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.status((PublicationStatus) parseString(PublicationStatus.builder(), "status", getJsonValue(jsonObject, "status", JsonString.class), jsonObject.get("_status"), -1));
@@ -14841,10 +15266,11 @@ private NamingSystem.UniqueId parseNamingSystemUniqueId(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(NamingSystem.UniqueId.class, jsonObject);
         }
         NamingSystem.UniqueId.Builder builder = NamingSystem.UniqueId.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((NamingSystemIdentifierType) parseString(NamingSystemIdentifierType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.value(parseString("value", getJsonValue(jsonObject, "value", JsonString.class), jsonObject.get("_value"), -1));
@@ -14860,10 +15286,11 @@ private Narrative parseNarrative(java.lang.String elementName, JsonObject jsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Narrative.class, jsonObject);
         }
         Narrative.Builder builder = Narrative.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.status((NarrativeStatus) parseString(NarrativeStatus.builder(), "status", getJsonValue(jsonObject, "status", JsonString.class), jsonObject.get("_status"), -1));
         builder.div(parseXhtml("div", getJsonValue(jsonObject, "div", JsonString.class), jsonObject.get("_div"), -1));
@@ -14876,10 +15303,11 @@ private NutritionOrder parseNutritionOrder(java.lang.String elementName, JsonObj
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(NutritionOrder.class, jsonObject);
         }
         NutritionOrder.Builder builder = NutritionOrder.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -14955,10 +15383,11 @@ private NutritionOrder.EnteralFormula parseNutritionOrderEnteralFormula(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(NutritionOrder.EnteralFormula.class, jsonObject);
         }
         NutritionOrder.EnteralFormula.Builder builder = NutritionOrder.EnteralFormula.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.baseFormulaType(parseCodeableConcept("baseFormulaType", getJsonValue(jsonObject, "baseFormulaType", JsonObject.class), -1));
         builder.baseFormulaProductName(parseString("baseFormulaProductName", getJsonValue(jsonObject, "baseFormulaProductName", JsonString.class), jsonObject.get("_baseFormulaProductName"), -1));
@@ -14983,10 +15412,11 @@ private NutritionOrder.EnteralFormula.Administration parseNutritionOrderEnteralF
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(NutritionOrder.EnteralFormula.Administration.class, jsonObject);
         }
         NutritionOrder.EnteralFormula.Administration.Builder builder = NutritionOrder.EnteralFormula.Administration.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.schedule(parseTiming("schedule", getJsonValue(jsonObject, "schedule", JsonObject.class), -1));
         builder.quantity((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "quantity", getJsonValue(jsonObject, "quantity", JsonObject.class), -1));
@@ -15000,10 +15430,11 @@ private NutritionOrder.OralDiet parseNutritionOrderOralDiet(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(NutritionOrder.OralDiet.class, jsonObject);
         }
         NutritionOrder.OralDiet.Builder builder = NutritionOrder.OralDiet.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray typeArray = getJsonArray(jsonObject, "type");
         if (typeArray != null) {
@@ -15045,10 +15476,11 @@ private NutritionOrder.OralDiet.Nutrient parseNutritionOrderOralDietNutrient(jav
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(NutritionOrder.OralDiet.Nutrient.class, jsonObject);
         }
         NutritionOrder.OralDiet.Nutrient.Builder builder = NutritionOrder.OralDiet.Nutrient.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.modifier(parseCodeableConcept("modifier", getJsonValue(jsonObject, "modifier", JsonObject.class), -1));
         builder.amount((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "amount", getJsonValue(jsonObject, "amount", JsonObject.class), -1));
@@ -15061,10 +15493,11 @@ private NutritionOrder.OralDiet.Texture parseNutritionOrderOralDietTexture(java.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(NutritionOrder.OralDiet.Texture.class, jsonObject);
         }
         NutritionOrder.OralDiet.Texture.Builder builder = NutritionOrder.OralDiet.Texture.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.modifier(parseCodeableConcept("modifier", getJsonValue(jsonObject, "modifier", JsonObject.class), -1));
         builder.foodType(parseCodeableConcept("foodType", getJsonValue(jsonObject, "foodType", JsonObject.class), -1));
@@ -15077,10 +15510,11 @@ private NutritionOrder.Supplement parseNutritionOrderSupplement(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(NutritionOrder.Supplement.class, jsonObject);
         }
         NutritionOrder.Supplement.Builder builder = NutritionOrder.Supplement.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.productName(parseString("productName", getJsonValue(jsonObject, "productName", JsonString.class), jsonObject.get("_productName"), -1));
@@ -15101,10 +15535,11 @@ private Observation parseObservation(java.lang.String elementName, JsonObject js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Observation.class, jsonObject);
         }
         Observation.Builder builder = Observation.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -15199,10 +15634,11 @@ private Observation.Component parseObservationComponent(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Observation.Component.class, jsonObject);
         }
         Observation.Component.Builder builder = Observation.Component.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, Quantity.class, CodeableConcept.class, String.class, Boolean.class, Integer.class, Range.class, Ratio.class, SampledData.class, Time.class, DateTime.class, Period.class));
@@ -15228,10 +15664,11 @@ private Observation.ReferenceRange parseObservationReferenceRange(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Observation.ReferenceRange.class, jsonObject);
         }
         Observation.ReferenceRange.Builder builder = Observation.ReferenceRange.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.low((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "low", getJsonValue(jsonObject, "low", JsonObject.class), -1));
         builder.high((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "high", getJsonValue(jsonObject, "high", JsonObject.class), -1));
@@ -15253,10 +15690,11 @@ private ObservationDefinition parseObservationDefinition(java.lang.String elemen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ObservationDefinition.class, jsonObject);
         }
         ObservationDefinition.Builder builder = ObservationDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray categoryArray = getJsonArray(jsonObject, "category");
         if (categoryArray != null) {
@@ -15301,10 +15739,11 @@ private ObservationDefinition.QualifiedInterval parseObservationDefinitionQualif
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ObservationDefinition.QualifiedInterval.class, jsonObject);
         }
         ObservationDefinition.QualifiedInterval.Builder builder = ObservationDefinition.QualifiedInterval.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category((ObservationRangeCategory) parseString(ObservationRangeCategory.builder(), "category", getJsonValue(jsonObject, "category", JsonString.class), jsonObject.get("_category"), -1));
         builder.range(parseRange("range", getJsonValue(jsonObject, "range", JsonObject.class), -1));
@@ -15328,10 +15767,11 @@ private ObservationDefinition.QuantitativeDetails parseObservationDefinitionQuan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ObservationDefinition.QuantitativeDetails.class, jsonObject);
         }
         ObservationDefinition.QuantitativeDetails.Builder builder = ObservationDefinition.QuantitativeDetails.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.customaryUnit(parseCodeableConcept("customaryUnit", getJsonValue(jsonObject, "customaryUnit", JsonObject.class), -1));
         builder.unit(parseCodeableConcept("unit", getJsonValue(jsonObject, "unit", JsonObject.class), -1));
@@ -15346,10 +15786,11 @@ private OperationDefinition parseOperationDefinition(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(OperationDefinition.class, jsonObject);
         }
         OperationDefinition.Builder builder = OperationDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -15417,10 +15858,11 @@ private OperationDefinition.Overload parseOperationDefinitionOverload(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(OperationDefinition.Overload.class, jsonObject);
         }
         OperationDefinition.Overload.Builder builder = OperationDefinition.Overload.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray parameterNameArray = getJsonArray(jsonObject, "parameterName", true);
         if (parameterNameArray != null) {
@@ -15439,10 +15881,11 @@ private OperationDefinition.Parameter parseOperationDefinitionParameter(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(OperationDefinition.Parameter.class, jsonObject);
         }
         OperationDefinition.Parameter.Builder builder = OperationDefinition.Parameter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name((Code) parseString(Code.builder(), "name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.use((OperationParameterUse) parseString(OperationParameterUse.builder(), "use", getJsonValue(jsonObject, "use", JsonString.class), jsonObject.get("_use"), -1));
@@ -15480,10 +15923,11 @@ private OperationDefinition.Parameter.Binding parseOperationDefinitionParameterB
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(OperationDefinition.Parameter.Binding.class, jsonObject);
         }
         OperationDefinition.Parameter.Binding.Builder builder = OperationDefinition.Parameter.Binding.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.strength((BindingStrength) parseString(BindingStrength.builder(), "strength", getJsonValue(jsonObject, "strength", JsonString.class), jsonObject.get("_strength"), -1));
         builder.valueSet((Canonical) parseUri(Canonical.builder(), "valueSet", getJsonValue(jsonObject, "valueSet", JsonString.class), jsonObject.get("_valueSet"), -1));
@@ -15496,10 +15940,11 @@ private OperationDefinition.Parameter.ReferencedFrom parseOperationDefinitionPar
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(OperationDefinition.Parameter.ReferencedFrom.class, jsonObject);
         }
         OperationDefinition.Parameter.ReferencedFrom.Builder builder = OperationDefinition.Parameter.ReferencedFrom.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.source(parseString("source", getJsonValue(jsonObject, "source", JsonString.class), jsonObject.get("_source"), -1));
         builder.sourceId(parseString("sourceId", getJsonValue(jsonObject, "sourceId", JsonString.class), jsonObject.get("_sourceId"), -1));
@@ -15512,10 +15957,11 @@ private OperationOutcome parseOperationOutcome(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(OperationOutcome.class, jsonObject);
         }
         OperationOutcome.Builder builder = OperationOutcome.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray issueArray = getJsonArray(jsonObject, "issue");
         if (issueArray != null) {
@@ -15532,10 +15978,11 @@ private OperationOutcome.Issue parseOperationOutcomeIssue(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(OperationOutcome.Issue.class, jsonObject);
         }
         OperationOutcome.Issue.Builder builder = OperationOutcome.Issue.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.severity((IssueSeverity) parseString(IssueSeverity.builder(), "severity", getJsonValue(jsonObject, "severity", JsonString.class), jsonObject.get("_severity"), -1));
         builder.code((IssueType) parseString(IssueType.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
@@ -15564,10 +16011,11 @@ private Organization parseOrganization(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Organization.class, jsonObject);
         }
         Organization.Builder builder = Organization.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -15624,10 +16072,11 @@ private Organization.Contact parseOrganizationContact(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Organization.Contact.class, jsonObject);
         }
         Organization.Contact.Builder builder = Organization.Contact.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.purpose(parseCodeableConcept("purpose", getJsonValue(jsonObject, "purpose", JsonObject.class), -1));
         builder.name(parseHumanName("name", getJsonValue(jsonObject, "name", JsonObject.class), -1));
@@ -15647,10 +16096,11 @@ private OrganizationAffiliation parseOrganizationAffiliation(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(OrganizationAffiliation.class, jsonObject);
         }
         OrganizationAffiliation.Builder builder = OrganizationAffiliation.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -15713,10 +16163,11 @@ private ParameterDefinition parseParameterDefinition(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ParameterDefinition.class, jsonObject);
         }
         ParameterDefinition.Builder builder = ParameterDefinition.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.name((Code) parseString(Code.builder(), "name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.use((ParameterUse) parseString(ParameterUse.builder(), "use", getJsonValue(jsonObject, "use", JsonString.class), jsonObject.get("_use"), -1));
@@ -15734,10 +16185,11 @@ private Parameters parseParameters(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Parameters.class, jsonObject);
         }
         Parameters.Builder builder = Parameters.builder();
+        builder.setValidating(validating);
         parseResource(builder, jsonObject);
         JsonArray parameterArray = getJsonArray(jsonObject, "parameter");
         if (parameterArray != null) {
@@ -15754,10 +16206,11 @@ private Parameters.Parameter parseParametersParameter(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Parameters.Parameter.class, jsonObject);
         }
         Parameters.Parameter.Builder builder = Parameters.Parameter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.value(parseChoiceElement("value", jsonObject, Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class));
@@ -15777,10 +16230,11 @@ private Patient parsePatient(java.lang.String elementName, JsonObject jsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Patient.class, jsonObject);
         }
         Patient.Builder builder = Patient.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -15852,10 +16306,11 @@ private Patient.Communication parsePatientCommunication(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Patient.Communication.class, jsonObject);
         }
         Patient.Communication.Builder builder = Patient.Communication.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.language(parseCodeableConcept("language", getJsonValue(jsonObject, "language", JsonObject.class), -1));
         builder.preferred(parseBoolean("preferred", getJsonValue(jsonObject, "preferred", JsonValue.class), jsonObject.get("_preferred"), -1));
@@ -15868,10 +16323,11 @@ private Patient.Contact parsePatientContact(java.lang.String elementName, JsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Patient.Contact.class, jsonObject);
         }
         Patient.Contact.Builder builder = Patient.Contact.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray relationshipArray = getJsonArray(jsonObject, "relationship");
         if (relationshipArray != null) {
@@ -15899,10 +16355,11 @@ private Patient.Link parsePatientLink(java.lang.String elementName, JsonObject j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Patient.Link.class, jsonObject);
         }
         Patient.Link.Builder builder = Patient.Link.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.other(parseReference("other", getJsonValue(jsonObject, "other", JsonObject.class), -1));
         builder.type((LinkType) parseString(LinkType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -15915,10 +16372,11 @@ private PaymentNotice parsePaymentNotice(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PaymentNotice.class, jsonObject);
         }
         PaymentNotice.Builder builder = PaymentNotice.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -15946,10 +16404,11 @@ private PaymentReconciliation parsePaymentReconciliation(java.lang.String elemen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PaymentReconciliation.class, jsonObject);
         }
         PaymentReconciliation.Builder builder = PaymentReconciliation.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -15990,10 +16449,11 @@ private PaymentReconciliation.Detail parsePaymentReconciliationDetail(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PaymentReconciliation.Detail.class, jsonObject);
         }
         PaymentReconciliation.Detail.Builder builder = PaymentReconciliation.Detail.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.predecessor(parseIdentifier("predecessor", getJsonValue(jsonObject, "predecessor", JsonObject.class), -1));
@@ -16014,10 +16474,11 @@ private PaymentReconciliation.ProcessNote parsePaymentReconciliationProcessNote(
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PaymentReconciliation.ProcessNote.class, jsonObject);
         }
         PaymentReconciliation.ProcessNote.Builder builder = PaymentReconciliation.ProcessNote.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((NoteType) parseString(NoteType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.text(parseString("text", getJsonValue(jsonObject, "text", JsonString.class), jsonObject.get("_text"), -1));
@@ -16030,10 +16491,11 @@ private Period parsePeriod(java.lang.String elementName, JsonObject jsonObject,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Period.class, jsonObject);
         }
         Period.Builder builder = Period.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.start(parseDateTime("start", getJsonValue(jsonObject, "start", JsonString.class), jsonObject.get("_start"), -1));
         builder.end(parseDateTime("end", getJsonValue(jsonObject, "end", JsonString.class), jsonObject.get("_end"), -1));
@@ -16046,10 +16508,11 @@ private Person parsePerson(java.lang.String elementName, JsonObject jsonObject,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Person.class, jsonObject);
         }
         Person.Builder builder = Person.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -16095,10 +16558,11 @@ private Person.Link parsePersonLink(java.lang.String elementName, JsonObject jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Person.Link.class, jsonObject);
         }
         Person.Link.Builder builder = Person.Link.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.target(parseReference("target", getJsonValue(jsonObject, "target", JsonObject.class), -1));
         builder.assurance((IdentityAssuranceLevel) parseString(IdentityAssuranceLevel.builder(), "assurance", getJsonValue(jsonObject, "assurance", JsonString.class), jsonObject.get("_assurance"), -1));
@@ -16111,10 +16575,11 @@ private PlanDefinition parsePlanDefinition(java.lang.String elementName, JsonObj
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PlanDefinition.class, jsonObject);
         }
         PlanDefinition.Builder builder = PlanDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -16222,10 +16687,11 @@ private PlanDefinition.Action parsePlanDefinitionAction(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PlanDefinition.Action.class, jsonObject);
         }
         PlanDefinition.Action.Builder builder = PlanDefinition.Action.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.prefix(parseString("prefix", getJsonValue(jsonObject, "prefix", JsonString.class), jsonObject.get("_prefix"), -1));
         builder.title(parseString("title", getJsonValue(jsonObject, "title", JsonString.class), jsonObject.get("_title"), -1));
@@ -16324,10 +16790,11 @@ private PlanDefinition.Action.Condition parsePlanDefinitionActionCondition(java.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PlanDefinition.Action.Condition.class, jsonObject);
         }
         PlanDefinition.Action.Condition.Builder builder = PlanDefinition.Action.Condition.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.kind((ActionConditionKind) parseString(ActionConditionKind.builder(), "kind", getJsonValue(jsonObject, "kind", JsonString.class), jsonObject.get("_kind"), -1));
         builder.expression(parseExpression("expression", getJsonValue(jsonObject, "expression", JsonObject.class), -1));
@@ -16340,10 +16807,11 @@ private PlanDefinition.Action.DynamicValue parsePlanDefinitionActionDynamicValue
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PlanDefinition.Action.DynamicValue.class, jsonObject);
         }
         PlanDefinition.Action.DynamicValue.Builder builder = PlanDefinition.Action.DynamicValue.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.path(parseString("path", getJsonValue(jsonObject, "path", JsonString.class), jsonObject.get("_path"), -1));
         builder.expression(parseExpression("expression", getJsonValue(jsonObject, "expression", JsonObject.class), -1));
@@ -16356,10 +16824,11 @@ private PlanDefinition.Action.Participant parsePlanDefinitionActionParticipant(j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PlanDefinition.Action.Participant.class, jsonObject);
         }
         PlanDefinition.Action.Participant.Builder builder = PlanDefinition.Action.Participant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((ActionParticipantType) parseString(ActionParticipantType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.role(parseCodeableConcept("role", getJsonValue(jsonObject, "role", JsonObject.class), -1));
@@ -16372,10 +16841,11 @@ private PlanDefinition.Action.RelatedAction parsePlanDefinitionActionRelatedActi
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PlanDefinition.Action.RelatedAction.class, jsonObject);
         }
         PlanDefinition.Action.RelatedAction.Builder builder = PlanDefinition.Action.RelatedAction.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.actionId((Id) parseString(Id.builder(), "actionId", getJsonValue(jsonObject, "actionId", JsonString.class), jsonObject.get("_actionId"), -1));
         builder.relationship((ActionRelationshipType) parseString(ActionRelationshipType.builder(), "relationship", getJsonValue(jsonObject, "relationship", JsonString.class), jsonObject.get("_relationship"), -1));
@@ -16389,10 +16859,11 @@ private PlanDefinition.Goal parsePlanDefinitionGoal(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PlanDefinition.Goal.class, jsonObject);
         }
         PlanDefinition.Goal.Builder builder = PlanDefinition.Goal.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
         builder.description(parseCodeableConcept("description", getJsonValue(jsonObject, "description", JsonObject.class), -1));
@@ -16425,10 +16896,11 @@ private PlanDefinition.Goal.Target parsePlanDefinitionGoalTarget(java.lang.Strin
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PlanDefinition.Goal.Target.class, jsonObject);
         }
         PlanDefinition.Goal.Target.Builder builder = PlanDefinition.Goal.Target.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.measure(parseCodeableConcept("measure", getJsonValue(jsonObject, "measure", JsonObject.class), -1));
         builder.detail(parseChoiceElement("detail", jsonObject, Quantity.class, Range.class, CodeableConcept.class));
@@ -16442,10 +16914,11 @@ private Population parsePopulation(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Population.class, jsonObject);
         }
         Population.Builder builder = Population.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.age(parseChoiceElement("age", jsonObject, Range.class, CodeableConcept.class));
         builder.gender(parseCodeableConcept("gender", getJsonValue(jsonObject, "gender", JsonObject.class), -1));
@@ -16460,10 +16933,11 @@ private Practitioner parsePractitioner(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Practitioner.class, jsonObject);
         }
         Practitioner.Builder builder = Practitioner.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -16519,10 +16993,11 @@ private Practitioner.Qualification parsePractitionerQualification(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Practitioner.Qualification.class, jsonObject);
         }
         Practitioner.Qualification.Builder builder = Practitioner.Qualification.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -16542,10 +17017,11 @@ private PractitionerRole parsePractitionerRole(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PractitionerRole.class, jsonObject);
         }
         PractitionerRole.Builder builder = PractitionerRole.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -16615,10 +17091,11 @@ private PractitionerRole.AvailableTime parsePractitionerRoleAvailableTime(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PractitionerRole.AvailableTime.class, jsonObject);
         }
         PractitionerRole.AvailableTime.Builder builder = PractitionerRole.AvailableTime.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray daysOfWeekArray = getJsonArray(jsonObject, "daysOfWeek", true);
         if (daysOfWeekArray != null) {
@@ -16639,10 +17116,11 @@ private PractitionerRole.NotAvailable parsePractitionerRoleNotAvailable(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(PractitionerRole.NotAvailable.class, jsonObject);
         }
         PractitionerRole.NotAvailable.Builder builder = PractitionerRole.NotAvailable.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.during(parsePeriod("during", getJsonValue(jsonObject, "during", JsonObject.class), -1));
@@ -16655,10 +17133,11 @@ private Procedure parseProcedure(java.lang.String elementName, JsonObject jsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Procedure.class, jsonObject);
         }
         Procedure.Builder builder = Procedure.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -16784,10 +17263,11 @@ private Procedure.FocalDevice parseProcedureFocalDevice(java.lang.String element
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Procedure.FocalDevice.class, jsonObject);
         }
         Procedure.FocalDevice.Builder builder = Procedure.FocalDevice.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.action(parseCodeableConcept("action", getJsonValue(jsonObject, "action", JsonObject.class), -1));
         builder.manipulated(parseReference("manipulated", getJsonValue(jsonObject, "manipulated", JsonObject.class), -1));
@@ -16800,10 +17280,11 @@ private Procedure.Performer parseProcedurePerformer(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Procedure.Performer.class, jsonObject);
         }
         Procedure.Performer.Builder builder = Procedure.Performer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.function(parseCodeableConcept("function", getJsonValue(jsonObject, "function", JsonObject.class), -1));
         builder.actor(parseReference("actor", getJsonValue(jsonObject, "actor", JsonObject.class), -1));
@@ -16817,10 +17298,11 @@ private ProdCharacteristic parseProdCharacteristic(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ProdCharacteristic.class, jsonObject);
         }
         ProdCharacteristic.Builder builder = ProdCharacteristic.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.height(parseQuantity("height", getJsonValue(jsonObject, "height", JsonObject.class), -1));
         builder.width(parseQuantity("width", getJsonValue(jsonObject, "width", JsonObject.class), -1));
@@ -16859,10 +17341,11 @@ private ProductShelfLife parseProductShelfLife(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ProductShelfLife.class, jsonObject);
         }
         ProductShelfLife.Builder builder = ProductShelfLife.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -16882,10 +17365,11 @@ private Provenance parseProvenance(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Provenance.class, jsonObject);
         }
         Provenance.Builder builder = Provenance.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray targetArray = getJsonArray(jsonObject, "target");
         if (targetArray != null) {
@@ -16937,10 +17421,11 @@ private Provenance.Agent parseProvenanceAgent(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Provenance.Agent.class, jsonObject);
         }
         Provenance.Agent.Builder builder = Provenance.Agent.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray roleArray = getJsonArray(jsonObject, "role");
@@ -16960,10 +17445,11 @@ private Provenance.Entity parseProvenanceEntity(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Provenance.Entity.class, jsonObject);
         }
         Provenance.Entity.Builder builder = Provenance.Entity.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.role((ProvenanceEntityRole) parseString(ProvenanceEntityRole.builder(), "role", getJsonValue(jsonObject, "role", JsonString.class), jsonObject.get("_role"), -1));
         builder.what(parseReference("what", getJsonValue(jsonObject, "what", JsonObject.class), -1));
@@ -16982,9 +17468,10 @@ private Quantity parseQuantity(Quantity.Builder builder, java.lang.String elemen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Quantity.class, jsonObject);
         }
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.value(parseDecimal("value", getJsonValue(jsonObject, "value", JsonNumber.class), jsonObject.get("_value"), -1));
         builder.comparator((QuantityComparator) parseString(QuantityComparator.builder(), "comparator", getJsonValue(jsonObject, "comparator", JsonString.class), jsonObject.get("_comparator"), -1));
@@ -17004,10 +17491,11 @@ private Questionnaire parseQuestionnaire(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Questionnaire.class, jsonObject);
         }
         Questionnaire.Builder builder = Questionnaire.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -17082,10 +17570,11 @@ private Questionnaire.Item parseQuestionnaireItem(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Questionnaire.Item.class, jsonObject);
         }
         Questionnaire.Item.Builder builder = Questionnaire.Item.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.linkId(parseString("linkId", getJsonValue(jsonObject, "linkId", JsonString.class), jsonObject.get("_linkId"), -1));
         builder.definition(parseUri("definition", getJsonValue(jsonObject, "definition", JsonString.class), jsonObject.get("_definition"), -1));
@@ -17137,10 +17626,11 @@ private Questionnaire.Item.AnswerOption parseQuestionnaireItemAnswerOption(java.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Questionnaire.Item.AnswerOption.class, jsonObject);
         }
         Questionnaire.Item.AnswerOption.Builder builder = Questionnaire.Item.AnswerOption.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.value(parseChoiceElement("value", jsonObject, Integer.class, Date.class, Time.class, String.class, Coding.class, Reference.class));
         builder.initialSelected(parseBoolean("initialSelected", getJsonValue(jsonObject, "initialSelected", JsonValue.class), jsonObject.get("_initialSelected"), -1));
@@ -17153,10 +17643,11 @@ private Questionnaire.Item.EnableWhen parseQuestionnaireItemEnableWhen(java.lang
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Questionnaire.Item.EnableWhen.class, jsonObject);
         }
         Questionnaire.Item.EnableWhen.Builder builder = Questionnaire.Item.EnableWhen.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.question(parseString("question", getJsonValue(jsonObject, "question", JsonString.class), jsonObject.get("_question"), -1));
         builder.operator((QuestionnaireItemOperator) parseString(QuestionnaireItemOperator.builder(), "operator", getJsonValue(jsonObject, "operator", JsonString.class), jsonObject.get("_operator"), -1));
@@ -17170,10 +17661,11 @@ private Questionnaire.Item.Initial parseQuestionnaireItemInitial(java.lang.Strin
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Questionnaire.Item.Initial.class, jsonObject);
         }
         Questionnaire.Item.Initial.Builder builder = Questionnaire.Item.Initial.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.value(parseChoiceElement("value", jsonObject, Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Uri.class, Attachment.class, Coding.class, Quantity.class, Reference.class));
         stackPop();
@@ -17185,10 +17677,11 @@ private QuestionnaireResponse parseQuestionnaireResponse(java.lang.String elemen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(QuestionnaireResponse.class, jsonObject);
         }
         QuestionnaireResponse.Builder builder = QuestionnaireResponse.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         JsonArray basedOnArray = getJsonArray(jsonObject, "basedOn");
@@ -17225,10 +17718,11 @@ private QuestionnaireResponse.Item parseQuestionnaireResponseItem(java.lang.Stri
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(QuestionnaireResponse.Item.class, jsonObject);
         }
         QuestionnaireResponse.Item.Builder builder = QuestionnaireResponse.Item.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.linkId(parseString("linkId", getJsonValue(jsonObject, "linkId", JsonString.class), jsonObject.get("_linkId"), -1));
         builder.definition(parseUri("definition", getJsonValue(jsonObject, "definition", JsonString.class), jsonObject.get("_definition"), -1));
@@ -17254,10 +17748,11 @@ private QuestionnaireResponse.Item.Answer parseQuestionnaireResponseItemAnswer(j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(QuestionnaireResponse.Item.Answer.class, jsonObject);
         }
         QuestionnaireResponse.Item.Answer.Builder builder = QuestionnaireResponse.Item.Answer.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.value(parseChoiceElement("value", jsonObject, Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Uri.class, Attachment.class, Coding.class, Quantity.class, Reference.class));
         JsonArray itemArray = getJsonArray(jsonObject, "item");
@@ -17275,10 +17770,11 @@ private Range parseRange(java.lang.String elementName, JsonObject jsonObject, in
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Range.class, jsonObject);
         }
         Range.Builder builder = Range.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.low((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "low", getJsonValue(jsonObject, "low", JsonObject.class), -1));
         builder.high((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "high", getJsonValue(jsonObject, "high", JsonObject.class), -1));
@@ -17291,10 +17787,11 @@ private Ratio parseRatio(java.lang.String elementName, JsonObject jsonObject, in
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Ratio.class, jsonObject);
         }
         Ratio.Builder builder = Ratio.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.numerator(parseQuantity("numerator", getJsonValue(jsonObject, "numerator", JsonObject.class), -1));
         builder.denominator(parseQuantity("denominator", getJsonValue(jsonObject, "denominator", JsonObject.class), -1));
@@ -17307,10 +17804,11 @@ private Reference parseReference(java.lang.String elementName, JsonObject jsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Reference.class, jsonObject);
         }
         Reference.Builder builder = Reference.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.reference(parseString("reference", getJsonValue(jsonObject, "reference", JsonString.class), jsonObject.get("_reference"), -1));
         builder.type(parseUri("type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -17325,10 +17823,11 @@ private RelatedArtifact parseRelatedArtifact(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RelatedArtifact.class, jsonObject);
         }
         RelatedArtifact.Builder builder = RelatedArtifact.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.type((RelatedArtifactType) parseString(RelatedArtifactType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.label(parseString("label", getJsonValue(jsonObject, "label", JsonString.class), jsonObject.get("_label"), -1));
@@ -17346,10 +17845,11 @@ private RelatedPerson parseRelatedPerson(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RelatedPerson.class, jsonObject);
         }
         RelatedPerson.Builder builder = RelatedPerson.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -17407,10 +17907,11 @@ private RelatedPerson.Communication parseRelatedPersonCommunication(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RelatedPerson.Communication.class, jsonObject);
         }
         RelatedPerson.Communication.Builder builder = RelatedPerson.Communication.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.language(parseCodeableConcept("language", getJsonValue(jsonObject, "language", JsonObject.class), -1));
         builder.preferred(parseBoolean("preferred", getJsonValue(jsonObject, "preferred", JsonValue.class), jsonObject.get("_preferred"), -1));
@@ -17423,10 +17924,11 @@ private RequestGroup parseRequestGroup(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RequestGroup.class, jsonObject);
         }
         RequestGroup.Builder builder = RequestGroup.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -17502,10 +18004,11 @@ private RequestGroup.Action parseRequestGroupAction(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RequestGroup.Action.class, jsonObject);
         }
         RequestGroup.Action.Builder builder = RequestGroup.Action.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.prefix(parseString("prefix", getJsonValue(jsonObject, "prefix", JsonString.class), jsonObject.get("_prefix"), -1));
         builder.title(parseString("title", getJsonValue(jsonObject, "title", JsonString.class), jsonObject.get("_title"), -1));
@@ -17565,10 +18068,11 @@ private RequestGroup.Action.Condition parseRequestGroupActionCondition(java.lang
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RequestGroup.Action.Condition.class, jsonObject);
         }
         RequestGroup.Action.Condition.Builder builder = RequestGroup.Action.Condition.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.kind((ActionConditionKind) parseString(ActionConditionKind.builder(), "kind", getJsonValue(jsonObject, "kind", JsonString.class), jsonObject.get("_kind"), -1));
         builder.expression(parseExpression("expression", getJsonValue(jsonObject, "expression", JsonObject.class), -1));
@@ -17581,10 +18085,11 @@ private RequestGroup.Action.RelatedAction parseRequestGroupActionRelatedAction(j
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RequestGroup.Action.RelatedAction.class, jsonObject);
         }
         RequestGroup.Action.RelatedAction.Builder builder = RequestGroup.Action.RelatedAction.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.actionId((Id) parseString(Id.builder(), "actionId", getJsonValue(jsonObject, "actionId", JsonString.class), jsonObject.get("_actionId"), -1));
         builder.relationship((ActionRelationshipType) parseString(ActionRelationshipType.builder(), "relationship", getJsonValue(jsonObject, "relationship", JsonString.class), jsonObject.get("_relationship"), -1));
@@ -17598,10 +18103,11 @@ private ResearchDefinition parseResearchDefinition(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ResearchDefinition.class, jsonObject);
         }
         ResearchDefinition.Builder builder = ResearchDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -17708,10 +18214,11 @@ private ResearchElementDefinition parseResearchElementDefinition(java.lang.Strin
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ResearchElementDefinition.class, jsonObject);
         }
         ResearchElementDefinition.Builder builder = ResearchElementDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -17822,10 +18329,11 @@ private ResearchElementDefinition.Characteristic parseResearchElementDefinitionC
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ResearchElementDefinition.Characteristic.class, jsonObject);
         }
         ResearchElementDefinition.Characteristic.Builder builder = ResearchElementDefinition.Characteristic.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.definition(parseChoiceElement("definition", jsonObject, CodeableConcept.class, Canonical.class, Expression.class, DataRequirement.class));
         JsonArray usageContextArray = getJsonArray(jsonObject, "usageContext");
@@ -17853,10 +18361,11 @@ private ResearchStudy parseResearchStudy(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ResearchStudy.class, jsonObject);
         }
         ResearchStudy.Builder builder = ResearchStudy.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -17966,10 +18475,11 @@ private ResearchStudy.Arm parseResearchStudyArm(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ResearchStudy.Arm.class, jsonObject);
         }
         ResearchStudy.Arm.Builder builder = ResearchStudy.Arm.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -17983,10 +18493,11 @@ private ResearchStudy.Objective parseResearchStudyObjective(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ResearchStudy.Objective.class, jsonObject);
         }
         ResearchStudy.Objective.Builder builder = ResearchStudy.Objective.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -17999,10 +18510,11 @@ private ResearchSubject parseResearchSubject(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ResearchSubject.class, jsonObject);
         }
         ResearchSubject.Builder builder = ResearchSubject.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -18022,6 +18534,7 @@ private ResearchSubject parseResearchSubject(java.lang.String elementName, JsonO
     }
 
     private void parseResource(Resource.Builder builder, JsonObject jsonObject) {
+        builder.setValidating(validating);
         builder.id(parseJavaString("id", getJsonValue(jsonObject, "id", JsonString.class), -1));
         builder.meta(parseMeta("meta", getJsonValue(jsonObject, "meta", JsonObject.class), -1));
         builder.implicitRules(parseUri("implicitRules", getJsonValue(jsonObject, "implicitRules", JsonString.class), jsonObject.get("_implicitRules"), -1));
@@ -18033,10 +18546,11 @@ private RiskAssessment parseRiskAssessment(java.lang.String elementName, JsonObj
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RiskAssessment.class, jsonObject);
         }
         RiskAssessment.Builder builder = RiskAssessment.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -18094,10 +18608,11 @@ private RiskAssessment.Prediction parseRiskAssessmentPrediction(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RiskAssessment.Prediction.class, jsonObject);
         }
         RiskAssessment.Prediction.Builder builder = RiskAssessment.Prediction.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.outcome(parseCodeableConcept("outcome", getJsonValue(jsonObject, "outcome", JsonObject.class), -1));
         builder.probability(parseChoiceElement("probability", jsonObject, Decimal.class, Range.class));
@@ -18114,10 +18629,11 @@ private RiskEvidenceSynthesis parseRiskEvidenceSynthesis(java.lang.String elemen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RiskEvidenceSynthesis.class, jsonObject);
         }
         RiskEvidenceSynthesis.Builder builder = RiskEvidenceSynthesis.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -18219,10 +18735,11 @@ private RiskEvidenceSynthesis.Certainty parseRiskEvidenceSynthesisCertainty(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RiskEvidenceSynthesis.Certainty.class, jsonObject);
         }
         RiskEvidenceSynthesis.Certainty.Builder builder = RiskEvidenceSynthesis.Certainty.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray ratingArray = getJsonArray(jsonObject, "rating");
         if (ratingArray != null) {
@@ -18251,10 +18768,11 @@ private RiskEvidenceSynthesis.Certainty.CertaintySubcomponent parseRiskEvidenceS
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RiskEvidenceSynthesis.Certainty.CertaintySubcomponent.class, jsonObject);
         }
         RiskEvidenceSynthesis.Certainty.CertaintySubcomponent.Builder builder = RiskEvidenceSynthesis.Certainty.CertaintySubcomponent.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         JsonArray ratingArray = getJsonArray(jsonObject, "rating");
@@ -18278,10 +18796,11 @@ private RiskEvidenceSynthesis.RiskEstimate parseRiskEvidenceSynthesisRiskEstimat
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RiskEvidenceSynthesis.RiskEstimate.class, jsonObject);
         }
         RiskEvidenceSynthesis.RiskEstimate.Builder builder = RiskEvidenceSynthesis.RiskEstimate.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -18304,10 +18823,11 @@ private RiskEvidenceSynthesis.RiskEstimate.PrecisionEstimate parseRiskEvidenceSy
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RiskEvidenceSynthesis.RiskEstimate.PrecisionEstimate.class, jsonObject);
         }
         RiskEvidenceSynthesis.RiskEstimate.PrecisionEstimate.Builder builder = RiskEvidenceSynthesis.RiskEstimate.PrecisionEstimate.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.level(parseDecimal("level", getJsonValue(jsonObject, "level", JsonNumber.class), jsonObject.get("_level"), -1));
@@ -18322,10 +18842,11 @@ private RiskEvidenceSynthesis.SampleSize parseRiskEvidenceSynthesisSampleSize(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(RiskEvidenceSynthesis.SampleSize.class, jsonObject);
         }
         RiskEvidenceSynthesis.SampleSize.Builder builder = RiskEvidenceSynthesis.SampleSize.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.numberOfStudies(parseInteger("numberOfStudies", getJsonValue(jsonObject, "numberOfStudies", JsonNumber.class), jsonObject.get("_numberOfStudies"), -1));
@@ -18339,10 +18860,11 @@ private SampledData parseSampledData(java.lang.String elementName, JsonObject js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SampledData.class, jsonObject);
         }
         SampledData.Builder builder = SampledData.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.origin((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "origin", getJsonValue(jsonObject, "origin", JsonObject.class), -1));
         builder.period(parseDecimal("period", getJsonValue(jsonObject, "period", JsonNumber.class), jsonObject.get("_period"), -1));
@@ -18360,10 +18882,11 @@ private Schedule parseSchedule(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Schedule.class, jsonObject);
         }
         Schedule.Builder builder = Schedule.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -18407,10 +18930,11 @@ private SearchParameter parseSearchParameter(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SearchParameter.class, jsonObject);
         }
         SearchParameter.Builder builder = SearchParameter.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -18497,10 +19021,11 @@ private SearchParameter.Component parseSearchParameterComponent(java.lang.String
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SearchParameter.Component.class, jsonObject);
         }
         SearchParameter.Component.Builder builder = SearchParameter.Component.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.definition((Canonical) parseUri(Canonical.builder(), "definition", getJsonValue(jsonObject, "definition", JsonString.class), jsonObject.get("_definition"), -1));
         builder.expression(parseString("expression", getJsonValue(jsonObject, "expression", JsonString.class), jsonObject.get("_expression"), -1));
@@ -18513,10 +19038,11 @@ private ServiceRequest parseServiceRequest(java.lang.String elementName, JsonObj
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ServiceRequest.class, jsonObject);
         }
         ServiceRequest.Builder builder = ServiceRequest.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -18652,10 +19178,11 @@ private Signature parseSignature(java.lang.String elementName, JsonObject jsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Signature.class, jsonObject);
         }
         Signature.Builder builder = Signature.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         JsonArray typeArray = getJsonArray(jsonObject, "type");
         if (typeArray != null) {
@@ -18678,10 +19205,11 @@ private Slot parseSlot(java.lang.String elementName, JsonObject jsonObject, int
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Slot.class, jsonObject);
         }
         Slot.Builder builder = Slot.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -18723,10 +19251,11 @@ private Specimen parseSpecimen(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Specimen.class, jsonObject);
         }
         Specimen.Builder builder = Specimen.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -18785,10 +19314,11 @@ private Specimen.Collection parseSpecimenCollection(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Specimen.Collection.class, jsonObject);
         }
         Specimen.Collection.Builder builder = Specimen.Collection.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.collector(parseReference("collector", getJsonValue(jsonObject, "collector", JsonObject.class), -1));
         builder.collected(parseChoiceElement("collected", jsonObject, DateTime.class, Period.class));
@@ -18806,10 +19336,11 @@ private Specimen.Container parseSpecimenContainer(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Specimen.Container.class, jsonObject);
         }
         Specimen.Container.Builder builder = Specimen.Container.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -18831,10 +19362,11 @@ private Specimen.Processing parseSpecimenProcessing(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Specimen.Processing.class, jsonObject);
         }
         Specimen.Processing.Builder builder = Specimen.Processing.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.procedure(parseCodeableConcept("procedure", getJsonValue(jsonObject, "procedure", JsonObject.class), -1));
@@ -18854,10 +19386,11 @@ private SpecimenDefinition parseSpecimenDefinition(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SpecimenDefinition.class, jsonObject);
         }
         SpecimenDefinition.Builder builder = SpecimenDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.typeCollected(parseCodeableConcept("typeCollected", getJsonValue(jsonObject, "typeCollected", JsonObject.class), -1));
@@ -18889,10 +19422,11 @@ private SpecimenDefinition.TypeTested parseSpecimenDefinitionTypeTested(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SpecimenDefinition.TypeTested.class, jsonObject);
         }
         SpecimenDefinition.TypeTested.Builder builder = SpecimenDefinition.TypeTested.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.isDerived(parseBoolean("isDerived", getJsonValue(jsonObject, "isDerived", JsonValue.class), jsonObject.get("_isDerived"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -18921,10 +19455,11 @@ private SpecimenDefinition.TypeTested.Container parseSpecimenDefinitionTypeTeste
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SpecimenDefinition.TypeTested.Container.class, jsonObject);
         }
         SpecimenDefinition.TypeTested.Container.Builder builder = SpecimenDefinition.TypeTested.Container.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.material(parseCodeableConcept("material", getJsonValue(jsonObject, "material", JsonObject.class), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -18948,10 +19483,11 @@ private SpecimenDefinition.TypeTested.Container.Additive parseSpecimenDefinition
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SpecimenDefinition.TypeTested.Container.Additive.class, jsonObject);
         }
         SpecimenDefinition.TypeTested.Container.Additive.Builder builder = SpecimenDefinition.TypeTested.Container.Additive.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.additive(parseChoiceElement("additive", jsonObject, CodeableConcept.class, Reference.class));
         stackPop();
@@ -18963,10 +19499,11 @@ private SpecimenDefinition.TypeTested.Handling parseSpecimenDefinitionTypeTested
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SpecimenDefinition.TypeTested.Handling.class, jsonObject);
         }
         SpecimenDefinition.TypeTested.Handling.Builder builder = SpecimenDefinition.TypeTested.Handling.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.temperatureQualifier(parseCodeableConcept("temperatureQualifier", getJsonValue(jsonObject, "temperatureQualifier", JsonObject.class), -1));
         builder.temperatureRange(parseRange("temperatureRange", getJsonValue(jsonObject, "temperatureRange", JsonObject.class), -1));
@@ -18981,9 +19518,10 @@ private String parseString(String.Builder builder, java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -19009,10 +19547,11 @@ private StructureDefinition parseStructureDefinition(java.lang.String elementNam
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureDefinition.class, jsonObject);
         }
         StructureDefinition.Builder builder = StructureDefinition.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -19091,10 +19630,11 @@ private StructureDefinition.Context parseStructureDefinitionContext(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureDefinition.Context.class, jsonObject);
         }
         StructureDefinition.Context.Builder builder = StructureDefinition.Context.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((ExtensionContextType) parseString(ExtensionContextType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.expression(parseString("expression", getJsonValue(jsonObject, "expression", JsonString.class), jsonObject.get("_expression"), -1));
@@ -19107,10 +19647,11 @@ private StructureDefinition.Differential parseStructureDefinitionDifferential(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureDefinition.Differential.class, jsonObject);
         }
         StructureDefinition.Differential.Builder builder = StructureDefinition.Differential.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray elementArray = getJsonArray(jsonObject, "element");
         if (elementArray != null) {
@@ -19127,10 +19668,11 @@ private StructureDefinition.Mapping parseStructureDefinitionMapping(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureDefinition.Mapping.class, jsonObject);
         }
         StructureDefinition.Mapping.Builder builder = StructureDefinition.Mapping.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identity((Id) parseString(Id.builder(), "identity", getJsonValue(jsonObject, "identity", JsonString.class), jsonObject.get("_identity"), -1));
         builder.uri(parseUri("uri", getJsonValue(jsonObject, "uri", JsonString.class), jsonObject.get("_uri"), -1));
@@ -19145,10 +19687,11 @@ private StructureDefinition.Snapshot parseStructureDefinitionSnapshot(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureDefinition.Snapshot.class, jsonObject);
         }
         StructureDefinition.Snapshot.Builder builder = StructureDefinition.Snapshot.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray elementArray = getJsonArray(jsonObject, "element");
         if (elementArray != null) {
@@ -19165,10 +19708,11 @@ private StructureMap parseStructureMap(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureMap.class, jsonObject);
         }
         StructureMap.Builder builder = StructureMap.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -19233,10 +19777,11 @@ private StructureMap.Group parseStructureMapGroup(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureMap.Group.class, jsonObject);
         }
         StructureMap.Group.Builder builder = StructureMap.Group.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name((Id) parseString(Id.builder(), "name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder._extends((Id) parseString(Id.builder(), "extends", getJsonValue(jsonObject, "extends", JsonString.class), jsonObject.get("_extends"), -1));
@@ -19263,10 +19808,11 @@ private StructureMap.Group.Input parseStructureMapGroupInput(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureMap.Group.Input.class, jsonObject);
         }
         StructureMap.Group.Input.Builder builder = StructureMap.Group.Input.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name((Id) parseString(Id.builder(), "name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.type(parseString("type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
@@ -19281,10 +19827,11 @@ private StructureMap.Group.Rule parseStructureMapGroupRule(java.lang.String elem
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureMap.Group.Rule.class, jsonObject);
         }
         StructureMap.Group.Rule.Builder builder = StructureMap.Group.Rule.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name((Id) parseString(Id.builder(), "name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         JsonArray sourceArray = getJsonArray(jsonObject, "source");
@@ -19321,10 +19868,11 @@ private StructureMap.Group.Rule.Dependent parseStructureMapGroupRuleDependent(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureMap.Group.Rule.Dependent.class, jsonObject);
         }
         StructureMap.Group.Rule.Dependent.Builder builder = StructureMap.Group.Rule.Dependent.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name((Id) parseString(Id.builder(), "name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         JsonArray variableArray = getJsonArray(jsonObject, "variable", true);
@@ -19343,10 +19891,11 @@ private StructureMap.Group.Rule.Source parseStructureMapGroupRuleSource(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureMap.Group.Rule.Source.class, jsonObject);
         }
         StructureMap.Group.Rule.Source.Builder builder = StructureMap.Group.Rule.Source.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.context((Id) parseString(Id.builder(), "context", getJsonValue(jsonObject, "context", JsonString.class), jsonObject.get("_context"), -1));
         builder.min(parseInteger("min", getJsonValue(jsonObject, "min", JsonNumber.class), jsonObject.get("_min"), -1));
@@ -19368,10 +19917,11 @@ private StructureMap.Group.Rule.Target parseStructureMapGroupRuleTarget(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureMap.Group.Rule.Target.class, jsonObject);
         }
         StructureMap.Group.Rule.Target.Builder builder = StructureMap.Group.Rule.Target.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.context((Id) parseString(Id.builder(), "context", getJsonValue(jsonObject, "context", JsonString.class), jsonObject.get("_context"), -1));
         builder.contextType((StructureMapContextType) parseString(StructureMapContextType.builder(), "contextType", getJsonValue(jsonObject, "contextType", JsonString.class), jsonObject.get("_contextType"), -1));
@@ -19401,10 +19951,11 @@ private StructureMap.Group.Rule.Target.Parameter parseStructureMapGroupRuleTarge
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureMap.Group.Rule.Target.Parameter.class, jsonObject);
         }
         StructureMap.Group.Rule.Target.Parameter.Builder builder = StructureMap.Group.Rule.Target.Parameter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.value(parseChoiceElement("value", jsonObject, Id.class, String.class, Boolean.class, Integer.class, Decimal.class));
         stackPop();
@@ -19416,10 +19967,11 @@ private StructureMap.Structure parseStructureMapStructure(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(StructureMap.Structure.class, jsonObject);
         }
         StructureMap.Structure.Builder builder = StructureMap.Structure.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.url((Canonical) parseUri(Canonical.builder(), "url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.mode((StructureMapModelMode) parseString(StructureMapModelMode.builder(), "mode", getJsonValue(jsonObject, "mode", JsonString.class), jsonObject.get("_mode"), -1));
@@ -19434,10 +19986,11 @@ private Subscription parseSubscription(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Subscription.class, jsonObject);
         }
         Subscription.Builder builder = Subscription.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.status((SubscriptionStatus) parseString(SubscriptionStatus.builder(), "status", getJsonValue(jsonObject, "status", JsonString.class), jsonObject.get("_status"), -1));
         JsonArray contactArray = getJsonArray(jsonObject, "contact");
@@ -19460,10 +20013,11 @@ private Subscription.Channel parseSubscriptionChannel(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Subscription.Channel.class, jsonObject);
         }
         Subscription.Channel.Builder builder = Subscription.Channel.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((SubscriptionChannelType) parseString(SubscriptionChannelType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.endpoint((Url) parseUri(Url.builder(), "endpoint", getJsonValue(jsonObject, "endpoint", JsonString.class), jsonObject.get("_endpoint"), -1));
@@ -19484,10 +20038,11 @@ private Substance parseSubstance(java.lang.String elementName, JsonObject jsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Substance.class, jsonObject);
         }
         Substance.Builder builder = Substance.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -19525,10 +20080,11 @@ private Substance.Ingredient parseSubstanceIngredient(java.lang.String elementNa
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Substance.Ingredient.class, jsonObject);
         }
         Substance.Ingredient.Builder builder = Substance.Ingredient.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.quantity(parseRatio("quantity", getJsonValue(jsonObject, "quantity", JsonObject.class), -1));
         builder.substance(parseChoiceElement("substance", jsonObject, CodeableConcept.class, Reference.class));
@@ -19541,10 +20097,11 @@ private Substance.Instance parseSubstanceInstance(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Substance.Instance.class, jsonObject);
         }
         Substance.Instance.Builder builder = Substance.Instance.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.expiry(parseDateTime("expiry", getJsonValue(jsonObject, "expiry", JsonString.class), jsonObject.get("_expiry"), -1));
@@ -19558,10 +20115,11 @@ private SubstanceAmount parseSubstanceAmount(java.lang.String elementName, JsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceAmount.class, jsonObject);
         }
         SubstanceAmount.Builder builder = SubstanceAmount.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.amount(parseChoiceElement("amount", jsonObject, Quantity.class, Range.class, String.class));
         builder.amountType(parseCodeableConcept("amountType", getJsonValue(jsonObject, "amountType", JsonObject.class), -1));
@@ -19576,10 +20134,11 @@ private SubstanceAmount.ReferenceRange parseSubstanceAmountReferenceRange(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceAmount.ReferenceRange.class, jsonObject);
         }
         SubstanceAmount.ReferenceRange.Builder builder = SubstanceAmount.ReferenceRange.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.lowLimit(parseQuantity("lowLimit", getJsonValue(jsonObject, "lowLimit", JsonObject.class), -1));
         builder.highLimit(parseQuantity("highLimit", getJsonValue(jsonObject, "highLimit", JsonObject.class), -1));
@@ -19592,10 +20151,11 @@ private SubstanceNucleicAcid parseSubstanceNucleicAcid(java.lang.String elementN
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceNucleicAcid.class, jsonObject);
         }
         SubstanceNucleicAcid.Builder builder = SubstanceNucleicAcid.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.sequenceType(parseCodeableConcept("sequenceType", getJsonValue(jsonObject, "sequenceType", JsonObject.class), -1));
         builder.numberOfSubunits(parseInteger("numberOfSubunits", getJsonValue(jsonObject, "numberOfSubunits", JsonNumber.class), jsonObject.get("_numberOfSubunits"), -1));
@@ -19616,10 +20176,11 @@ private SubstanceNucleicAcid.Subunit parseSubstanceNucleicAcidSubunit(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceNucleicAcid.Subunit.class, jsonObject);
         }
         SubstanceNucleicAcid.Subunit.Builder builder = SubstanceNucleicAcid.Subunit.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.subunit(parseInteger("subunit", getJsonValue(jsonObject, "subunit", JsonNumber.class), jsonObject.get("_subunit"), -1));
         builder.sequence(parseString("sequence", getJsonValue(jsonObject, "sequence", JsonString.class), jsonObject.get("_sequence"), -1));
@@ -19648,10 +20209,11 @@ private SubstanceNucleicAcid.Subunit.Linkage parseSubstanceNucleicAcidSubunitLin
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceNucleicAcid.Subunit.Linkage.class, jsonObject);
         }
         SubstanceNucleicAcid.Subunit.Linkage.Builder builder = SubstanceNucleicAcid.Subunit.Linkage.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.connectivity(parseString("connectivity", getJsonValue(jsonObject, "connectivity", JsonString.class), jsonObject.get("_connectivity"), -1));
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
@@ -19666,10 +20228,11 @@ private SubstanceNucleicAcid.Subunit.Sugar parseSubstanceNucleicAcidSubunitSugar
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceNucleicAcid.Subunit.Sugar.class, jsonObject);
         }
         SubstanceNucleicAcid.Subunit.Sugar.Builder builder = SubstanceNucleicAcid.Subunit.Sugar.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
@@ -19683,10 +20246,11 @@ private SubstancePolymer parseSubstancePolymer(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstancePolymer.class, jsonObject);
         }
         SubstancePolymer.Builder builder = SubstancePolymer.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.clazz(parseCodeableConcept("class", getJsonValue(jsonObject, "class", JsonObject.class), -1));
         builder.geometry(parseCodeableConcept("geometry", getJsonValue(jsonObject, "geometry", JsonObject.class), -1));
@@ -19724,10 +20288,11 @@ private SubstancePolymer.MonomerSet parseSubstancePolymerMonomerSet(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstancePolymer.MonomerSet.class, jsonObject);
         }
         SubstancePolymer.MonomerSet.Builder builder = SubstancePolymer.MonomerSet.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.ratioType(parseCodeableConcept("ratioType", getJsonValue(jsonObject, "ratioType", JsonObject.class), -1));
         JsonArray startingMaterialArray = getJsonArray(jsonObject, "startingMaterial");
@@ -19745,10 +20310,11 @@ private SubstancePolymer.MonomerSet.StartingMaterial parseSubstancePolymerMonome
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstancePolymer.MonomerSet.StartingMaterial.class, jsonObject);
         }
         SubstancePolymer.MonomerSet.StartingMaterial.Builder builder = SubstancePolymer.MonomerSet.StartingMaterial.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.material(parseCodeableConcept("material", getJsonValue(jsonObject, "material", JsonObject.class), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -19763,10 +20329,11 @@ private SubstancePolymer.Repeat parseSubstancePolymerRepeat(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstancePolymer.Repeat.class, jsonObject);
         }
         SubstancePolymer.Repeat.Builder builder = SubstancePolymer.Repeat.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.numberOfUnits(parseInteger("numberOfUnits", getJsonValue(jsonObject, "numberOfUnits", JsonNumber.class), jsonObject.get("_numberOfUnits"), -1));
         builder.averageMolecularFormula(parseString("averageMolecularFormula", getJsonValue(jsonObject, "averageMolecularFormula", JsonString.class), jsonObject.get("_averageMolecularFormula"), -1));
@@ -19786,10 +20353,11 @@ private SubstancePolymer.Repeat.RepeatUnit parseSubstancePolymerRepeatRepeatUnit
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstancePolymer.Repeat.RepeatUnit.class, jsonObject);
         }
         SubstancePolymer.Repeat.RepeatUnit.Builder builder = SubstancePolymer.Repeat.RepeatUnit.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.orientationOfPolymerisation(parseCodeableConcept("orientationOfPolymerisation", getJsonValue(jsonObject, "orientationOfPolymerisation", JsonObject.class), -1));
         builder.repeatUnit(parseString("repeatUnit", getJsonValue(jsonObject, "repeatUnit", JsonString.class), jsonObject.get("_repeatUnit"), -1));
@@ -19815,10 +20383,11 @@ private SubstancePolymer.Repeat.RepeatUnit.DegreeOfPolymerisation parseSubstance
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstancePolymer.Repeat.RepeatUnit.DegreeOfPolymerisation.class, jsonObject);
         }
         SubstancePolymer.Repeat.RepeatUnit.DegreeOfPolymerisation.Builder builder = SubstancePolymer.Repeat.RepeatUnit.DegreeOfPolymerisation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.degree(parseCodeableConcept("degree", getJsonValue(jsonObject, "degree", JsonObject.class), -1));
         builder.amount(parseSubstanceAmount("amount", getJsonValue(jsonObject, "amount", JsonObject.class), -1));
@@ -19831,10 +20400,11 @@ private SubstancePolymer.Repeat.RepeatUnit.StructuralRepresentation parseSubstan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstancePolymer.Repeat.RepeatUnit.StructuralRepresentation.class, jsonObject);
         }
         SubstancePolymer.Repeat.RepeatUnit.StructuralRepresentation.Builder builder = SubstancePolymer.Repeat.RepeatUnit.StructuralRepresentation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.representation(parseString("representation", getJsonValue(jsonObject, "representation", JsonString.class), jsonObject.get("_representation"), -1));
@@ -19848,10 +20418,11 @@ private SubstanceProtein parseSubstanceProtein(java.lang.String elementName, Jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceProtein.class, jsonObject);
         }
         SubstanceProtein.Builder builder = SubstanceProtein.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.sequenceType(parseCodeableConcept("sequenceType", getJsonValue(jsonObject, "sequenceType", JsonObject.class), -1));
         builder.numberOfSubunits(parseInteger("numberOfSubunits", getJsonValue(jsonObject, "numberOfSubunits", JsonNumber.class), jsonObject.get("_numberOfSubunits"), -1));
@@ -19877,10 +20448,11 @@ private SubstanceProtein.Subunit parseSubstanceProteinSubunit(java.lang.String e
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceProtein.Subunit.class, jsonObject);
         }
         SubstanceProtein.Subunit.Builder builder = SubstanceProtein.Subunit.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.subunit(parseInteger("subunit", getJsonValue(jsonObject, "subunit", JsonNumber.class), jsonObject.get("_subunit"), -1));
         builder.sequence(parseString("sequence", getJsonValue(jsonObject, "sequence", JsonString.class), jsonObject.get("_sequence"), -1));
@@ -19899,10 +20471,11 @@ private SubstanceReferenceInformation parseSubstanceReferenceInformation(java.la
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceReferenceInformation.class, jsonObject);
         }
         SubstanceReferenceInformation.Builder builder = SubstanceReferenceInformation.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.comment(parseString("comment", getJsonValue(jsonObject, "comment", JsonString.class), jsonObject.get("_comment"), -1));
         JsonArray geneArray = getJsonArray(jsonObject, "gene");
@@ -19938,10 +20511,11 @@ private SubstanceReferenceInformation.Classification parseSubstanceReferenceInfo
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceReferenceInformation.Classification.class, jsonObject);
         }
         SubstanceReferenceInformation.Classification.Builder builder = SubstanceReferenceInformation.Classification.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.domain(parseCodeableConcept("domain", getJsonValue(jsonObject, "domain", JsonObject.class), -1));
         builder.classification(parseCodeableConcept("classification", getJsonValue(jsonObject, "classification", JsonObject.class), -1));
@@ -19966,10 +20540,11 @@ private SubstanceReferenceInformation.Gene parseSubstanceReferenceInformationGen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceReferenceInformation.Gene.class, jsonObject);
         }
         SubstanceReferenceInformation.Gene.Builder builder = SubstanceReferenceInformation.Gene.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.geneSequenceOrigin(parseCodeableConcept("geneSequenceOrigin", getJsonValue(jsonObject, "geneSequenceOrigin", JsonObject.class), -1));
         builder.gene(parseCodeableConcept("gene", getJsonValue(jsonObject, "gene", JsonObject.class), -1));
@@ -19988,10 +20563,11 @@ private SubstanceReferenceInformation.GeneElement parseSubstanceReferenceInforma
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceReferenceInformation.GeneElement.class, jsonObject);
         }
         SubstanceReferenceInformation.GeneElement.Builder builder = SubstanceReferenceInformation.GeneElement.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.element(parseIdentifier("element", getJsonValue(jsonObject, "element", JsonObject.class), -1));
@@ -20010,10 +20586,11 @@ private SubstanceReferenceInformation.Target parseSubstanceReferenceInformationT
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceReferenceInformation.Target.class, jsonObject);
         }
         SubstanceReferenceInformation.Target.Builder builder = SubstanceReferenceInformation.Target.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.target(parseIdentifier("target", getJsonValue(jsonObject, "target", JsonObject.class), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -20037,10 +20614,11 @@ private SubstanceSourceMaterial parseSubstanceSourceMaterial(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSourceMaterial.class, jsonObject);
         }
         SubstanceSourceMaterial.Builder builder = SubstanceSourceMaterial.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.sourceMaterialClass(parseCodeableConcept("sourceMaterialClass", getJsonValue(jsonObject, "sourceMaterialClass", JsonObject.class), -1));
         builder.sourceMaterialType(parseCodeableConcept("sourceMaterialType", getJsonValue(jsonObject, "sourceMaterialType", JsonObject.class), -1));
@@ -20096,10 +20674,11 @@ private SubstanceSourceMaterial.FractionDescription parseSubstanceSourceMaterial
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSourceMaterial.FractionDescription.class, jsonObject);
         }
         SubstanceSourceMaterial.FractionDescription.Builder builder = SubstanceSourceMaterial.FractionDescription.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.fraction(parseString("fraction", getJsonValue(jsonObject, "fraction", JsonString.class), jsonObject.get("_fraction"), -1));
         builder.materialType(parseCodeableConcept("materialType", getJsonValue(jsonObject, "materialType", JsonObject.class), -1));
@@ -20112,10 +20691,11 @@ private SubstanceSourceMaterial.Organism parseSubstanceSourceMaterialOrganism(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSourceMaterial.Organism.class, jsonObject);
         }
         SubstanceSourceMaterial.Organism.Builder builder = SubstanceSourceMaterial.Organism.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.family(parseCodeableConcept("family", getJsonValue(jsonObject, "family", JsonObject.class), -1));
         builder.genus(parseCodeableConcept("genus", getJsonValue(jsonObject, "genus", JsonObject.class), -1));
@@ -20139,10 +20719,11 @@ private SubstanceSourceMaterial.Organism.Author parseSubstanceSourceMaterialOrga
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSourceMaterial.Organism.Author.class, jsonObject);
         }
         SubstanceSourceMaterial.Organism.Author.Builder builder = SubstanceSourceMaterial.Organism.Author.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.authorType(parseCodeableConcept("authorType", getJsonValue(jsonObject, "authorType", JsonObject.class), -1));
         builder.authorDescription(parseString("authorDescription", getJsonValue(jsonObject, "authorDescription", JsonString.class), jsonObject.get("_authorDescription"), -1));
@@ -20155,10 +20736,11 @@ private SubstanceSourceMaterial.Organism.Hybrid parseSubstanceSourceMaterialOrga
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSourceMaterial.Organism.Hybrid.class, jsonObject);
         }
         SubstanceSourceMaterial.Organism.Hybrid.Builder builder = SubstanceSourceMaterial.Organism.Hybrid.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.maternalOrganismId(parseString("maternalOrganismId", getJsonValue(jsonObject, "maternalOrganismId", JsonString.class), jsonObject.get("_maternalOrganismId"), -1));
         builder.maternalOrganismName(parseString("maternalOrganismName", getJsonValue(jsonObject, "maternalOrganismName", JsonString.class), jsonObject.get("_maternalOrganismName"), -1));
@@ -20174,10 +20756,11 @@ private SubstanceSourceMaterial.Organism.OrganismGeneral parseSubstanceSourceMat
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSourceMaterial.Organism.OrganismGeneral.class, jsonObject);
         }
         SubstanceSourceMaterial.Organism.OrganismGeneral.Builder builder = SubstanceSourceMaterial.Organism.OrganismGeneral.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.kingdom(parseCodeableConcept("kingdom", getJsonValue(jsonObject, "kingdom", JsonObject.class), -1));
         builder.phylum(parseCodeableConcept("phylum", getJsonValue(jsonObject, "phylum", JsonObject.class), -1));
@@ -20192,10 +20775,11 @@ private SubstanceSourceMaterial.PartDescription parseSubstanceSourceMaterialPart
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSourceMaterial.PartDescription.class, jsonObject);
         }
         SubstanceSourceMaterial.PartDescription.Builder builder = SubstanceSourceMaterial.PartDescription.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.part(parseCodeableConcept("part", getJsonValue(jsonObject, "part", JsonObject.class), -1));
         builder.partLocation(parseCodeableConcept("partLocation", getJsonValue(jsonObject, "partLocation", JsonObject.class), -1));
@@ -20208,10 +20792,11 @@ private SubstanceSpecification parseSubstanceSpecification(java.lang.String elem
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.class, jsonObject);
         }
         SubstanceSpecification.Builder builder = SubstanceSpecification.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -20276,10 +20861,11 @@ private SubstanceSpecification.Code parseSubstanceSpecificationCode(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Code.class, jsonObject);
         }
         SubstanceSpecification.Code.Builder builder = SubstanceSpecification.Code.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.status(parseCodeableConcept("status", getJsonValue(jsonObject, "status", JsonObject.class), -1));
@@ -20300,10 +20886,11 @@ private SubstanceSpecification.Moiety parseSubstanceSpecificationMoiety(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Moiety.class, jsonObject);
         }
         SubstanceSpecification.Moiety.Builder builder = SubstanceSpecification.Moiety.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.role(parseCodeableConcept("role", getJsonValue(jsonObject, "role", JsonObject.class), -1));
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
@@ -20321,10 +20908,11 @@ private SubstanceSpecification.Name parseSubstanceSpecificationName(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Name.class, jsonObject);
         }
         SubstanceSpecification.Name.Builder builder = SubstanceSpecification.Name.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -20381,10 +20969,11 @@ private SubstanceSpecification.Name.Official parseSubstanceSpecificationNameOffi
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Name.Official.class, jsonObject);
         }
         SubstanceSpecification.Name.Official.Builder builder = SubstanceSpecification.Name.Official.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.authority(parseCodeableConcept("authority", getJsonValue(jsonObject, "authority", JsonObject.class), -1));
         builder.status(parseCodeableConcept("status", getJsonValue(jsonObject, "status", JsonObject.class), -1));
@@ -20398,10 +20987,11 @@ private SubstanceSpecification.Property parseSubstanceSpecificationProperty(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Property.class, jsonObject);
         }
         SubstanceSpecification.Property.Builder builder = SubstanceSpecification.Property.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.category(parseCodeableConcept("category", getJsonValue(jsonObject, "category", JsonObject.class), -1));
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
@@ -20417,10 +21007,11 @@ private SubstanceSpecification.Relationship parseSubstanceSpecificationRelations
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Relationship.class, jsonObject);
         }
         SubstanceSpecification.Relationship.Builder builder = SubstanceSpecification.Relationship.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.substance(parseChoiceElement("substance", jsonObject, Reference.class, CodeableConcept.class));
         builder.relationship(parseCodeableConcept("relationship", getJsonValue(jsonObject, "relationship", JsonObject.class), -1));
@@ -20443,10 +21034,11 @@ private SubstanceSpecification.Structure parseSubstanceSpecificationStructure(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Structure.class, jsonObject);
         }
         SubstanceSpecification.Structure.Builder builder = SubstanceSpecification.Structure.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.stereochemistry(parseCodeableConcept("stereochemistry", getJsonValue(jsonObject, "stereochemistry", JsonObject.class), -1));
         builder.opticalActivity(parseCodeableConcept("opticalActivity", getJsonValue(jsonObject, "opticalActivity", JsonObject.class), -1));
@@ -20480,10 +21072,11 @@ private SubstanceSpecification.Structure.Isotope parseSubstanceSpecificationStru
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Structure.Isotope.class, jsonObject);
         }
         SubstanceSpecification.Structure.Isotope.Builder builder = SubstanceSpecification.Structure.Isotope.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.name(parseCodeableConcept("name", getJsonValue(jsonObject, "name", JsonObject.class), -1));
@@ -20499,10 +21092,11 @@ private SubstanceSpecification.Structure.Isotope.MolecularWeight parseSubstanceS
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Structure.Isotope.MolecularWeight.class, jsonObject);
         }
         SubstanceSpecification.Structure.Isotope.MolecularWeight.Builder builder = SubstanceSpecification.Structure.Isotope.MolecularWeight.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.method(parseCodeableConcept("method", getJsonValue(jsonObject, "method", JsonObject.class), -1));
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
@@ -20516,10 +21110,11 @@ private SubstanceSpecification.Structure.Representation parseSubstanceSpecificat
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SubstanceSpecification.Structure.Representation.class, jsonObject);
         }
         SubstanceSpecification.Structure.Representation.Builder builder = SubstanceSpecification.Structure.Representation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.representation(parseString("representation", getJsonValue(jsonObject, "representation", JsonString.class), jsonObject.get("_representation"), -1));
@@ -20533,10 +21128,11 @@ private SupplyDelivery parseSupplyDelivery(java.lang.String elementName, JsonObj
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SupplyDelivery.class, jsonObject);
         }
         SupplyDelivery.Builder builder = SupplyDelivery.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -20578,10 +21174,11 @@ private SupplyDelivery.SuppliedItem parseSupplyDeliverySuppliedItem(java.lang.St
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SupplyDelivery.SuppliedItem.class, jsonObject);
         }
         SupplyDelivery.SuppliedItem.Builder builder = SupplyDelivery.SuppliedItem.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.quantity((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "quantity", getJsonValue(jsonObject, "quantity", JsonObject.class), -1));
         builder.item(parseChoiceElement("item", jsonObject, CodeableConcept.class, Reference.class));
@@ -20594,10 +21191,11 @@ private SupplyRequest parseSupplyRequest(java.lang.String elementName, JsonObjec
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SupplyRequest.class, jsonObject);
         }
         SupplyRequest.Builder builder = SupplyRequest.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -20648,10 +21246,11 @@ private SupplyRequest.Parameter parseSupplyRequestParameter(java.lang.String ele
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(SupplyRequest.Parameter.class, jsonObject);
         }
         SupplyRequest.Parameter.Builder builder = SupplyRequest.Parameter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseCodeableConcept("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, CodeableConcept.class, Quantity.class, Range.class, Boolean.class));
@@ -20664,10 +21263,11 @@ private Task parseTask(java.lang.String elementName, JsonObject jsonObject, int
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Task.class, jsonObject);
         }
         Task.Builder builder = Task.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -20754,10 +21354,11 @@ private Task.Input parseTaskInput(java.lang.String elementName, JsonObject jsonO
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Task.Input.class, jsonObject);
         }
         Task.Input.Builder builder = Task.Input.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class));
@@ -20770,10 +21371,11 @@ private Task.Output parseTaskOutput(java.lang.String elementName, JsonObject jso
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Task.Output.class, jsonObject);
         }
         Task.Output.Builder builder = Task.Output.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCodeableConcept("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class));
@@ -20786,10 +21388,11 @@ private Task.Restriction parseTaskRestriction(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Task.Restriction.class, jsonObject);
         }
         Task.Restriction.Builder builder = Task.Restriction.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.repetitions((PositiveInt) parseInteger(PositiveInt.builder(), "repetitions", getJsonValue(jsonObject, "repetitions", JsonNumber.class), jsonObject.get("_repetitions"), -1));
         builder.period(parsePeriod("period", getJsonValue(jsonObject, "period", JsonObject.class), -1));
@@ -20808,10 +21411,11 @@ private TerminologyCapabilities parseTerminologyCapabilities(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.class, jsonObject);
         }
         TerminologyCapabilities.Builder builder = TerminologyCapabilities.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -20866,10 +21470,11 @@ private TerminologyCapabilities.Closure parseTerminologyCapabilitiesClosure(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.Closure.class, jsonObject);
         }
         TerminologyCapabilities.Closure.Builder builder = TerminologyCapabilities.Closure.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.translation(parseBoolean("translation", getJsonValue(jsonObject, "translation", JsonValue.class), jsonObject.get("_translation"), -1));
         stackPop();
@@ -20881,10 +21486,11 @@ private TerminologyCapabilities.CodeSystem parseTerminologyCapabilitiesCodeSyste
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.CodeSystem.class, jsonObject);
         }
         TerminologyCapabilities.CodeSystem.Builder builder = TerminologyCapabilities.CodeSystem.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.uri((Canonical) parseUri(Canonical.builder(), "uri", getJsonValue(jsonObject, "uri", JsonString.class), jsonObject.get("_uri"), -1));
         JsonArray versionArray = getJsonArray(jsonObject, "version");
@@ -20903,10 +21509,11 @@ private TerminologyCapabilities.CodeSystem.Version parseTerminologyCapabilitiesC
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.CodeSystem.Version.class, jsonObject);
         }
         TerminologyCapabilities.CodeSystem.Version.Builder builder = TerminologyCapabilities.CodeSystem.Version.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code(parseString("code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.isDefault(parseBoolean("isDefault", getJsonValue(jsonObject, "isDefault", JsonValue.class), jsonObject.get("_isDefault"), -1));
@@ -20940,10 +21547,11 @@ private TerminologyCapabilities.CodeSystem.Version.Filter parseTerminologyCapabi
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.CodeSystem.Version.Filter.class, jsonObject);
         }
         TerminologyCapabilities.CodeSystem.Version.Filter.Builder builder = TerminologyCapabilities.CodeSystem.Version.Filter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         JsonArray opArray = getJsonArray(jsonObject, "op", true);
@@ -20962,10 +21570,11 @@ private TerminologyCapabilities.Expansion parseTerminologyCapabilitiesExpansion(
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.Expansion.class, jsonObject);
         }
         TerminologyCapabilities.Expansion.Builder builder = TerminologyCapabilities.Expansion.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.hierarchical(parseBoolean("hierarchical", getJsonValue(jsonObject, "hierarchical", JsonValue.class), jsonObject.get("_hierarchical"), -1));
         builder.paging(parseBoolean("paging", getJsonValue(jsonObject, "paging", JsonValue.class), jsonObject.get("_paging"), -1));
@@ -20986,10 +21595,11 @@ private TerminologyCapabilities.Expansion.Parameter parseTerminologyCapabilities
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.Expansion.Parameter.class, jsonObject);
         }
         TerminologyCapabilities.Expansion.Parameter.Builder builder = TerminologyCapabilities.Expansion.Parameter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name((Code) parseString(Code.builder(), "name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.documentation(parseString("documentation", getJsonValue(jsonObject, "documentation", JsonString.class), jsonObject.get("_documentation"), -1));
@@ -21002,10 +21612,11 @@ private TerminologyCapabilities.Implementation parseTerminologyCapabilitiesImple
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.Implementation.class, jsonObject);
         }
         TerminologyCapabilities.Implementation.Builder builder = TerminologyCapabilities.Implementation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
         builder.url((Url) parseUri(Url.builder(), "url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
@@ -21018,10 +21629,11 @@ private TerminologyCapabilities.Software parseTerminologyCapabilitiesSoftware(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.Software.class, jsonObject);
         }
         TerminologyCapabilities.Software.Builder builder = TerminologyCapabilities.Software.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -21034,10 +21646,11 @@ private TerminologyCapabilities.Translation parseTerminologyCapabilitiesTranslat
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.Translation.class, jsonObject);
         }
         TerminologyCapabilities.Translation.Builder builder = TerminologyCapabilities.Translation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.needsMap(parseBoolean("needsMap", getJsonValue(jsonObject, "needsMap", JsonValue.class), jsonObject.get("_needsMap"), -1));
         stackPop();
@@ -21049,10 +21662,11 @@ private TerminologyCapabilities.ValidateCode parseTerminologyCapabilitiesValidat
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TerminologyCapabilities.ValidateCode.class, jsonObject);
         }
         TerminologyCapabilities.ValidateCode.Builder builder = TerminologyCapabilities.ValidateCode.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.translations(parseBoolean("translations", getJsonValue(jsonObject, "translations", JsonValue.class), jsonObject.get("_translations"), -1));
         stackPop();
@@ -21064,10 +21678,11 @@ private TestReport parseTestReport(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.class, jsonObject);
         }
         TestReport.Builder builder = TestReport.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
@@ -21100,10 +21715,11 @@ private TestReport.Participant parseTestReportParticipant(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.Participant.class, jsonObject);
         }
         TestReport.Participant.Builder builder = TestReport.Participant.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type((TestReportParticipantType) parseString(TestReportParticipantType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.uri(parseUri("uri", getJsonValue(jsonObject, "uri", JsonString.class), jsonObject.get("_uri"), -1));
@@ -21117,10 +21733,11 @@ private TestReport.Setup parseTestReportSetup(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.Setup.class, jsonObject);
         }
         TestReport.Setup.Builder builder = TestReport.Setup.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray actionArray = getJsonArray(jsonObject, "action");
         if (actionArray != null) {
@@ -21137,10 +21754,11 @@ private TestReport.Setup.Action parseTestReportSetupAction(java.lang.String elem
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.Setup.Action.class, jsonObject);
         }
         TestReport.Setup.Action.Builder builder = TestReport.Setup.Action.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.operation(parseTestReportSetupActionOperation("operation", getJsonValue(jsonObject, "operation", JsonObject.class), -1));
         builder._assert(parseTestReportSetupActionAssert("assert", getJsonValue(jsonObject, "assert", JsonObject.class), -1));
@@ -21153,10 +21771,11 @@ private TestReport.Setup.Action.Assert parseTestReportSetupActionAssert(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.Setup.Action.Assert.class, jsonObject);
         }
         TestReport.Setup.Action.Assert.Builder builder = TestReport.Setup.Action.Assert.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.result((TestReportActionResult) parseString(TestReportActionResult.builder(), "result", getJsonValue(jsonObject, "result", JsonString.class), jsonObject.get("_result"), -1));
         builder.message((Markdown) parseString(Markdown.builder(), "message", getJsonValue(jsonObject, "message", JsonString.class), jsonObject.get("_message"), -1));
@@ -21170,10 +21789,11 @@ private TestReport.Setup.Action.Operation parseTestReportSetupActionOperation(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.Setup.Action.Operation.class, jsonObject);
         }
         TestReport.Setup.Action.Operation.Builder builder = TestReport.Setup.Action.Operation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.result((TestReportActionResult) parseString(TestReportActionResult.builder(), "result", getJsonValue(jsonObject, "result", JsonString.class), jsonObject.get("_result"), -1));
         builder.message((Markdown) parseString(Markdown.builder(), "message", getJsonValue(jsonObject, "message", JsonString.class), jsonObject.get("_message"), -1));
@@ -21187,10 +21807,11 @@ private TestReport.Teardown parseTestReportTeardown(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.Teardown.class, jsonObject);
         }
         TestReport.Teardown.Builder builder = TestReport.Teardown.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray actionArray = getJsonArray(jsonObject, "action");
         if (actionArray != null) {
@@ -21207,10 +21828,11 @@ private TestReport.Teardown.Action parseTestReportTeardownAction(java.lang.Strin
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.Teardown.Action.class, jsonObject);
         }
         TestReport.Teardown.Action.Builder builder = TestReport.Teardown.Action.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.operation(parseTestReportSetupActionOperation("operation", getJsonValue(jsonObject, "operation", JsonObject.class), -1));
         stackPop();
@@ -21222,10 +21844,11 @@ private TestReport.Test parseTestReportTest(java.lang.String elementName, JsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.Test.class, jsonObject);
         }
         TestReport.Test.Builder builder = TestReport.Test.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -21244,10 +21867,11 @@ private TestReport.Test.Action parseTestReportTestAction(java.lang.String elemen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestReport.Test.Action.class, jsonObject);
         }
         TestReport.Test.Action.Builder builder = TestReport.Test.Action.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.operation(parseTestReportSetupActionOperation("operation", getJsonValue(jsonObject, "operation", JsonObject.class), -1));
         builder._assert(parseTestReportSetupActionAssert("assert", getJsonValue(jsonObject, "assert", JsonObject.class), -1));
@@ -21260,10 +21884,11 @@ private TestScript parseTestScript(java.lang.String elementName, JsonObject json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.class, jsonObject);
         }
         TestScript.Builder builder = TestScript.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.identifier(parseIdentifier("identifier", getJsonValue(jsonObject, "identifier", JsonObject.class), -1));
@@ -21343,10 +21968,11 @@ private TestScript.Destination parseTestScriptDestination(java.lang.String eleme
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Destination.class, jsonObject);
         }
         TestScript.Destination.Builder builder = TestScript.Destination.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.index(parseInteger("index", getJsonValue(jsonObject, "index", JsonNumber.class), jsonObject.get("_index"), -1));
         builder.profile(parseCoding("profile", getJsonValue(jsonObject, "profile", JsonObject.class), -1));
@@ -21359,10 +21985,11 @@ private TestScript.Fixture parseTestScriptFixture(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Fixture.class, jsonObject);
         }
         TestScript.Fixture.Builder builder = TestScript.Fixture.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.autocreate(parseBoolean("autocreate", getJsonValue(jsonObject, "autocreate", JsonValue.class), jsonObject.get("_autocreate"), -1));
         builder.autodelete(parseBoolean("autodelete", getJsonValue(jsonObject, "autodelete", JsonValue.class), jsonObject.get("_autodelete"), -1));
@@ -21376,10 +22003,11 @@ private TestScript.Metadata parseTestScriptMetadata(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Metadata.class, jsonObject);
         }
         TestScript.Metadata.Builder builder = TestScript.Metadata.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray linkArray = getJsonArray(jsonObject, "link");
         if (linkArray != null) {
@@ -21402,10 +22030,11 @@ private TestScript.Metadata.Capability parseTestScriptMetadataCapability(java.la
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Metadata.Capability.class, jsonObject);
         }
         TestScript.Metadata.Capability.Builder builder = TestScript.Metadata.Capability.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.required(parseBoolean("required", getJsonValue(jsonObject, "required", JsonValue.class), jsonObject.get("_required"), -1));
         builder.validated(parseBoolean("validated", getJsonValue(jsonObject, "validated", JsonValue.class), jsonObject.get("_validated"), -1));
@@ -21435,10 +22064,11 @@ private TestScript.Metadata.Link parseTestScriptMetadataLink(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Metadata.Link.class, jsonObject);
         }
         TestScript.Metadata.Link.Builder builder = TestScript.Metadata.Link.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -21451,10 +22081,11 @@ private TestScript.Origin parseTestScriptOrigin(java.lang.String elementName, Js
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Origin.class, jsonObject);
         }
         TestScript.Origin.Builder builder = TestScript.Origin.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.index(parseInteger("index", getJsonValue(jsonObject, "index", JsonNumber.class), jsonObject.get("_index"), -1));
         builder.profile(parseCoding("profile", getJsonValue(jsonObject, "profile", JsonObject.class), -1));
@@ -21467,10 +22098,11 @@ private TestScript.Setup parseTestScriptSetup(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Setup.class, jsonObject);
         }
         TestScript.Setup.Builder builder = TestScript.Setup.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray actionArray = getJsonArray(jsonObject, "action");
         if (actionArray != null) {
@@ -21487,10 +22119,11 @@ private TestScript.Setup.Action parseTestScriptSetupAction(java.lang.String elem
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Setup.Action.class, jsonObject);
         }
         TestScript.Setup.Action.Builder builder = TestScript.Setup.Action.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.operation(parseTestScriptSetupActionOperation("operation", getJsonValue(jsonObject, "operation", JsonObject.class), -1));
         builder._assert(parseTestScriptSetupActionAssert("assert", getJsonValue(jsonObject, "assert", JsonObject.class), -1));
@@ -21503,10 +22136,11 @@ private TestScript.Setup.Action.Assert parseTestScriptSetupActionAssert(java.lan
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Setup.Action.Assert.class, jsonObject);
         }
         TestScript.Setup.Action.Assert.Builder builder = TestScript.Setup.Action.Assert.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.label(parseString("label", getJsonValue(jsonObject, "label", JsonString.class), jsonObject.get("_label"), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -21539,10 +22173,11 @@ private TestScript.Setup.Action.Operation parseTestScriptSetupActionOperation(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Setup.Action.Operation.class, jsonObject);
         }
         TestScript.Setup.Action.Operation.Builder builder = TestScript.Setup.Action.Operation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.type(parseCoding("type", getJsonValue(jsonObject, "type", JsonObject.class), -1));
         builder.resource((FHIRDefinedType) parseString(FHIRDefinedType.builder(), "resource", getJsonValue(jsonObject, "resource", JsonString.class), jsonObject.get("_resource"), -1));
@@ -21575,10 +22210,11 @@ private TestScript.Setup.Action.Operation.RequestHeader parseTestScriptSetupActi
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Setup.Action.Operation.RequestHeader.class, jsonObject);
         }
         TestScript.Setup.Action.Operation.RequestHeader.Builder builder = TestScript.Setup.Action.Operation.RequestHeader.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.field(parseString("field", getJsonValue(jsonObject, "field", JsonString.class), jsonObject.get("_field"), -1));
         builder.value(parseString("value", getJsonValue(jsonObject, "value", JsonString.class), jsonObject.get("_value"), -1));
@@ -21591,10 +22227,11 @@ private TestScript.Teardown parseTestScriptTeardown(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Teardown.class, jsonObject);
         }
         TestScript.Teardown.Builder builder = TestScript.Teardown.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray actionArray = getJsonArray(jsonObject, "action");
         if (actionArray != null) {
@@ -21611,10 +22248,11 @@ private TestScript.Teardown.Action parseTestScriptTeardownAction(java.lang.Strin
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Teardown.Action.class, jsonObject);
         }
         TestScript.Teardown.Action.Builder builder = TestScript.Teardown.Action.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.operation(parseTestScriptSetupActionOperation("operation", getJsonValue(jsonObject, "operation", JsonObject.class), -1));
         stackPop();
@@ -21626,10 +22264,11 @@ private TestScript.Test parseTestScriptTest(java.lang.String elementName, JsonOb
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Test.class, jsonObject);
         }
         TestScript.Test.Builder builder = TestScript.Test.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.description(parseString("description", getJsonValue(jsonObject, "description", JsonString.class), jsonObject.get("_description"), -1));
@@ -21648,10 +22287,11 @@ private TestScript.Test.Action parseTestScriptTestAction(java.lang.String elemen
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Test.Action.class, jsonObject);
         }
         TestScript.Test.Action.Builder builder = TestScript.Test.Action.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.operation(parseTestScriptSetupActionOperation("operation", getJsonValue(jsonObject, "operation", JsonObject.class), -1));
         builder._assert(parseTestScriptSetupActionAssert("assert", getJsonValue(jsonObject, "assert", JsonObject.class), -1));
@@ -21664,10 +22304,11 @@ private TestScript.Variable parseTestScriptVariable(java.lang.String elementName
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TestScript.Variable.class, jsonObject);
         }
         TestScript.Variable.Builder builder = TestScript.Variable.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.defaultValue(parseString("defaultValue", getJsonValue(jsonObject, "defaultValue", JsonString.class), jsonObject.get("_defaultValue"), -1));
@@ -21687,9 +22328,10 @@ private Time parseTime(java.lang.String elementName, JsonValue jsonValue, JsonVa
         }
         stackPush(elementName, elementIndex);
         Time.Builder builder = Time.builder();
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -21711,10 +22353,11 @@ private Timing parseTiming(java.lang.String elementName, JsonObject jsonObject,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Timing.class, jsonObject);
         }
         Timing.Builder builder = Timing.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         JsonArray eventArray = getJsonArray(jsonObject, "event", true);
         if (eventArray != null) {
@@ -21734,10 +22377,11 @@ private Timing.Repeat parseTimingRepeat(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(Timing.Repeat.class, jsonObject);
         }
         Timing.Repeat.Builder builder = Timing.Repeat.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.bounds(parseChoiceElement("bounds", jsonObject, Duration.class, Range.class, Period.class));
         builder.count((PositiveInt) parseInteger(PositiveInt.builder(), "count", getJsonValue(jsonObject, "count", JsonNumber.class), jsonObject.get("_count"), -1));
@@ -21781,10 +22425,11 @@ private TriggerDefinition parseTriggerDefinition(java.lang.String elementName, J
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(TriggerDefinition.class, jsonObject);
         }
         TriggerDefinition.Builder builder = TriggerDefinition.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.type((TriggerType) parseString(TriggerType.builder(), "type", getJsonValue(jsonObject, "type", JsonString.class), jsonObject.get("_type"), -1));
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
@@ -21805,9 +22450,10 @@ private Uri parseUri(Uri.Builder builder, java.lang.String elementName, JsonValu
             return null;
         }
         stackPush(elementName, elementIndex);
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
@@ -21833,10 +22479,11 @@ private UsageContext parseUsageContext(java.lang.String elementName, JsonObject
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(UsageContext.class, jsonObject);
         }
         UsageContext.Builder builder = UsageContext.builder();
+        builder.setValidating(validating);
         parseElement(builder, jsonObject);
         builder.code(parseCoding("code", getJsonValue(jsonObject, "code", JsonObject.class), -1));
         builder.value(parseChoiceElement("value", jsonObject, CodeableConcept.class, Quantity.class, Range.class, Reference.class));
@@ -21849,10 +22496,11 @@ private ValueSet parseValueSet(java.lang.String elementName, JsonObject jsonObje
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ValueSet.class, jsonObject);
         }
         ValueSet.Builder builder = ValueSet.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         builder.url(parseUri("url", getJsonValue(jsonObject, "url", JsonString.class), jsonObject.get("_url"), -1));
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
@@ -21901,10 +22549,11 @@ private ValueSet.Compose parseValueSetCompose(java.lang.String elementName, Json
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ValueSet.Compose.class, jsonObject);
         }
         ValueSet.Compose.Builder builder = ValueSet.Compose.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.lockedDate(parseDate("lockedDate", getJsonValue(jsonObject, "lockedDate", JsonString.class), jsonObject.get("_lockedDate"), -1));
         builder.inactive(parseBoolean("inactive", getJsonValue(jsonObject, "inactive", JsonValue.class), jsonObject.get("_inactive"), -1));
@@ -21929,10 +22578,11 @@ private ValueSet.Compose.Include parseValueSetComposeInclude(java.lang.String el
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ValueSet.Compose.Include.class, jsonObject);
         }
         ValueSet.Compose.Include.Builder builder = ValueSet.Compose.Include.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.system(parseUri("system", getJsonValue(jsonObject, "system", JsonString.class), jsonObject.get("_system"), -1));
         builder.version(parseString("version", getJsonValue(jsonObject, "version", JsonString.class), jsonObject.get("_version"), -1));
@@ -21964,10 +22614,11 @@ private ValueSet.Compose.Include.Concept parseValueSetComposeIncludeConcept(java
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ValueSet.Compose.Include.Concept.class, jsonObject);
         }
         ValueSet.Compose.Include.Concept.Builder builder = ValueSet.Compose.Include.Concept.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.code((Code) parseString(Code.builder(), "code", getJsonValue(jsonObject, "code", JsonString.class), jsonObject.get("_code"), -1));
         builder.display(parseString("display", getJsonValue(jsonObject, "display", JsonString.class), jsonObject.get("_display"), -1));
@@ -21986,10 +22637,11 @@ private ValueSet.Compose.Include.Concept.Designation parseValueSetComposeInclude
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ValueSet.Compose.Include.Concept.Designation.class, jsonObject);
         }
         ValueSet.Compose.Include.Concept.Designation.Builder builder = ValueSet.Compose.Include.Concept.Designation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.language((Code) parseString(Code.builder(), "language", getJsonValue(jsonObject, "language", JsonString.class), jsonObject.get("_language"), -1));
         builder.use(parseCoding("use", getJsonValue(jsonObject, "use", JsonObject.class), -1));
@@ -22003,10 +22655,11 @@ private ValueSet.Compose.Include.Filter parseValueSetComposeIncludeFilter(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ValueSet.Compose.Include.Filter.class, jsonObject);
         }
         ValueSet.Compose.Include.Filter.Builder builder = ValueSet.Compose.Include.Filter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.property((Code) parseString(Code.builder(), "property", getJsonValue(jsonObject, "property", JsonString.class), jsonObject.get("_property"), -1));
         builder.op((FilterOperator) parseString(FilterOperator.builder(), "op", getJsonValue(jsonObject, "op", JsonString.class), jsonObject.get("_op"), -1));
@@ -22020,10 +22673,11 @@ private ValueSet.Expansion parseValueSetExpansion(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ValueSet.Expansion.class, jsonObject);
         }
         ValueSet.Expansion.Builder builder = ValueSet.Expansion.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.identifier(parseUri("identifier", getJsonValue(jsonObject, "identifier", JsonString.class), jsonObject.get("_identifier"), -1));
         builder.timestamp(parseDateTime("timestamp", getJsonValue(jsonObject, "timestamp", JsonString.class), jsonObject.get("_timestamp"), -1));
@@ -22050,10 +22704,11 @@ private ValueSet.Expansion.Contains parseValueSetExpansionContains(java.lang.Str
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ValueSet.Expansion.Contains.class, jsonObject);
         }
         ValueSet.Expansion.Contains.Builder builder = ValueSet.Expansion.Contains.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.system(parseUri("system", getJsonValue(jsonObject, "system", JsonString.class), jsonObject.get("_system"), -1));
         builder._abstract(parseBoolean("abstract", getJsonValue(jsonObject, "abstract", JsonValue.class), jsonObject.get("_abstract"), -1));
@@ -22082,10 +22737,11 @@ private ValueSet.Expansion.Parameter parseValueSetExpansionParameter(java.lang.S
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(ValueSet.Expansion.Parameter.class, jsonObject);
         }
         ValueSet.Expansion.Parameter.Builder builder = ValueSet.Expansion.Parameter.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.name(parseString("name", getJsonValue(jsonObject, "name", JsonString.class), jsonObject.get("_name"), -1));
         builder.value(parseChoiceElement("value", jsonObject, String.class, Boolean.class, Integer.class, Decimal.class, Uri.class, Code.class, DateTime.class));
@@ -22098,10 +22754,11 @@ private VerificationResult parseVerificationResult(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(VerificationResult.class, jsonObject);
         }
         VerificationResult.Builder builder = VerificationResult.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray targetArray = getJsonArray(jsonObject, "target");
         if (targetArray != null) {
@@ -22152,10 +22809,11 @@ private VerificationResult.Attestation parseVerificationResultAttestation(java.l
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(VerificationResult.Attestation.class, jsonObject);
         }
         VerificationResult.Attestation.Builder builder = VerificationResult.Attestation.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.who(parseReference("who", getJsonValue(jsonObject, "who", JsonObject.class), -1));
         builder.onBehalfOf(parseReference("onBehalfOf", getJsonValue(jsonObject, "onBehalfOf", JsonObject.class), -1));
@@ -22174,10 +22832,11 @@ private VerificationResult.PrimarySource parseVerificationResultPrimarySource(ja
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(VerificationResult.PrimarySource.class, jsonObject);
         }
         VerificationResult.PrimarySource.Builder builder = VerificationResult.PrimarySource.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.who(parseReference("who", getJsonValue(jsonObject, "who", JsonObject.class), -1));
         JsonArray typeArray = getJsonArray(jsonObject, "type");
@@ -22210,10 +22869,11 @@ private VerificationResult.Validator parseVerificationResultValidator(java.lang.
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(VerificationResult.Validator.class, jsonObject);
         }
         VerificationResult.Validator.Builder builder = VerificationResult.Validator.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.organization(parseReference("organization", getJsonValue(jsonObject, "organization", JsonObject.class), -1));
         builder.identityCertificate(parseString("identityCertificate", getJsonValue(jsonObject, "identityCertificate", JsonString.class), jsonObject.get("_identityCertificate"), -1));
@@ -22227,10 +22887,11 @@ private VisionPrescription parseVisionPrescription(java.lang.String elementName,
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(VisionPrescription.class, jsonObject);
         }
         VisionPrescription.Builder builder = VisionPrescription.builder();
+        builder.setValidating(validating);
         parseDomainResource(builder, jsonObject);
         JsonArray identifierArray = getJsonArray(jsonObject, "identifier");
         if (identifierArray != null) {
@@ -22259,10 +22920,11 @@ private VisionPrescription.LensSpecification parseVisionPrescriptionLensSpecific
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(VisionPrescription.LensSpecification.class, jsonObject);
         }
         VisionPrescription.LensSpecification.Builder builder = VisionPrescription.LensSpecification.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.product(parseCodeableConcept("product", getJsonValue(jsonObject, "product", JsonObject.class), -1));
         builder.eye((VisionEyes) parseString(VisionEyes.builder(), "eye", getJsonValue(jsonObject, "eye", JsonString.class), jsonObject.get("_eye"), -1));
@@ -22297,10 +22959,11 @@ private VisionPrescription.LensSpecification.Prism parseVisionPrescriptionLensSp
             return null;
         }
         stackPush(elementName, elementIndex);
-        if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+        if (!ignoringUnrecognizedElements) {
             checkForUnrecognizedElements(VisionPrescription.LensSpecification.Prism.class, jsonObject);
         }
         VisionPrescription.LensSpecification.Prism.Builder builder = VisionPrescription.LensSpecification.Prism.builder();
+        builder.setValidating(validating);
         parseBackboneElement(builder, jsonObject);
         builder.amount(parseDecimal("amount", getJsonValue(jsonObject, "amount", JsonNumber.class), jsonObject.get("_amount"), -1));
         builder.base((VisionBase) parseString(VisionBase.builder(), "base", getJsonValue(jsonObject, "base", JsonString.class), jsonObject.get("_base"), -1));
@@ -22314,9 +22977,10 @@ private Xhtml parseXhtml(java.lang.String elementName, JsonValue jsonValue, Json
         }
         stackPush(elementName, elementIndex);
         Xhtml.Builder builder = Xhtml.builder();
+        builder.setValidating(validating);
         if (_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT) {
             JsonObject jsonObject = (JsonObject) _jsonValue;
-            if (getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false) {
+            if (!ignoringUnrecognizedElements) {
                 checkForUnrecognizedElements(Element.class, jsonObject);
             }
             parseElement(builder, jsonObject);
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRParser.java b/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRParser.java
index b6a1478785d..e57b110490b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRParser.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRParser.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -12,6 +12,7 @@
 import com.ibm.fhir.model.format.Format;
 import com.ibm.fhir.model.parser.exception.FHIRParserException;
 import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.util.ValidationSupport;
 
 /**
  * Parse FHIR resource representations into fhir-model objects
@@ -20,75 +21,116 @@ public interface FHIRParser {
     /**
      * Property name for a property that controls whether the parser will ignore or throw an exception on unrecognized elements
      */
+    @Deprecated
     public static final String PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS = "com.ibm.fhir.model.parser.ignoreUnrecognizedElements";
-    
+
     /**
      * Read a resource from the passed InputStream. This method does not close the passed InputStream.
-     * 
+     *
      * @param <T> The resource type to read
      * @param in
      * @return
      * @throws FHIRParserException
-     * @throws ClassCastException If the InputStream contains a FHIR resource type that cannot be cast to the requested type 
+     * @throws ClassCastException If the InputStream contains a FHIR resource type that cannot be cast to the requested type
      */
     <T extends Resource> T parse(InputStream in) throws FHIRParserException;
-    
+
     /**
      * Read a resource using the passed Reader. This method does not close the passed Reader.
-     * 
+     *
      * @param <T> The resource type to read
      * @param reader
      * @return
      * @throws FHIRParserException
-     * @throws ClassCastException If the InputStream contains a FHIR resource type that cannot be cast to the requested type 
+     * @throws ClassCastException If the InputStream contains a FHIR resource type that cannot be cast to the requested type
      */
     <T extends Resource> T parse(Reader reader) throws FHIRParserException;
 
+    /**
+     * Set the validating parser indicator for this parser
+     *
+     * <p>A validating parser performs basic validation during parsing / deserialization of the input format including:
+     * <ul>
+     * <li>element cardinality checking</li>
+     * <li>element type checking</li>
+     * <li>element value checking</li>
+     * </ul>
+     *
+     * @param validating
+     *     the validating parser indicator
+     * @see ValidationSupport
+     */
+    void setValidating(boolean validating);
+
+    /**
+     * Indicates whether this parser is a validating parser
+     *
+     * @return
+     *     true if this parser is a validating parser, false otherwise
+     */
+    boolean isValidating();
+
+    /**
+     * Set the ignoring unrecognized elements indicator for this parser
+     *
+     * @param ignoringUnrecognizedElements
+     *     the ignoring unrecognized elements indicator
+     */
+    void setIgnoringUnrecognizedElements(boolean ignoringUnrecognizedElements);
+
+    /**
+     * Indicates whether this parser is ignoring unrecognized elements
+     *
+     * @return
+     *     true if this parser is ignoring unrecognized elements, false otherwise
+     */
+    boolean isIgnoringUnrecognizedElements();
+
     /**
      * Set the property with the given name to the passed value
-     * 
+     *
      * @throws IllegalArgumentException if the property {@code name} is unknown or unsupported
      * @see {@link #isPropertySupported(String)}
      */
     void setProperty(String name, Object value);
-    
+
     /**
      * @return the property value or {@code null} if the property has no value
      */
     Object getProperty(String name);
-    
+
     /**
      * @return the property value or {@code defaultValue} if the property has no value
      */
     Object getPropertyOrDefault(String name, Object defaultValue);
-    
+
     /**
      * @return the property value or {@code null} if the property has no value
      */
     <T> T getProperty(String name, Class<T> type);
-    
+
     /**
      * @return the property value or {@code defaultValue} if the property has no value
      */
     <T> T getPropertyOrDefault(String name, T defaultValue, Class<T> type);
-    
+
     /**
      * Whether the generator supports the property with the passed name
      */
     boolean isPropertySupported(String name);
-    
+
     /**
      * Attempt to cast the FHIRParser to a specific subclass
-     * 
+     *
      * @param <T> The FHIRParser subclass to cast to
      * @return
-     * @throws ClassCastException If the InputStream contains a FHIR resource type that cannot be cast to the requested type 
+     * @throws ClassCastException If the InputStream contains a FHIR resource type that cannot be cast to the requested type
      */
     <T extends FHIRParser> T as(Class<T> parserClass);
-    
+
     /**
      * Create a FHIRParser for the given format.
-     * 
+     *
      * @param format
      * @return
      * @throws IllegalArgumentException if {@code format} is not supported
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRXMLParser.java b/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRXMLParser.java
index 02e72861491..58a18de601b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRXMLParser.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/parser/FHIRXMLParser.java
@@ -392,6 +392,7 @@ private Resource parseResource(java.lang.String elementName, XMLStreamReader rea
     private Account parseAccount(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Account.Builder builder = Account.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, subjectElementIndex = 0, coverageElementIndex = 0, guarantorElementIndex = 0;
         while (reader.hasNext()) {
@@ -478,7 +479,11 @@ private Account parseAccount(java.lang.String elementName, XMLStreamReader reade
                     builder.partOf(parseReference("partOf", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -495,6 +500,7 @@ private Account parseAccount(java.lang.String elementName, XMLStreamReader reade
     private Account.Coverage parseAccountCoverage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Account.Coverage.Builder builder = Account.Coverage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -525,7 +531,11 @@ private Account.Coverage parseAccountCoverage(java.lang.String elementName, XMLS
                     builder.priority((PositiveInt) parseInteger(PositiveInt.builder(), "priority", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -542,6 +552,7 @@ private Account.Coverage parseAccountCoverage(java.lang.String elementName, XMLS
     private Account.Guarantor parseAccountGuarantor(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Account.Guarantor.Builder builder = Account.Guarantor.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -576,7 +587,11 @@ private Account.Guarantor parseAccountGuarantor(java.lang.String elementName, XM
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -593,6 +608,7 @@ private Account.Guarantor parseAccountGuarantor(java.lang.String elementName, XM
     private ActivityDefinition parseActivityDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ActivityDefinition.Builder builder = ActivityDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, libraryElementIndex = 0, participantElementIndex = 0, dosageElementIndex = 0, bodySiteElementIndex = 0, specimenRequirementElementIndex = 0, observationRequirementElementIndex = 0, observationResultRequirementElementIndex = 0, dynamicValueElementIndex = 0;
         while (reader.hasNext()) {
@@ -847,7 +863,11 @@ private ActivityDefinition parseActivityDefinition(java.lang.String elementName,
                     builder.dynamicValue(parseActivityDefinitionDynamicValue("dynamicValue", reader, dynamicValueElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -864,6 +884,7 @@ private ActivityDefinition parseActivityDefinition(java.lang.String elementName,
     private ActivityDefinition.DynamicValue parseActivityDefinitionDynamicValue(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ActivityDefinition.DynamicValue.Builder builder = ActivityDefinition.DynamicValue.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -894,7 +915,11 @@ private ActivityDefinition.DynamicValue parseActivityDefinitionDynamicValue(java
                     builder.expression(parseExpression("expression", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -911,6 +936,7 @@ private ActivityDefinition.DynamicValue parseActivityDefinitionDynamicValue(java
     private ActivityDefinition.Participant parseActivityDefinitionParticipant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ActivityDefinition.Participant.Builder builder = ActivityDefinition.Participant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -941,7 +967,11 @@ private ActivityDefinition.Participant parseActivityDefinitionParticipant(java.l
                     builder.role(parseCodeableConcept("role", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -958,6 +988,7 @@ private ActivityDefinition.Participant parseActivityDefinitionParticipant(java.l
     private Address parseAddress(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Address.Builder builder = Address.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -1016,7 +1047,11 @@ private Address parseAddress(java.lang.String elementName, XMLStreamReader reade
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1033,6 +1068,7 @@ private Address parseAddress(java.lang.String elementName, XMLStreamReader reade
     private AdverseEvent parseAdverseEvent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AdverseEvent.Builder builder = AdverseEvent.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, categoryElementIndex = 0, resultingConditionElementIndex = 0, contributorElementIndex = 0, suspectEntityElementIndex = 0, subjectMedicalHistoryElementIndex = 0, referenceDocumentElementIndex = 0, studyElementIndex = 0;
         while (reader.hasNext()) {
@@ -1155,7 +1191,11 @@ private AdverseEvent parseAdverseEvent(java.lang.String elementName, XMLStreamRe
                     builder.study(parseReference("study", reader, studyElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1172,6 +1212,7 @@ private AdverseEvent parseAdverseEvent(java.lang.String elementName, XMLStreamRe
     private AdverseEvent.SuspectEntity parseAdverseEventSuspectEntity(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AdverseEvent.SuspectEntity.Builder builder = AdverseEvent.SuspectEntity.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -1202,7 +1243,11 @@ private AdverseEvent.SuspectEntity parseAdverseEventSuspectEntity(java.lang.Stri
                     builder.causality(parseAdverseEventSuspectEntityCausality("causality", reader, causalityElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1219,6 +1264,7 @@ private AdverseEvent.SuspectEntity parseAdverseEventSuspectEntity(java.lang.Stri
     private AdverseEvent.SuspectEntity.Causality parseAdverseEventSuspectEntityCausality(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AdverseEvent.SuspectEntity.Causality.Builder builder = AdverseEvent.SuspectEntity.Causality.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -1257,7 +1303,11 @@ private AdverseEvent.SuspectEntity.Causality parseAdverseEventSuspectEntityCausa
                     builder.method(parseCodeableConcept("method", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1274,6 +1324,7 @@ private AdverseEvent.SuspectEntity.Causality parseAdverseEventSuspectEntityCausa
     private AllergyIntolerance parseAllergyIntolerance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AllergyIntolerance.Builder builder = AllergyIntolerance.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0, noteElementIndex = 0, reactionElementIndex = 0;
         while (reader.hasNext()) {
@@ -1396,7 +1447,11 @@ private AllergyIntolerance parseAllergyIntolerance(java.lang.String elementName,
                     builder.reaction(parseAllergyIntoleranceReaction("reaction", reader, reactionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1413,6 +1468,7 @@ private AllergyIntolerance parseAllergyIntolerance(java.lang.String elementName,
     private AllergyIntolerance.Reaction parseAllergyIntoleranceReaction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AllergyIntolerance.Reaction.Builder builder = AllergyIntolerance.Reaction.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -1463,7 +1519,11 @@ private AllergyIntolerance.Reaction parseAllergyIntoleranceReaction(java.lang.St
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1480,6 +1540,7 @@ private AllergyIntolerance.Reaction parseAllergyIntoleranceReaction(java.lang.St
     private Annotation parseAnnotation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Annotation.Builder builder = Annotation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -1514,7 +1575,11 @@ private Annotation parseAnnotation(java.lang.String elementName, XMLStreamReader
                     builder.text((Markdown) parseString(Markdown.builder(), "text", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1531,6 +1596,7 @@ private Annotation parseAnnotation(java.lang.String elementName, XMLStreamReader
     private Appointment parseAppointment(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Appointment.Builder builder = Appointment.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, serviceCategoryElementIndex = 0, serviceTypeElementIndex = 0, specialtyElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, supportingInformationElementIndex = 0, slotElementIndex = 0, basedOnElementIndex = 0, participantElementIndex = 0, requestedPeriodElementIndex = 0;
         while (reader.hasNext()) {
@@ -1661,7 +1727,11 @@ private Appointment parseAppointment(java.lang.String elementName, XMLStreamRead
                     builder.requestedPeriod(parsePeriod("requestedPeriod", reader, requestedPeriodElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1678,6 +1748,7 @@ private Appointment parseAppointment(java.lang.String elementName, XMLStreamRead
     private Appointment.Participant parseAppointmentParticipant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Appointment.Participant.Builder builder = Appointment.Participant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -1720,7 +1791,11 @@ private Appointment.Participant parseAppointmentParticipant(java.lang.String ele
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1737,6 +1812,7 @@ private Appointment.Participant parseAppointmentParticipant(java.lang.String ele
     private AppointmentResponse parseAppointmentResponse(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AppointmentResponse.Builder builder = AppointmentResponse.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, participantTypeElementIndex = 0;
         while (reader.hasNext()) {
@@ -1811,7 +1887,11 @@ private AppointmentResponse parseAppointmentResponse(java.lang.String elementNam
                     builder.comment(parseString("comment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1828,6 +1908,7 @@ private AppointmentResponse parseAppointmentResponse(java.lang.String elementNam
     private Attachment parseAttachment(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Attachment.Builder builder = Attachment.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -1878,7 +1959,11 @@ private Attachment parseAttachment(java.lang.String elementName, XMLStreamReader
                     builder.creation(parseDateTime("creation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1895,6 +1980,7 @@ private Attachment parseAttachment(java.lang.String elementName, XMLStreamReader
     private AuditEvent parseAuditEvent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AuditEvent.Builder builder = AuditEvent.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, subtypeElementIndex = 0, purposeOfEventElementIndex = 0, agentElementIndex = 0, entityElementIndex = 0;
         while (reader.hasNext()) {
@@ -1981,7 +2067,11 @@ private AuditEvent parseAuditEvent(java.lang.String elementName, XMLStreamReader
                     builder.entity(parseAuditEventEntity("entity", reader, entityElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -1998,6 +2088,7 @@ private AuditEvent parseAuditEvent(java.lang.String elementName, XMLStreamReader
     private AuditEvent.Agent parseAuditEventAgent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AuditEvent.Agent.Builder builder = AuditEvent.Agent.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2064,7 +2155,11 @@ private AuditEvent.Agent parseAuditEventAgent(java.lang.String elementName, XMLS
                     builder.purposeOfUse(parseCodeableConcept("purposeOfUse", reader, purposeOfUseElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2081,6 +2176,7 @@ private AuditEvent.Agent parseAuditEventAgent(java.lang.String elementName, XMLS
     private AuditEvent.Agent.Network parseAuditEventAgentNetwork(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AuditEvent.Agent.Network.Builder builder = AuditEvent.Agent.Network.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2111,7 +2207,11 @@ private AuditEvent.Agent.Network parseAuditEventAgentNetwork(java.lang.String el
                     builder.type((AuditEventAgentNetworkType) parseString(AuditEventAgentNetworkType.builder(), "type", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2128,6 +2228,7 @@ private AuditEvent.Agent.Network parseAuditEventAgentNetwork(java.lang.String el
     private AuditEvent.Entity parseAuditEventEntity(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AuditEvent.Entity.Builder builder = AuditEvent.Entity.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2186,7 +2287,11 @@ private AuditEvent.Entity parseAuditEventEntity(java.lang.String elementName, XM
                     builder.detail(parseAuditEventEntityDetail("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2203,6 +2308,7 @@ private AuditEvent.Entity parseAuditEventEntity(java.lang.String elementName, XM
     private AuditEvent.Entity.Detail parseAuditEventEntityDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AuditEvent.Entity.Detail.Builder builder = AuditEvent.Entity.Detail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2237,7 +2343,11 @@ private AuditEvent.Entity.Detail parseAuditEventEntityDetail(java.lang.String el
                     builder.value(parseBase64Binary("valueBase64Binary", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2254,6 +2364,7 @@ private AuditEvent.Entity.Detail parseAuditEventEntityDetail(java.lang.String el
     private AuditEvent.Source parseAuditEventSource(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         AuditEvent.Source.Builder builder = AuditEvent.Source.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2288,7 +2399,11 @@ private AuditEvent.Source parseAuditEventSource(java.lang.String elementName, XM
                     builder.type(parseCoding("type", reader, typeElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2305,6 +2420,7 @@ private AuditEvent.Source parseAuditEventSource(java.lang.String elementName, XM
     private Base64Binary parseBase64Binary(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Base64Binary.Builder builder = Base64Binary.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2327,7 +2443,11 @@ private Base64Binary parseBase64Binary(java.lang.String elementName, XMLStreamRe
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2344,6 +2464,7 @@ private Base64Binary parseBase64Binary(java.lang.String elementName, XMLStreamRe
     private Basic parseBasic(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Basic.Builder builder = Basic.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0;
         while (reader.hasNext()) {
@@ -2406,7 +2527,11 @@ private Basic parseBasic(java.lang.String elementName, XMLStreamReader reader, i
                     builder.author(parseReference("author", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2423,6 +2548,7 @@ private Basic parseBasic(java.lang.String elementName, XMLStreamReader reader, i
     private Binary parseBinary(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Binary.Builder builder = Binary.builder();
+        builder.setValidating(validating);
         int position = -1;
         while (reader.hasNext()) {
             int eventType = reader.next();
@@ -2460,7 +2586,11 @@ private Binary parseBinary(java.lang.String elementName, XMLStreamReader reader,
                     builder.data(parseBase64Binary("data", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2477,6 +2607,7 @@ private Binary parseBinary(java.lang.String elementName, XMLStreamReader reader,
     private BiologicallyDerivedProduct parseBiologicallyDerivedProduct(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         BiologicallyDerivedProduct.Builder builder = BiologicallyDerivedProduct.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, requestElementIndex = 0, parentElementIndex = 0, processingElementIndex = 0, storageElementIndex = 0;
         while (reader.hasNext()) {
@@ -2563,7 +2694,11 @@ private BiologicallyDerivedProduct parseBiologicallyDerivedProduct(java.lang.Str
                     builder.storage(parseBiologicallyDerivedProductStorage("storage", reader, storageElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2580,6 +2715,7 @@ private BiologicallyDerivedProduct parseBiologicallyDerivedProduct(java.lang.Str
     private BiologicallyDerivedProduct.Collection parseBiologicallyDerivedProductCollection(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         BiologicallyDerivedProduct.Collection.Builder builder = BiologicallyDerivedProduct.Collection.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2618,7 +2754,11 @@ private BiologicallyDerivedProduct.Collection parseBiologicallyDerivedProductCol
                     builder.collected(parsePeriod("collectedPeriod", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2635,6 +2775,7 @@ private BiologicallyDerivedProduct.Collection parseBiologicallyDerivedProductCol
     private BiologicallyDerivedProduct.Manipulation parseBiologicallyDerivedProductManipulation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         BiologicallyDerivedProduct.Manipulation.Builder builder = BiologicallyDerivedProduct.Manipulation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2669,7 +2810,11 @@ private BiologicallyDerivedProduct.Manipulation parseBiologicallyDerivedProductM
                     builder.time(parsePeriod("timePeriod", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2686,6 +2831,7 @@ private BiologicallyDerivedProduct.Manipulation parseBiologicallyDerivedProductM
     private BiologicallyDerivedProduct.Processing parseBiologicallyDerivedProductProcessing(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         BiologicallyDerivedProduct.Processing.Builder builder = BiologicallyDerivedProduct.Processing.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2728,7 +2874,11 @@ private BiologicallyDerivedProduct.Processing parseBiologicallyDerivedProductPro
                     builder.time(parsePeriod("timePeriod", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2745,6 +2895,7 @@ private BiologicallyDerivedProduct.Processing parseBiologicallyDerivedProductPro
     private BiologicallyDerivedProduct.Storage parseBiologicallyDerivedProductStorage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         BiologicallyDerivedProduct.Storage.Builder builder = BiologicallyDerivedProduct.Storage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2783,7 +2934,11 @@ private BiologicallyDerivedProduct.Storage parseBiologicallyDerivedProductStorag
                     builder.duration(parsePeriod("duration", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2800,6 +2955,7 @@ private BiologicallyDerivedProduct.Storage parseBiologicallyDerivedProductStorag
     private BodyStructure parseBodyStructure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         BodyStructure.Builder builder = BodyStructure.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, locationQualifierElementIndex = 0, imageElementIndex = 0;
         while (reader.hasNext()) {
@@ -2874,7 +3030,11 @@ private BodyStructure parseBodyStructure(java.lang.String elementName, XMLStream
                     builder.patient(parseReference("patient", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2891,6 +3051,7 @@ private BodyStructure parseBodyStructure(java.lang.String elementName, XMLStream
     private Boolean parseBoolean(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Boolean.Builder builder = Boolean.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -2913,7 +3074,11 @@ private Boolean parseBoolean(java.lang.String elementName, XMLStreamReader reade
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -2930,6 +3095,7 @@ private Boolean parseBoolean(java.lang.String elementName, XMLStreamReader reade
     private Bundle parseBundle(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Bundle.Builder builder = Bundle.builder();
+        builder.setValidating(validating);
         int position = -1;
         int linkElementIndex = 0, entryElementIndex = 0;
         while (reader.hasNext()) {
@@ -2984,7 +3150,11 @@ private Bundle parseBundle(java.lang.String elementName, XMLStreamReader reader,
                     builder.signature(parseSignature("signature", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3001,6 +3171,7 @@ private Bundle parseBundle(java.lang.String elementName, XMLStreamReader reader,
     private Bundle.Entry parseBundleEntry(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Bundle.Entry.Builder builder = Bundle.Entry.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3047,7 +3218,11 @@ private Bundle.Entry parseBundleEntry(java.lang.String elementName, XMLStreamRea
                     builder.response(parseBundleEntryResponse("response", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3064,6 +3239,7 @@ private Bundle.Entry parseBundleEntry(java.lang.String elementName, XMLStreamRea
     private Bundle.Entry.Request parseBundleEntryRequest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Bundle.Entry.Request.Builder builder = Bundle.Entry.Request.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3110,7 +3286,11 @@ private Bundle.Entry.Request parseBundleEntryRequest(java.lang.String elementNam
                     builder.ifNoneExist(parseString("ifNoneExist", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3127,6 +3307,7 @@ private Bundle.Entry.Request parseBundleEntryRequest(java.lang.String elementNam
     private Bundle.Entry.Response parseBundleEntryResponse(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Bundle.Entry.Response.Builder builder = Bundle.Entry.Response.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3169,7 +3350,11 @@ private Bundle.Entry.Response parseBundleEntryResponse(java.lang.String elementN
                     builder.outcome(parseResource("outcome", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3186,6 +3371,7 @@ private Bundle.Entry.Response parseBundleEntryResponse(java.lang.String elementN
     private Bundle.Entry.Search parseBundleEntrySearch(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Bundle.Entry.Search.Builder builder = Bundle.Entry.Search.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3216,7 +3402,11 @@ private Bundle.Entry.Search parseBundleEntrySearch(java.lang.String elementName,
                     builder.score(parseDecimal("score", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3233,6 +3423,7 @@ private Bundle.Entry.Search parseBundleEntrySearch(java.lang.String elementName,
     private Bundle.Link parseBundleLink(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Bundle.Link.Builder builder = Bundle.Link.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3263,7 +3454,11 @@ private Bundle.Link parseBundleLink(java.lang.String elementName, XMLStreamReade
                     builder.url(parseUri("url", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3280,6 +3475,7 @@ private Bundle.Link parseBundleLink(java.lang.String elementName, XMLStreamReade
     private CapabilityStatement parseCapabilityStatement(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Builder builder = CapabilityStatement.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, instantiatesElementIndex = 0, importsElementIndex = 0, formatElementIndex = 0, patchFormatElementIndex = 0, implementationGuideElementIndex = 0, restElementIndex = 0, messagingElementIndex = 0, documentElementIndex = 0;
         while (reader.hasNext()) {
@@ -3426,7 +3622,11 @@ private CapabilityStatement parseCapabilityStatement(java.lang.String elementNam
                     builder.document(parseCapabilityStatementDocument("document", reader, documentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3443,6 +3643,7 @@ private CapabilityStatement parseCapabilityStatement(java.lang.String elementNam
     private CapabilityStatement.Document parseCapabilityStatementDocument(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Document.Builder builder = CapabilityStatement.Document.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3477,7 +3678,11 @@ private CapabilityStatement.Document parseCapabilityStatementDocument(java.lang.
                     builder.profile((Canonical) parseUri(Canonical.builder(), "profile", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3494,6 +3699,7 @@ private CapabilityStatement.Document parseCapabilityStatementDocument(java.lang.
     private CapabilityStatement.Implementation parseCapabilityStatementImplementation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Implementation.Builder builder = CapabilityStatement.Implementation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3528,7 +3734,11 @@ private CapabilityStatement.Implementation parseCapabilityStatementImplementatio
                     builder.custodian(parseReference("custodian", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3545,6 +3755,7 @@ private CapabilityStatement.Implementation parseCapabilityStatementImplementatio
     private CapabilityStatement.Messaging parseCapabilityStatementMessaging(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Messaging.Builder builder = CapabilityStatement.Messaging.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3583,7 +3794,11 @@ private CapabilityStatement.Messaging parseCapabilityStatementMessaging(java.lan
                     builder.supportedMessage(parseCapabilityStatementMessagingSupportedMessage("supportedMessage", reader, supportedMessageElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3600,6 +3815,7 @@ private CapabilityStatement.Messaging parseCapabilityStatementMessaging(java.lan
     private CapabilityStatement.Messaging.Endpoint parseCapabilityStatementMessagingEndpoint(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Messaging.Endpoint.Builder builder = CapabilityStatement.Messaging.Endpoint.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3630,7 +3846,11 @@ private CapabilityStatement.Messaging.Endpoint parseCapabilityStatementMessaging
                     builder.address((Url) parseUri(Url.builder(), "address", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3647,6 +3867,7 @@ private CapabilityStatement.Messaging.Endpoint parseCapabilityStatementMessaging
     private CapabilityStatement.Messaging.SupportedMessage parseCapabilityStatementMessagingSupportedMessage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Messaging.SupportedMessage.Builder builder = CapabilityStatement.Messaging.SupportedMessage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3677,7 +3898,11 @@ private CapabilityStatement.Messaging.SupportedMessage parseCapabilityStatementM
                     builder.definition((Canonical) parseUri(Canonical.builder(), "definition", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3694,6 +3919,7 @@ private CapabilityStatement.Messaging.SupportedMessage parseCapabilityStatementM
     private CapabilityStatement.Rest parseCapabilityStatementRest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Rest.Builder builder = CapabilityStatement.Rest.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3748,7 +3974,11 @@ private CapabilityStatement.Rest parseCapabilityStatementRest(java.lang.String e
                     builder.compartment((Canonical) parseUri(Canonical.builder(), "compartment", reader, compartmentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3765,6 +3995,7 @@ private CapabilityStatement.Rest parseCapabilityStatementRest(java.lang.String e
     private CapabilityStatement.Rest.Interaction parseCapabilityStatementRestInteraction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Rest.Interaction.Builder builder = CapabilityStatement.Rest.Interaction.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3795,7 +4026,11 @@ private CapabilityStatement.Rest.Interaction parseCapabilityStatementRestInterac
                     builder.documentation((Markdown) parseString(Markdown.builder(), "documentation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3812,6 +4047,7 @@ private CapabilityStatement.Rest.Interaction parseCapabilityStatementRestInterac
     private CapabilityStatement.Rest.Resource parseCapabilityStatementRestResource(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Rest.Resource.Builder builder = CapabilityStatement.Rest.Resource.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3902,7 +4138,11 @@ private CapabilityStatement.Rest.Resource parseCapabilityStatementRestResource(j
                     builder.operation(parseCapabilityStatementRestResourceOperation("operation", reader, operationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3919,6 +4159,7 @@ private CapabilityStatement.Rest.Resource parseCapabilityStatementRestResource(j
     private CapabilityStatement.Rest.Resource.Interaction parseCapabilityStatementRestResourceInteraction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Rest.Resource.Interaction.Builder builder = CapabilityStatement.Rest.Resource.Interaction.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -3949,7 +4190,11 @@ private CapabilityStatement.Rest.Resource.Interaction parseCapabilityStatementRe
                     builder.documentation((Markdown) parseString(Markdown.builder(), "documentation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -3966,6 +4211,7 @@ private CapabilityStatement.Rest.Resource.Interaction parseCapabilityStatementRe
     private CapabilityStatement.Rest.Resource.Operation parseCapabilityStatementRestResourceOperation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Rest.Resource.Operation.Builder builder = CapabilityStatement.Rest.Resource.Operation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -4000,7 +4246,11 @@ private CapabilityStatement.Rest.Resource.Operation parseCapabilityStatementRest
                     builder.documentation((Markdown) parseString(Markdown.builder(), "documentation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4017,6 +4267,7 @@ private CapabilityStatement.Rest.Resource.Operation parseCapabilityStatementRest
     private CapabilityStatement.Rest.Resource.SearchParam parseCapabilityStatementRestResourceSearchParam(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Rest.Resource.SearchParam.Builder builder = CapabilityStatement.Rest.Resource.SearchParam.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -4055,7 +4306,11 @@ private CapabilityStatement.Rest.Resource.SearchParam parseCapabilityStatementRe
                     builder.documentation((Markdown) parseString(Markdown.builder(), "documentation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4072,6 +4327,7 @@ private CapabilityStatement.Rest.Resource.SearchParam parseCapabilityStatementRe
     private CapabilityStatement.Rest.Security parseCapabilityStatementRestSecurity(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Rest.Security.Builder builder = CapabilityStatement.Rest.Security.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -4106,7 +4362,11 @@ private CapabilityStatement.Rest.Security parseCapabilityStatementRestSecurity(j
                     builder.description((Markdown) parseString(Markdown.builder(), "description", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4123,6 +4383,7 @@ private CapabilityStatement.Rest.Security parseCapabilityStatementRestSecurity(j
     private CapabilityStatement.Software parseCapabilityStatementSoftware(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CapabilityStatement.Software.Builder builder = CapabilityStatement.Software.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -4157,7 +4418,11 @@ private CapabilityStatement.Software parseCapabilityStatementSoftware(java.lang.
                     builder.releaseDate(parseDateTime("releaseDate", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4174,6 +4439,7 @@ private CapabilityStatement.Software parseCapabilityStatementSoftware(java.lang.
     private CarePlan parseCarePlan(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CarePlan.Builder builder = CarePlan.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, instantiatesCanonicalElementIndex = 0, instantiatesUriElementIndex = 0, basedOnElementIndex = 0, replacesElementIndex = 0, partOfElementIndex = 0, categoryElementIndex = 0, contributorElementIndex = 0, careTeamElementIndex = 0, addressesElementIndex = 0, supportingInfoElementIndex = 0, goalElementIndex = 0, activityElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -4308,7 +4574,11 @@ private CarePlan parseCarePlan(java.lang.String elementName, XMLStreamReader rea
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4325,6 +4595,7 @@ private CarePlan parseCarePlan(java.lang.String elementName, XMLStreamReader rea
     private CarePlan.Activity parseCarePlanActivity(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CarePlan.Activity.Builder builder = CarePlan.Activity.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -4367,7 +4638,11 @@ private CarePlan.Activity parseCarePlanActivity(java.lang.String elementName, XM
                     builder.detail(parseCarePlanActivityDetail("detail", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4384,6 +4659,7 @@ private CarePlan.Activity parseCarePlanActivity(java.lang.String elementName, XM
     private CarePlan.Activity.Detail parseCarePlanActivityDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CarePlan.Activity.Detail.Builder builder = CarePlan.Activity.Detail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -4486,7 +4762,11 @@ private CarePlan.Activity.Detail parseCarePlanActivityDetail(java.lang.String el
                     builder.description(parseString("description", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4503,6 +4783,7 @@ private CarePlan.Activity.Detail parseCarePlanActivityDetail(java.lang.String el
     private CareTeam parseCareTeam(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CareTeam.Builder builder = CareTeam.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0, participantElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, managingOrganizationElementIndex = 0, telecomElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -4597,7 +4878,11 @@ private CareTeam parseCareTeam(java.lang.String elementName, XMLStreamReader rea
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4614,6 +4899,7 @@ private CareTeam parseCareTeam(java.lang.String elementName, XMLStreamReader rea
     private CareTeam.Participant parseCareTeamParticipant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CareTeam.Participant.Builder builder = CareTeam.Participant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -4652,7 +4938,11 @@ private CareTeam.Participant parseCareTeamParticipant(java.lang.String elementNa
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4669,6 +4959,7 @@ private CareTeam.Participant parseCareTeamParticipant(java.lang.String elementNa
     private CatalogEntry parseCatalogEntry(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CatalogEntry.Builder builder = CatalogEntry.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, additionalIdentifierElementIndex = 0, classificationElementIndex = 0, additionalCharacteristicElementIndex = 0, additionalClassificationElementIndex = 0, relatedEntryElementIndex = 0;
         while (reader.hasNext()) {
@@ -4763,7 +5054,11 @@ private CatalogEntry parseCatalogEntry(java.lang.String elementName, XMLStreamRe
                     builder.relatedEntry(parseCatalogEntryRelatedEntry("relatedEntry", reader, relatedEntryElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4780,6 +5075,7 @@ private CatalogEntry parseCatalogEntry(java.lang.String elementName, XMLStreamRe
     private CatalogEntry.RelatedEntry parseCatalogEntryRelatedEntry(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CatalogEntry.RelatedEntry.Builder builder = CatalogEntry.RelatedEntry.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -4810,7 +5106,11 @@ private CatalogEntry.RelatedEntry parseCatalogEntryRelatedEntry(java.lang.String
                     builder.item(parseReference("item", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -4827,6 +5127,7 @@ private CatalogEntry.RelatedEntry parseCatalogEntryRelatedEntry(java.lang.String
     private ChargeItem parseChargeItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ChargeItem.Builder builder = ChargeItem.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, definitionUriElementIndex = 0, definitionCanonicalElementIndex = 0, partOfElementIndex = 0, performerElementIndex = 0, bodysiteElementIndex = 0, reasonElementIndex = 0, serviceElementIndex = 0, accountElementIndex = 0, noteElementIndex = 0, supportingInformationElementIndex = 0;
         while (reader.hasNext()) {
@@ -4985,7 +5286,11 @@ private ChargeItem parseChargeItem(java.lang.String elementName, XMLStreamReader
                     builder.supportingInformation(parseReference("supportingInformation", reader, supportingInformationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5002,6 +5307,7 @@ private ChargeItem parseChargeItem(java.lang.String elementName, XMLStreamReader
     private ChargeItem.Performer parseChargeItemPerformer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ChargeItem.Performer.Builder builder = ChargeItem.Performer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5032,7 +5338,11 @@ private ChargeItem.Performer parseChargeItemPerformer(java.lang.String elementNa
                     builder.actor(parseReference("actor", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5049,6 +5359,7 @@ private ChargeItem.Performer parseChargeItemPerformer(java.lang.String elementNa
     private ChargeItemDefinition parseChargeItemDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ChargeItemDefinition.Builder builder = ChargeItemDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, derivedFromUriElementIndex = 0, partOfElementIndex = 0, replacesElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, instanceElementIndex = 0, applicabilityElementIndex = 0, propertyGroupElementIndex = 0;
         while (reader.hasNext()) {
@@ -5183,7 +5494,11 @@ private ChargeItemDefinition parseChargeItemDefinition(java.lang.String elementN
                     builder.propertyGroup(parseChargeItemDefinitionPropertyGroup("propertyGroup", reader, propertyGroupElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5200,6 +5515,7 @@ private ChargeItemDefinition parseChargeItemDefinition(java.lang.String elementN
     private ChargeItemDefinition.Applicability parseChargeItemDefinitionApplicability(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ChargeItemDefinition.Applicability.Builder builder = ChargeItemDefinition.Applicability.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5234,7 +5550,11 @@ private ChargeItemDefinition.Applicability parseChargeItemDefinitionApplicabilit
                     builder.expression(parseString("expression", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5251,6 +5571,7 @@ private ChargeItemDefinition.Applicability parseChargeItemDefinitionApplicabilit
     private ChargeItemDefinition.PropertyGroup parseChargeItemDefinitionPropertyGroup(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ChargeItemDefinition.PropertyGroup.Builder builder = ChargeItemDefinition.PropertyGroup.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5281,7 +5602,11 @@ private ChargeItemDefinition.PropertyGroup parseChargeItemDefinitionPropertyGrou
                     builder.priceComponent(parseChargeItemDefinitionPropertyGroupPriceComponent("priceComponent", reader, priceComponentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5298,6 +5623,7 @@ private ChargeItemDefinition.PropertyGroup parseChargeItemDefinitionPropertyGrou
     private ChargeItemDefinition.PropertyGroup.PriceComponent parseChargeItemDefinitionPropertyGroupPriceComponent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ChargeItemDefinition.PropertyGroup.PriceComponent.Builder builder = ChargeItemDefinition.PropertyGroup.PriceComponent.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5336,7 +5662,11 @@ private ChargeItemDefinition.PropertyGroup.PriceComponent parseChargeItemDefinit
                     builder.amount(parseMoney("amount", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5353,6 +5683,7 @@ private ChargeItemDefinition.PropertyGroup.PriceComponent parseChargeItemDefinit
     private Claim parseClaim(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Builder builder = Claim.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, relatedElementIndex = 0, careTeamElementIndex = 0, supportingInfoElementIndex = 0, diagnosisElementIndex = 0, procedureElementIndex = 0, insuranceElementIndex = 0, itemElementIndex = 0;
         while (reader.hasNext()) {
@@ -5503,7 +5834,11 @@ private Claim parseClaim(java.lang.String elementName, XMLStreamReader reader, i
                     builder.total(parseMoney("total", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5520,6 +5855,7 @@ private Claim parseClaim(java.lang.String elementName, XMLStreamReader reader, i
     private Claim.Accident parseClaimAccident(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Accident.Builder builder = Claim.Accident.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5558,7 +5894,11 @@ private Claim.Accident parseClaimAccident(java.lang.String elementName, XMLStrea
                     builder.location(parseReference("locationReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5575,6 +5915,7 @@ private Claim.Accident parseClaimAccident(java.lang.String elementName, XMLStrea
     private Claim.CareTeam parseClaimCareTeam(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.CareTeam.Builder builder = Claim.CareTeam.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5617,7 +5958,11 @@ private Claim.CareTeam parseClaimCareTeam(java.lang.String elementName, XMLStrea
                     builder.qualification(parseCodeableConcept("qualification", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5634,6 +5979,7 @@ private Claim.CareTeam parseClaimCareTeam(java.lang.String elementName, XMLStrea
     private Claim.Diagnosis parseClaimDiagnosis(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Diagnosis.Builder builder = Claim.Diagnosis.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5680,7 +6026,11 @@ private Claim.Diagnosis parseClaimDiagnosis(java.lang.String elementName, XMLStr
                     builder.packageCode(parseCodeableConcept("packageCode", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5697,6 +6047,7 @@ private Claim.Diagnosis parseClaimDiagnosis(java.lang.String elementName, XMLStr
     private Claim.Insurance parseClaimInsurance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Insurance.Builder builder = Claim.Insurance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5747,7 +6098,11 @@ private Claim.Insurance parseClaimInsurance(java.lang.String elementName, XMLStr
                     builder.claimResponse(parseReference("claimResponse", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5764,6 +6119,7 @@ private Claim.Insurance parseClaimInsurance(java.lang.String elementName, XMLStr
     private Claim.Item parseClaimItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Item.Builder builder = Claim.Item.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5882,7 +6238,11 @@ private Claim.Item parseClaimItem(java.lang.String elementName, XMLStreamReader
                     builder.detail(parseClaimItemDetail("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5899,6 +6259,7 @@ private Claim.Item parseClaimItem(java.lang.String elementName, XMLStreamReader
     private Claim.Item.Detail parseClaimItemDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Item.Detail.Builder builder = Claim.Item.Detail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -5969,7 +6330,11 @@ private Claim.Item.Detail parseClaimItemDetail(java.lang.String elementName, XML
                     builder.subDetail(parseClaimItemDetailSubDetail("subDetail", reader, subDetailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -5986,6 +6351,7 @@ private Claim.Item.Detail parseClaimItemDetail(java.lang.String elementName, XML
     private Claim.Item.Detail.SubDetail parseClaimItemDetailSubDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Item.Detail.SubDetail.Builder builder = Claim.Item.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6052,7 +6418,11 @@ private Claim.Item.Detail.SubDetail parseClaimItemDetailSubDetail(java.lang.Stri
                     builder.udi(parseReference("udi", reader, udiElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6069,6 +6439,7 @@ private Claim.Item.Detail.SubDetail parseClaimItemDetailSubDetail(java.lang.Stri
     private Claim.Payee parseClaimPayee(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Payee.Builder builder = Claim.Payee.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6099,7 +6470,11 @@ private Claim.Payee parseClaimPayee(java.lang.String elementName, XMLStreamReade
                     builder.party(parseReference("party", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6116,6 +6491,7 @@ private Claim.Payee parseClaimPayee(java.lang.String elementName, XMLStreamReade
     private Claim.Procedure parseClaimProcedure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Procedure.Builder builder = Claim.Procedure.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6162,7 +6538,11 @@ private Claim.Procedure parseClaimProcedure(java.lang.String elementName, XMLStr
                     builder.udi(parseReference("udi", reader, udiElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6179,6 +6559,7 @@ private Claim.Procedure parseClaimProcedure(java.lang.String elementName, XMLStr
     private Claim.Related parseClaimRelated(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.Related.Builder builder = Claim.Related.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6213,7 +6594,11 @@ private Claim.Related parseClaimRelated(java.lang.String elementName, XMLStreamR
                     builder.reference(parseIdentifier("reference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6230,6 +6615,7 @@ private Claim.Related parseClaimRelated(java.lang.String elementName, XMLStreamR
     private Claim.SupportingInfo parseClaimSupportingInfo(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Claim.SupportingInfo.Builder builder = Claim.SupportingInfo.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6296,7 +6682,11 @@ private Claim.SupportingInfo parseClaimSupportingInfo(java.lang.String elementNa
                     builder.reason(parseCodeableConcept("reason", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6313,6 +6703,7 @@ private Claim.SupportingInfo parseClaimSupportingInfo(java.lang.String elementNa
     private ClaimResponse parseClaimResponse(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.Builder builder = ClaimResponse.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, itemElementIndex = 0, addItemElementIndex = 0, adjudicationElementIndex = 0, totalElementIndex = 0, processNoteElementIndex = 0, communicationRequestElementIndex = 0, insuranceElementIndex = 0, errorElementIndex = 0;
         while (reader.hasNext()) {
@@ -6463,7 +6854,11 @@ private ClaimResponse parseClaimResponse(java.lang.String elementName, XMLStream
                     builder.error(parseClaimResponseError("error", reader, errorElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6480,6 +6875,7 @@ private ClaimResponse parseClaimResponse(java.lang.String elementName, XMLStream
     private ClaimResponse.AddItem parseClaimResponseAddItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.AddItem.Builder builder = ClaimResponse.AddItem.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6586,7 +6982,11 @@ private ClaimResponse.AddItem parseClaimResponseAddItem(java.lang.String element
                     builder.detail(parseClaimResponseAddItemDetail("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6603,6 +7003,7 @@ private ClaimResponse.AddItem parseClaimResponseAddItem(java.lang.String element
     private ClaimResponse.AddItem.Detail parseClaimResponseAddItemDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.AddItem.Detail.Builder builder = ClaimResponse.AddItem.Detail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6661,7 +7062,11 @@ private ClaimResponse.AddItem.Detail parseClaimResponseAddItemDetail(java.lang.S
                     builder.subDetail(parseClaimResponseAddItemDetailSubDetail("subDetail", reader, subDetailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6678,6 +7083,7 @@ private ClaimResponse.AddItem.Detail parseClaimResponseAddItemDetail(java.lang.S
     private ClaimResponse.AddItem.Detail.SubDetail parseClaimResponseAddItemDetailSubDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.AddItem.Detail.SubDetail.Builder builder = ClaimResponse.AddItem.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6732,7 +7138,11 @@ private ClaimResponse.AddItem.Detail.SubDetail parseClaimResponseAddItemDetailSu
                     builder.adjudication(parseClaimResponseItemAdjudication("adjudication", reader, adjudicationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6749,6 +7159,7 @@ private ClaimResponse.AddItem.Detail.SubDetail parseClaimResponseAddItemDetailSu
     private ClaimResponse.Error parseClaimResponseError(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.Error.Builder builder = ClaimResponse.Error.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6787,7 +7198,11 @@ private ClaimResponse.Error parseClaimResponseError(java.lang.String elementName
                     builder.code(parseCodeableConcept("code", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6804,6 +7219,7 @@ private ClaimResponse.Error parseClaimResponseError(java.lang.String elementName
     private ClaimResponse.Insurance parseClaimResponseInsurance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.Insurance.Builder builder = ClaimResponse.Insurance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6846,7 +7262,11 @@ private ClaimResponse.Insurance parseClaimResponseInsurance(java.lang.String ele
                     builder.claimResponse(parseReference("claimResponse", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6863,6 +7283,7 @@ private ClaimResponse.Insurance parseClaimResponseInsurance(java.lang.String ele
     private ClaimResponse.Item parseClaimResponseItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.Item.Builder builder = ClaimResponse.Item.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6901,7 +7322,11 @@ private ClaimResponse.Item parseClaimResponseItem(java.lang.String elementName,
                     builder.detail(parseClaimResponseItemDetail("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6918,6 +7343,7 @@ private ClaimResponse.Item parseClaimResponseItem(java.lang.String elementName,
     private ClaimResponse.Item.Adjudication parseClaimResponseItemAdjudication(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.Item.Adjudication.Builder builder = ClaimResponse.Item.Adjudication.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -6956,7 +7382,11 @@ private ClaimResponse.Item.Adjudication parseClaimResponseItemAdjudication(java.
                     builder.value(parseDecimal("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -6973,6 +7403,7 @@ private ClaimResponse.Item.Adjudication parseClaimResponseItemAdjudication(java.
     private ClaimResponse.Item.Detail parseClaimResponseItemDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.Item.Detail.Builder builder = ClaimResponse.Item.Detail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7011,7 +7442,11 @@ private ClaimResponse.Item.Detail parseClaimResponseItemDetail(java.lang.String
                     builder.subDetail(parseClaimResponseItemDetailSubDetail("subDetail", reader, subDetailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7028,6 +7463,7 @@ private ClaimResponse.Item.Detail parseClaimResponseItemDetail(java.lang.String
     private ClaimResponse.Item.Detail.SubDetail parseClaimResponseItemDetailSubDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.Item.Detail.SubDetail.Builder builder = ClaimResponse.Item.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7062,7 +7498,11 @@ private ClaimResponse.Item.Detail.SubDetail parseClaimResponseItemDetailSubDetai
                     builder.adjudication(parseClaimResponseItemAdjudication("adjudication", reader, adjudicationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7079,6 +7519,7 @@ private ClaimResponse.Item.Detail.SubDetail parseClaimResponseItemDetailSubDetai
     private ClaimResponse.Payment parseClaimResponsePayment(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.Payment.Builder builder = ClaimResponse.Payment.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7125,7 +7566,11 @@ private ClaimResponse.Payment parseClaimResponsePayment(java.lang.String element
                     builder.identifier(parseIdentifier("identifier", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7142,6 +7587,7 @@ private ClaimResponse.Payment parseClaimResponsePayment(java.lang.String element
     private ClaimResponse.ProcessNote parseClaimResponseProcessNote(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.ProcessNote.Builder builder = ClaimResponse.ProcessNote.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7180,7 +7626,11 @@ private ClaimResponse.ProcessNote parseClaimResponseProcessNote(java.lang.String
                     builder.language(parseCodeableConcept("language", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7197,6 +7647,7 @@ private ClaimResponse.ProcessNote parseClaimResponseProcessNote(java.lang.String
     private ClaimResponse.Total parseClaimResponseTotal(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClaimResponse.Total.Builder builder = ClaimResponse.Total.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7227,7 +7678,11 @@ private ClaimResponse.Total parseClaimResponseTotal(java.lang.String elementName
                     builder.amount(parseMoney("amount", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7244,6 +7699,7 @@ private ClaimResponse.Total parseClaimResponseTotal(java.lang.String elementName
     private ClinicalImpression parseClinicalImpression(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClinicalImpression.Builder builder = ClinicalImpression.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, problemElementIndex = 0, investigationElementIndex = 0, protocolElementIndex = 0, findingElementIndex = 0, prognosisCodeableConceptElementIndex = 0, prognosisReferenceElementIndex = 0, supportingInfoElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -7370,7 +7826,11 @@ private ClinicalImpression parseClinicalImpression(java.lang.String elementName,
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7387,6 +7847,7 @@ private ClinicalImpression parseClinicalImpression(java.lang.String elementName,
     private ClinicalImpression.Finding parseClinicalImpressionFinding(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClinicalImpression.Finding.Builder builder = ClinicalImpression.Finding.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7421,7 +7882,11 @@ private ClinicalImpression.Finding parseClinicalImpressionFinding(java.lang.Stri
                     builder.basis(parseString("basis", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7438,6 +7903,7 @@ private ClinicalImpression.Finding parseClinicalImpressionFinding(java.lang.Stri
     private ClinicalImpression.Investigation parseClinicalImpressionInvestigation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ClinicalImpression.Investigation.Builder builder = ClinicalImpression.Investigation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7468,7 +7934,11 @@ private ClinicalImpression.Investigation parseClinicalImpressionInvestigation(ja
                     builder.item(parseReference("item", reader, itemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7485,6 +7955,7 @@ private ClinicalImpression.Investigation parseClinicalImpressionInvestigation(ja
     private CodeSystem parseCodeSystem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CodeSystem.Builder builder = CodeSystem.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, filterElementIndex = 0, propertyElementIndex = 0, conceptElementIndex = 0;
         while (reader.hasNext()) {
@@ -7631,7 +8102,11 @@ private CodeSystem parseCodeSystem(java.lang.String elementName, XMLStreamReader
                     builder.concept(parseCodeSystemConcept("concept", reader, conceptElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7648,6 +8123,7 @@ private CodeSystem parseCodeSystem(java.lang.String elementName, XMLStreamReader
     private CodeSystem.Concept parseCodeSystemConcept(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CodeSystem.Concept.Builder builder = CodeSystem.Concept.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7694,7 +8170,11 @@ private CodeSystem.Concept parseCodeSystemConcept(java.lang.String elementName,
                     builder.concept(parseCodeSystemConcept("concept", reader, conceptElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7711,6 +8191,7 @@ private CodeSystem.Concept parseCodeSystemConcept(java.lang.String elementName,
     private CodeSystem.Concept.Designation parseCodeSystemConceptDesignation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CodeSystem.Concept.Designation.Builder builder = CodeSystem.Concept.Designation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7745,7 +8226,11 @@ private CodeSystem.Concept.Designation parseCodeSystemConceptDesignation(java.la
                     builder.value(parseString("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7762,6 +8247,7 @@ private CodeSystem.Concept.Designation parseCodeSystemConceptDesignation(java.la
     private CodeSystem.Concept.Property parseCodeSystemConceptProperty(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CodeSystem.Concept.Property.Builder builder = CodeSystem.Concept.Property.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7816,7 +8302,11 @@ private CodeSystem.Concept.Property parseCodeSystemConceptProperty(java.lang.Str
                     builder.value(parseDecimal("valueDecimal", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7833,6 +8323,7 @@ private CodeSystem.Concept.Property parseCodeSystemConceptProperty(java.lang.Str
     private CodeSystem.Filter parseCodeSystemFilter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CodeSystem.Filter.Builder builder = CodeSystem.Filter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7871,7 +8362,11 @@ private CodeSystem.Filter parseCodeSystemFilter(java.lang.String elementName, XM
                     builder.value(parseString("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7888,6 +8383,7 @@ private CodeSystem.Filter parseCodeSystemFilter(java.lang.String elementName, XM
     private CodeSystem.Property parseCodeSystemProperty(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CodeSystem.Property.Builder builder = CodeSystem.Property.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7926,7 +8422,11 @@ private CodeSystem.Property parseCodeSystemProperty(java.lang.String elementName
                     builder.type((PropertyType) parseString(PropertyType.builder(), "type", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7943,6 +8443,7 @@ private CodeSystem.Property parseCodeSystemProperty(java.lang.String elementName
     private CodeableConcept parseCodeableConcept(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CodeableConcept.Builder builder = CodeableConcept.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -7969,7 +8470,11 @@ private CodeableConcept parseCodeableConcept(java.lang.String elementName, XMLSt
                     builder.text(parseString("text", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -7986,6 +8491,7 @@ private CodeableConcept parseCodeableConcept(java.lang.String elementName, XMLSt
     private Coding parseCoding(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Coding.Builder builder = Coding.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -8024,7 +8530,11 @@ private Coding parseCoding(java.lang.String elementName, XMLStreamReader reader,
                     builder.userSelected(parseBoolean("userSelected", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8041,6 +8551,7 @@ private Coding parseCoding(java.lang.String elementName, XMLStreamReader reader,
     private Communication parseCommunication(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Communication.Builder builder = Communication.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, instantiatesCanonicalElementIndex = 0, instantiatesUriElementIndex = 0, basedOnElementIndex = 0, partOfElementIndex = 0, inResponseToElementIndex = 0, categoryElementIndex = 0, mediumElementIndex = 0, aboutElementIndex = 0, recipientElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, payloadElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -8175,7 +8686,11 @@ private Communication parseCommunication(java.lang.String elementName, XMLStream
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8192,6 +8707,7 @@ private Communication parseCommunication(java.lang.String elementName, XMLStream
     private Communication.Payload parseCommunicationPayload(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Communication.Payload.Builder builder = Communication.Payload.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -8226,7 +8742,11 @@ private Communication.Payload parseCommunicationPayload(java.lang.String element
                     builder.content(parseReference("contentReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8243,6 +8763,7 @@ private Communication.Payload parseCommunicationPayload(java.lang.String element
     private CommunicationRequest parseCommunicationRequest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CommunicationRequest.Builder builder = CommunicationRequest.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, basedOnElementIndex = 0, replacesElementIndex = 0, categoryElementIndex = 0, mediumElementIndex = 0, aboutElementIndex = 0, payloadElementIndex = 0, recipientElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -8377,7 +8898,11 @@ private CommunicationRequest parseCommunicationRequest(java.lang.String elementN
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8394,6 +8919,7 @@ private CommunicationRequest parseCommunicationRequest(java.lang.String elementN
     private CommunicationRequest.Payload parseCommunicationRequestPayload(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CommunicationRequest.Payload.Builder builder = CommunicationRequest.Payload.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -8428,7 +8954,11 @@ private CommunicationRequest.Payload parseCommunicationRequestPayload(java.lang.
                     builder.content(parseReference("contentReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8445,6 +8975,7 @@ private CommunicationRequest.Payload parseCommunicationRequestPayload(java.lang.
     private CompartmentDefinition parseCompartmentDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CompartmentDefinition.Builder builder = CompartmentDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, resourceElementIndex = 0;
         while (reader.hasNext()) {
@@ -8543,7 +9074,11 @@ private CompartmentDefinition parseCompartmentDefinition(java.lang.String elemen
                     builder.resource(parseCompartmentDefinitionResource("resource", reader, resourceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8560,6 +9095,7 @@ private CompartmentDefinition parseCompartmentDefinition(java.lang.String elemen
     private CompartmentDefinition.Resource parseCompartmentDefinitionResource(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CompartmentDefinition.Resource.Builder builder = CompartmentDefinition.Resource.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -8594,7 +9130,11 @@ private CompartmentDefinition.Resource parseCompartmentDefinitionResource(java.l
                     builder.documentation(parseString("documentation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8611,6 +9151,7 @@ private CompartmentDefinition.Resource parseCompartmentDefinitionResource(java.l
     private Composition parseComposition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Composition.Builder builder = Composition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, categoryElementIndex = 0, authorElementIndex = 0, attesterElementIndex = 0, relatesToElementIndex = 0, eventElementIndex = 0, sectionElementIndex = 0;
         while (reader.hasNext()) {
@@ -8713,7 +9254,11 @@ private Composition parseComposition(java.lang.String elementName, XMLStreamRead
                     builder.section(parseCompositionSection("section", reader, sectionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8730,6 +9275,7 @@ private Composition parseComposition(java.lang.String elementName, XMLStreamRead
     private Composition.Attester parseCompositionAttester(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Composition.Attester.Builder builder = Composition.Attester.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -8764,7 +9310,11 @@ private Composition.Attester parseCompositionAttester(java.lang.String elementNa
                     builder.party(parseReference("party", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8781,6 +9331,7 @@ private Composition.Attester parseCompositionAttester(java.lang.String elementNa
     private Composition.Event parseCompositionEvent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Composition.Event.Builder builder = Composition.Event.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -8815,7 +9366,11 @@ private Composition.Event parseCompositionEvent(java.lang.String elementName, XM
                     builder.detail(parseReference("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8832,6 +9387,7 @@ private Composition.Event parseCompositionEvent(java.lang.String elementName, XM
     private Composition.RelatesTo parseCompositionRelatesTo(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Composition.RelatesTo.Builder builder = Composition.RelatesTo.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -8866,7 +9422,11 @@ private Composition.RelatesTo parseCompositionRelatesTo(java.lang.String element
                     builder.target(parseReference("targetReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8883,6 +9443,7 @@ private Composition.RelatesTo parseCompositionRelatesTo(java.lang.String element
     private Composition.Section parseCompositionSection(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Composition.Section.Builder builder = Composition.Section.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -8945,7 +9506,11 @@ private Composition.Section parseCompositionSection(java.lang.String elementName
                     builder.section(parseCompositionSection("section", reader, sectionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -8962,6 +9527,7 @@ private Composition.Section parseCompositionSection(java.lang.String elementName
     private ConceptMap parseConceptMap(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ConceptMap.Builder builder = ConceptMap.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, groupElementIndex = 0;
         while (reader.hasNext()) {
@@ -9084,7 +9650,11 @@ private ConceptMap parseConceptMap(java.lang.String elementName, XMLStreamReader
                     builder.group(parseConceptMapGroup("group", reader, groupElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9101,6 +9671,7 @@ private ConceptMap parseConceptMap(java.lang.String elementName, XMLStreamReader
     private ConceptMap.Group parseConceptMapGroup(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ConceptMap.Group.Builder builder = ConceptMap.Group.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9147,7 +9718,11 @@ private ConceptMap.Group parseConceptMapGroup(java.lang.String elementName, XMLS
                     builder.unmapped(parseConceptMapGroupUnmapped("unmapped", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9164,6 +9739,7 @@ private ConceptMap.Group parseConceptMapGroup(java.lang.String elementName, XMLS
     private ConceptMap.Group.Element parseConceptMapGroupElement(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ConceptMap.Group.Element.Builder builder = ConceptMap.Group.Element.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9198,7 +9774,11 @@ private ConceptMap.Group.Element parseConceptMapGroupElement(java.lang.String el
                     builder.target(parseConceptMapGroupElementTarget("target", reader, targetElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9215,6 +9795,7 @@ private ConceptMap.Group.Element parseConceptMapGroupElement(java.lang.String el
     private ConceptMap.Group.Element.Target parseConceptMapGroupElementTarget(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ConceptMap.Group.Element.Target.Builder builder = ConceptMap.Group.Element.Target.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9261,7 +9842,11 @@ private ConceptMap.Group.Element.Target parseConceptMapGroupElementTarget(java.l
                     builder.product(parseConceptMapGroupElementTargetDependsOn("product", reader, productElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9278,6 +9863,7 @@ private ConceptMap.Group.Element.Target parseConceptMapGroupElementTarget(java.l
     private ConceptMap.Group.Element.Target.DependsOn parseConceptMapGroupElementTargetDependsOn(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ConceptMap.Group.Element.Target.DependsOn.Builder builder = ConceptMap.Group.Element.Target.DependsOn.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9316,7 +9902,11 @@ private ConceptMap.Group.Element.Target.DependsOn parseConceptMapGroupElementTar
                     builder.display(parseString("display", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9333,6 +9923,7 @@ private ConceptMap.Group.Element.Target.DependsOn parseConceptMapGroupElementTar
     private ConceptMap.Group.Unmapped parseConceptMapGroupUnmapped(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ConceptMap.Group.Unmapped.Builder builder = ConceptMap.Group.Unmapped.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9371,7 +9962,11 @@ private ConceptMap.Group.Unmapped parseConceptMapGroupUnmapped(java.lang.String
                     builder.url((Canonical) parseUri(Canonical.builder(), "url", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9388,6 +9983,7 @@ private ConceptMap.Group.Unmapped parseConceptMapGroupUnmapped(java.lang.String
     private Condition parseCondition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Condition.Builder builder = Condition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0, bodySiteElementIndex = 0, stageElementIndex = 0, evidenceElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -9530,7 +10126,11 @@ private Condition parseCondition(java.lang.String elementName, XMLStreamReader r
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9547,6 +10147,7 @@ private Condition parseCondition(java.lang.String elementName, XMLStreamReader r
     private Condition.Evidence parseConditionEvidence(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Condition.Evidence.Builder builder = Condition.Evidence.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9577,7 +10178,11 @@ private Condition.Evidence parseConditionEvidence(java.lang.String elementName,
                     builder.detail(parseReference("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9594,6 +10199,7 @@ private Condition.Evidence parseConditionEvidence(java.lang.String elementName,
     private Condition.Stage parseConditionStage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Condition.Stage.Builder builder = Condition.Stage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9628,7 +10234,11 @@ private Condition.Stage parseConditionStage(java.lang.String elementName, XMLStr
                     builder.type(parseCodeableConcept("type", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9645,6 +10255,7 @@ private Condition.Stage parseConditionStage(java.lang.String elementName, XMLStr
     private Consent parseConsent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Consent.Builder builder = Consent.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0, performerElementIndex = 0, organizationElementIndex = 0, policyElementIndex = 0, verificationElementIndex = 0;
         while (reader.hasNext()) {
@@ -9743,7 +10354,11 @@ private Consent parseConsent(java.lang.String elementName, XMLStreamReader reade
                     builder.provision(parseConsentProvision("provision", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9760,6 +10375,7 @@ private Consent parseConsent(java.lang.String elementName, XMLStreamReader reade
     private Consent.Policy parseConsentPolicy(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Consent.Policy.Builder builder = Consent.Policy.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9790,7 +10406,11 @@ private Consent.Policy parseConsentPolicy(java.lang.String elementName, XMLStrea
                     builder.uri(parseUri("uri", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9807,6 +10427,7 @@ private Consent.Policy parseConsentPolicy(java.lang.String elementName, XMLStrea
     private Consent.Provision parseConsentProvision(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Consent.Provision.Builder builder = Consent.Provision.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9873,7 +10494,11 @@ private Consent.Provision parseConsentProvision(java.lang.String elementName, XM
                     builder.provision(parseConsentProvision("provision", reader, provisionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9890,6 +10515,7 @@ private Consent.Provision parseConsentProvision(java.lang.String elementName, XM
     private Consent.Provision.Actor parseConsentProvisionActor(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Consent.Provision.Actor.Builder builder = Consent.Provision.Actor.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9920,7 +10546,11 @@ private Consent.Provision.Actor parseConsentProvisionActor(java.lang.String elem
                     builder.reference(parseReference("reference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9937,6 +10567,7 @@ private Consent.Provision.Actor parseConsentProvisionActor(java.lang.String elem
     private Consent.Provision.Data parseConsentProvisionData(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Consent.Provision.Data.Builder builder = Consent.Provision.Data.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -9967,7 +10598,11 @@ private Consent.Provision.Data parseConsentProvisionData(java.lang.String elemen
                     builder.reference(parseReference("reference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -9984,6 +10619,7 @@ private Consent.Provision.Data parseConsentProvisionData(java.lang.String elemen
     private Consent.Verification parseConsentVerification(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Consent.Verification.Builder builder = Consent.Verification.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10018,7 +10654,11 @@ private Consent.Verification parseConsentVerification(java.lang.String elementNa
                     builder.verificationDate(parseDateTime("verificationDate", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10035,6 +10675,7 @@ private Consent.Verification parseConsentVerification(java.lang.String elementNa
     private ContactDetail parseContactDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ContactDetail.Builder builder = ContactDetail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10061,7 +10702,11 @@ private ContactDetail parseContactDetail(java.lang.String elementName, XMLStream
                     builder.telecom(parseContactPoint("telecom", reader, telecomElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10078,6 +10723,7 @@ private ContactDetail parseContactDetail(java.lang.String elementName, XMLStream
     private ContactPoint parseContactPoint(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ContactPoint.Builder builder = ContactPoint.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10116,7 +10762,11 @@ private ContactPoint parseContactPoint(java.lang.String elementName, XMLStreamRe
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10133,6 +10783,7 @@ private ContactPoint parseContactPoint(java.lang.String elementName, XMLStreamRe
     private Contract parseContract(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Builder builder = Contract.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, subjectElementIndex = 0, authorityElementIndex = 0, domainElementIndex = 0, siteElementIndex = 0, aliasElementIndex = 0, subTypeElementIndex = 0, termElementIndex = 0, supportingInfoElementIndex = 0, relevantHistoryElementIndex = 0, signerElementIndex = 0, friendlyElementIndex = 0, legalElementIndex = 0, ruleElementIndex = 0;
         while (reader.hasNext()) {
@@ -10315,7 +10966,11 @@ private Contract parseContract(java.lang.String elementName, XMLStreamReader rea
                     builder.legallyBinding(parseReference("legallyBindingReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10332,6 +10987,7 @@ private Contract parseContract(java.lang.String elementName, XMLStreamReader rea
     private Contract.ContentDefinition parseContractContentDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.ContentDefinition.Builder builder = Contract.ContentDefinition.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10378,7 +11034,11 @@ private Contract.ContentDefinition parseContractContentDefinition(java.lang.Stri
                     builder.copyright((Markdown) parseString(Markdown.builder(), "copyright", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10395,6 +11055,7 @@ private Contract.ContentDefinition parseContractContentDefinition(java.lang.Stri
     private Contract.Friendly parseContractFriendly(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Friendly.Builder builder = Contract.Friendly.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10425,7 +11086,11 @@ private Contract.Friendly parseContractFriendly(java.lang.String elementName, XM
                     builder.content(parseReference("contentReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10442,6 +11107,7 @@ private Contract.Friendly parseContractFriendly(java.lang.String elementName, XM
     private Contract.Legal parseContractLegal(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Legal.Builder builder = Contract.Legal.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10472,7 +11138,11 @@ private Contract.Legal parseContractLegal(java.lang.String elementName, XMLStrea
                     builder.content(parseReference("contentReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10489,6 +11159,7 @@ private Contract.Legal parseContractLegal(java.lang.String elementName, XMLStrea
     private Contract.Rule parseContractRule(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Rule.Builder builder = Contract.Rule.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10519,7 +11190,11 @@ private Contract.Rule parseContractRule(java.lang.String elementName, XMLStreamR
                     builder.content(parseReference("contentReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10536,6 +11211,7 @@ private Contract.Rule parseContractRule(java.lang.String elementName, XMLStreamR
     private Contract.Signer parseContractSigner(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Signer.Builder builder = Contract.Signer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10570,7 +11246,11 @@ private Contract.Signer parseContractSigner(java.lang.String elementName, XMLStr
                     builder.signature(parseSignature("signature", reader, signatureElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10587,6 +11267,7 @@ private Contract.Signer parseContractSigner(java.lang.String elementName, XMLStr
     private Contract.Term parseContractTerm(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.Builder builder = Contract.Term.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10661,7 +11342,11 @@ private Contract.Term parseContractTerm(java.lang.String elementName, XMLStreamR
                     builder.group(parseContractTerm("group", reader, groupElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10678,6 +11363,7 @@ private Contract.Term parseContractTerm(java.lang.String elementName, XMLStreamR
     private Contract.Term.Action parseContractTermAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.Action.Builder builder = Contract.Term.Action.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10792,7 +11478,11 @@ private Contract.Term.Action parseContractTermAction(java.lang.String elementNam
                     builder.securityLabelNumber((UnsignedInt) parseInteger(UnsignedInt.builder(), "securityLabelNumber", reader, securityLabelNumberElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10809,6 +11499,7 @@ private Contract.Term.Action parseContractTermAction(java.lang.String elementNam
     private Contract.Term.Action.Subject parseContractTermActionSubject(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.Action.Subject.Builder builder = Contract.Term.Action.Subject.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10839,7 +11530,11 @@ private Contract.Term.Action.Subject parseContractTermActionSubject(java.lang.St
                     builder.role(parseCodeableConcept("role", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10856,6 +11551,7 @@ private Contract.Term.Action.Subject parseContractTermActionSubject(java.lang.St
     private Contract.Term.Asset parseContractTermAsset(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.Asset.Builder builder = Contract.Term.Asset.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10938,7 +11634,11 @@ private Contract.Term.Asset parseContractTermAsset(java.lang.String elementName,
                     builder.valuedItem(parseContractTermAssetValuedItem("valuedItem", reader, valuedItemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -10955,6 +11655,7 @@ private Contract.Term.Asset parseContractTermAsset(java.lang.String elementName,
     private Contract.Term.Asset.Context parseContractTermAssetContext(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.Asset.Context.Builder builder = Contract.Term.Asset.Context.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -10989,7 +11690,11 @@ private Contract.Term.Asset.Context parseContractTermAssetContext(java.lang.Stri
                     builder.text(parseString("text", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11006,6 +11711,7 @@ private Contract.Term.Asset.Context parseContractTermAssetContext(java.lang.Stri
     private Contract.Term.Asset.ValuedItem parseContractTermAssetValuedItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.Asset.ValuedItem.Builder builder = Contract.Term.Asset.ValuedItem.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11088,7 +11794,11 @@ private Contract.Term.Asset.ValuedItem parseContractTermAssetValuedItem(java.lan
                     builder.securityLabelNumber((UnsignedInt) parseInteger(UnsignedInt.builder(), "securityLabelNumber", reader, securityLabelNumberElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11105,6 +11815,7 @@ private Contract.Term.Asset.ValuedItem parseContractTermAssetValuedItem(java.lan
     private Contract.Term.Offer parseContractTermOffer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.Offer.Builder builder = Contract.Term.Offer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11167,7 +11878,11 @@ private Contract.Term.Offer parseContractTermOffer(java.lang.String elementName,
                     builder.securityLabelNumber((UnsignedInt) parseInteger(UnsignedInt.builder(), "securityLabelNumber", reader, securityLabelNumberElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11184,6 +11899,7 @@ private Contract.Term.Offer parseContractTermOffer(java.lang.String elementName,
     private Contract.Term.Offer.Answer parseContractTermOfferAnswer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.Offer.Answer.Builder builder = Contract.Term.Offer.Answer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11254,7 +11970,11 @@ private Contract.Term.Offer.Answer parseContractTermOfferAnswer(java.lang.String
                     builder.value(parseReference("valueReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11271,6 +11991,7 @@ private Contract.Term.Offer.Answer parseContractTermOfferAnswer(java.lang.String
     private Contract.Term.Offer.Party parseContractTermOfferParty(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.Offer.Party.Builder builder = Contract.Term.Offer.Party.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11301,7 +12022,11 @@ private Contract.Term.Offer.Party parseContractTermOfferParty(java.lang.String e
                     builder.role(parseCodeableConcept("role", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11318,6 +12043,7 @@ private Contract.Term.Offer.Party parseContractTermOfferParty(java.lang.String e
     private Contract.Term.SecurityLabel parseContractTermSecurityLabel(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contract.Term.SecurityLabel.Builder builder = Contract.Term.SecurityLabel.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11356,7 +12082,11 @@ private Contract.Term.SecurityLabel parseContractTermSecurityLabel(java.lang.Str
                     builder.control(parseCoding("control", reader, controlElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11373,6 +12103,7 @@ private Contract.Term.SecurityLabel parseContractTermSecurityLabel(java.lang.Str
     private Contributor parseContributor(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Contributor.Builder builder = Contributor.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11403,7 +12134,11 @@ private Contributor parseContributor(java.lang.String elementName, XMLStreamRead
                     builder.contact(parseContactDetail("contact", reader, contactElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11420,6 +12155,7 @@ private Contributor parseContributor(java.lang.String elementName, XMLStreamRead
     private Coverage parseCoverage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Coverage.Builder builder = Coverage.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, payorElementIndex = 0, classElementIndex = 0, costToBeneficiaryElementIndex = 0, contractElementIndex = 0;
         while (reader.hasNext()) {
@@ -11530,7 +12266,11 @@ private Coverage parseCoverage(java.lang.String elementName, XMLStreamReader rea
                     builder.contract(parseReference("contract", reader, contractElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11547,6 +12287,7 @@ private Coverage parseCoverage(java.lang.String elementName, XMLStreamReader rea
     private Coverage.Class parseCoverageClass(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Coverage.Class.Builder builder = Coverage.Class.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11581,7 +12322,11 @@ private Coverage.Class parseCoverageClass(java.lang.String elementName, XMLStrea
                     builder.name(parseString("name", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11598,6 +12343,7 @@ private Coverage.Class parseCoverageClass(java.lang.String elementName, XMLStrea
     private Coverage.CostToBeneficiary parseCoverageCostToBeneficiary(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Coverage.CostToBeneficiary.Builder builder = Coverage.CostToBeneficiary.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11636,7 +12382,11 @@ private Coverage.CostToBeneficiary parseCoverageCostToBeneficiary(java.lang.Stri
                     builder.exception(parseCoverageCostToBeneficiaryException("exception", reader, exceptionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11653,6 +12403,7 @@ private Coverage.CostToBeneficiary parseCoverageCostToBeneficiary(java.lang.Stri
     private Coverage.CostToBeneficiary.Exception parseCoverageCostToBeneficiaryException(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Coverage.CostToBeneficiary.Exception.Builder builder = Coverage.CostToBeneficiary.Exception.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11683,7 +12434,11 @@ private Coverage.CostToBeneficiary.Exception parseCoverageCostToBeneficiaryExcep
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11700,6 +12455,7 @@ private Coverage.CostToBeneficiary.Exception parseCoverageCostToBeneficiaryExcep
     private CoverageEligibilityRequest parseCoverageEligibilityRequest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityRequest.Builder builder = CoverageEligibilityRequest.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, purposeElementIndex = 0, supportingInfoElementIndex = 0, insuranceElementIndex = 0, itemElementIndex = 0;
         while (reader.hasNext()) {
@@ -11802,7 +12558,11 @@ private CoverageEligibilityRequest parseCoverageEligibilityRequest(java.lang.Str
                     builder.item(parseCoverageEligibilityRequestItem("item", reader, itemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11819,6 +12579,7 @@ private CoverageEligibilityRequest parseCoverageEligibilityRequest(java.lang.Str
     private CoverageEligibilityRequest.Insurance parseCoverageEligibilityRequestInsurance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityRequest.Insurance.Builder builder = CoverageEligibilityRequest.Insurance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11853,7 +12614,11 @@ private CoverageEligibilityRequest.Insurance parseCoverageEligibilityRequestInsu
                     builder.businessArrangement(parseString("businessArrangement", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11870,6 +12635,7 @@ private CoverageEligibilityRequest.Insurance parseCoverageEligibilityRequestInsu
     private CoverageEligibilityRequest.Item parseCoverageEligibilityRequestItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityRequest.Item.Builder builder = CoverageEligibilityRequest.Item.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11932,7 +12698,11 @@ private CoverageEligibilityRequest.Item parseCoverageEligibilityRequestItem(java
                     builder.detail(parseReference("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11949,6 +12719,7 @@ private CoverageEligibilityRequest.Item parseCoverageEligibilityRequestItem(java
     private CoverageEligibilityRequest.Item.Diagnosis parseCoverageEligibilityRequestItemDiagnosis(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityRequest.Item.Diagnosis.Builder builder = CoverageEligibilityRequest.Item.Diagnosis.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -11979,7 +12750,11 @@ private CoverageEligibilityRequest.Item.Diagnosis parseCoverageEligibilityReques
                     builder.diagnosis(parseReference("diagnosisReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -11996,6 +12771,7 @@ private CoverageEligibilityRequest.Item.Diagnosis parseCoverageEligibilityReques
     private CoverageEligibilityRequest.SupportingInfo parseCoverageEligibilityRequestSupportingInfo(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityRequest.SupportingInfo.Builder builder = CoverageEligibilityRequest.SupportingInfo.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12030,7 +12806,11 @@ private CoverageEligibilityRequest.SupportingInfo parseCoverageEligibilityReques
                     builder.appliesToAll(parseBoolean("appliesToAll", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12047,6 +12827,7 @@ private CoverageEligibilityRequest.SupportingInfo parseCoverageEligibilityReques
     private CoverageEligibilityResponse parseCoverageEligibilityResponse(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityResponse.Builder builder = CoverageEligibilityResponse.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, purposeElementIndex = 0, insuranceElementIndex = 0, errorElementIndex = 0;
         while (reader.hasNext()) {
@@ -12153,7 +12934,11 @@ private CoverageEligibilityResponse parseCoverageEligibilityResponse(java.lang.S
                     builder.error(parseCoverageEligibilityResponseError("error", reader, errorElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12170,6 +12955,7 @@ private CoverageEligibilityResponse parseCoverageEligibilityResponse(java.lang.S
     private CoverageEligibilityResponse.Error parseCoverageEligibilityResponseError(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityResponse.Error.Builder builder = CoverageEligibilityResponse.Error.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12196,7 +12982,11 @@ private CoverageEligibilityResponse.Error parseCoverageEligibilityResponseError(
                     builder.code(parseCodeableConcept("code", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12213,6 +13003,7 @@ private CoverageEligibilityResponse.Error parseCoverageEligibilityResponseError(
     private CoverageEligibilityResponse.Insurance parseCoverageEligibilityResponseInsurance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityResponse.Insurance.Builder builder = CoverageEligibilityResponse.Insurance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12251,7 +13042,11 @@ private CoverageEligibilityResponse.Insurance parseCoverageEligibilityResponseIn
                     builder.item(parseCoverageEligibilityResponseInsuranceItem("item", reader, itemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12268,6 +13063,7 @@ private CoverageEligibilityResponse.Insurance parseCoverageEligibilityResponseIn
     private CoverageEligibilityResponse.Insurance.Item parseCoverageEligibilityResponseInsuranceItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityResponse.Insurance.Item.Builder builder = CoverageEligibilityResponse.Insurance.Item.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12346,7 +13142,11 @@ private CoverageEligibilityResponse.Insurance.Item parseCoverageEligibilityRespo
                     builder.authorizationUrl(parseUri("authorizationUrl", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12363,6 +13163,7 @@ private CoverageEligibilityResponse.Insurance.Item parseCoverageEligibilityRespo
     private CoverageEligibilityResponse.Insurance.Item.Benefit parseCoverageEligibilityResponseInsuranceItemBenefit(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         CoverageEligibilityResponse.Insurance.Item.Benefit.Builder builder = CoverageEligibilityResponse.Insurance.Item.Benefit.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12413,7 +13214,11 @@ private CoverageEligibilityResponse.Insurance.Item.Benefit parseCoverageEligibil
                     builder.used(parseMoney("usedMoney", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12430,6 +13235,7 @@ private CoverageEligibilityResponse.Insurance.Item.Benefit parseCoverageEligibil
     private DataRequirement parseDataRequirement(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DataRequirement.Builder builder = DataRequirement.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12484,7 +13290,11 @@ private DataRequirement parseDataRequirement(java.lang.String elementName, XMLSt
                     builder.sort(parseDataRequirementSort("sort", reader, sortElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12501,6 +13311,7 @@ private DataRequirement parseDataRequirement(java.lang.String elementName, XMLSt
     private DataRequirement.CodeFilter parseDataRequirementCodeFilter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DataRequirement.CodeFilter.Builder builder = DataRequirement.CodeFilter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12539,7 +13350,11 @@ private DataRequirement.CodeFilter parseDataRequirementCodeFilter(java.lang.Stri
                     builder.code(parseCoding("code", reader, codeElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12556,6 +13371,7 @@ private DataRequirement.CodeFilter parseDataRequirementCodeFilter(java.lang.Stri
     private DataRequirement.DateFilter parseDataRequirementDateFilter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DataRequirement.DateFilter.Builder builder = DataRequirement.DateFilter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12598,7 +13414,11 @@ private DataRequirement.DateFilter parseDataRequirementDateFilter(java.lang.Stri
                     builder.value((Duration) parseQuantity(Duration.builder(), "valueDuration", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12615,6 +13435,7 @@ private DataRequirement.DateFilter parseDataRequirementDateFilter(java.lang.Stri
     private DataRequirement.Sort parseDataRequirementSort(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DataRequirement.Sort.Builder builder = DataRequirement.Sort.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12645,7 +13466,11 @@ private DataRequirement.Sort parseDataRequirementSort(java.lang.String elementNa
                     builder.direction((SortDirection) parseString(SortDirection.builder(), "direction", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12662,6 +13487,7 @@ private DataRequirement.Sort parseDataRequirementSort(java.lang.String elementNa
     private Date parseDate(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Date.Builder builder = Date.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12684,7 +13510,11 @@ private Date parseDate(java.lang.String elementName, XMLStreamReader reader, int
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12701,6 +13531,7 @@ private Date parseDate(java.lang.String elementName, XMLStreamReader reader, int
     private DateTime parseDateTime(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DateTime.Builder builder = DateTime.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12723,7 +13554,11 @@ private DateTime parseDateTime(java.lang.String elementName, XMLStreamReader rea
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12740,6 +13575,7 @@ private DateTime parseDateTime(java.lang.String elementName, XMLStreamReader rea
     private Decimal parseDecimal(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Decimal.Builder builder = Decimal.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12762,7 +13598,11 @@ private Decimal parseDecimal(java.lang.String elementName, XMLStreamReader reade
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12779,6 +13619,7 @@ private Decimal parseDecimal(java.lang.String elementName, XMLStreamReader reade
     private DetectedIssue parseDetectedIssue(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DetectedIssue.Builder builder = DetectedIssue.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, implicatedElementIndex = 0, evidenceElementIndex = 0, mitigationElementIndex = 0;
         while (reader.hasNext()) {
@@ -12873,7 +13714,11 @@ private DetectedIssue parseDetectedIssue(java.lang.String elementName, XMLStream
                     builder.mitigation(parseDetectedIssueMitigation("mitigation", reader, mitigationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12890,6 +13735,7 @@ private DetectedIssue parseDetectedIssue(java.lang.String elementName, XMLStream
     private DetectedIssue.Evidence parseDetectedIssueEvidence(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DetectedIssue.Evidence.Builder builder = DetectedIssue.Evidence.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12920,7 +13766,11 @@ private DetectedIssue.Evidence parseDetectedIssueEvidence(java.lang.String eleme
                     builder.detail(parseReference("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12937,6 +13787,7 @@ private DetectedIssue.Evidence parseDetectedIssueEvidence(java.lang.String eleme
     private DetectedIssue.Mitigation parseDetectedIssueMitigation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DetectedIssue.Mitigation.Builder builder = DetectedIssue.Mitigation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -12971,7 +13822,11 @@ private DetectedIssue.Mitigation parseDetectedIssueMitigation(java.lang.String e
                     builder.author(parseReference("author", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -12988,6 +13843,7 @@ private DetectedIssue.Mitigation parseDetectedIssueMitigation(java.lang.String e
     private Device parseDevice(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Device.Builder builder = Device.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, udiCarrierElementIndex = 0, statusReasonElementIndex = 0, deviceNameElementIndex = 0, specializationElementIndex = 0, versionElementIndex = 0, propertyElementIndex = 0, contactElementIndex = 0, noteElementIndex = 0, safetyElementIndex = 0;
         while (reader.hasNext()) {
@@ -13134,7 +13990,11 @@ private Device parseDevice(java.lang.String elementName, XMLStreamReader reader,
                     builder.parent(parseReference("parent", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13151,6 +14011,7 @@ private Device parseDevice(java.lang.String elementName, XMLStreamReader reader,
     private Device.DeviceName parseDeviceDeviceName(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Device.DeviceName.Builder builder = Device.DeviceName.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13181,7 +14042,11 @@ private Device.DeviceName parseDeviceDeviceName(java.lang.String elementName, XM
                     builder.type((DeviceNameType) parseString(DeviceNameType.builder(), "type", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13198,6 +14063,7 @@ private Device.DeviceName parseDeviceDeviceName(java.lang.String elementName, XM
     private Device.Property parseDeviceProperty(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Device.Property.Builder builder = Device.Property.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13232,7 +14098,11 @@ private Device.Property parseDeviceProperty(java.lang.String elementName, XMLStr
                     builder.valueCode(parseCodeableConcept("valueCode", reader, valueCodeElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13249,6 +14119,7 @@ private Device.Property parseDeviceProperty(java.lang.String elementName, XMLStr
     private Device.Specialization parseDeviceSpecialization(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Device.Specialization.Builder builder = Device.Specialization.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13279,7 +14150,11 @@ private Device.Specialization parseDeviceSpecialization(java.lang.String element
                     builder.version(parseString("version", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13296,6 +14171,7 @@ private Device.Specialization parseDeviceSpecialization(java.lang.String element
     private Device.UdiCarrier parseDeviceUdiCarrier(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Device.UdiCarrier.Builder builder = Device.UdiCarrier.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13342,7 +14218,11 @@ private Device.UdiCarrier parseDeviceUdiCarrier(java.lang.String elementName, XM
                     builder.entryType((UDIEntryType) parseString(UDIEntryType.builder(), "entryType", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13359,6 +14239,7 @@ private Device.UdiCarrier parseDeviceUdiCarrier(java.lang.String elementName, XM
     private Device.Version parseDeviceVersion(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Device.Version.Builder builder = Device.Version.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13393,7 +14274,11 @@ private Device.Version parseDeviceVersion(java.lang.String elementName, XMLStrea
                     builder.value(parseString("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13410,6 +14295,7 @@ private Device.Version parseDeviceVersion(java.lang.String elementName, XMLStrea
     private DeviceDefinition parseDeviceDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceDefinition.Builder builder = DeviceDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, udiDeviceIdentifierElementIndex = 0, deviceNameElementIndex = 0, specializationElementIndex = 0, versionElementIndex = 0, safetyElementIndex = 0, shelfLifeStorageElementIndex = 0, languageCodeElementIndex = 0, capabilityElementIndex = 0, propertyElementIndex = 0, contactElementIndex = 0, noteElementIndex = 0, materialElementIndex = 0;
         while (reader.hasNext()) {
@@ -13544,7 +14430,11 @@ private DeviceDefinition parseDeviceDefinition(java.lang.String elementName, XML
                     builder.material(parseDeviceDefinitionMaterial("material", reader, materialElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13561,6 +14451,7 @@ private DeviceDefinition parseDeviceDefinition(java.lang.String elementName, XML
     private DeviceDefinition.Capability parseDeviceDefinitionCapability(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceDefinition.Capability.Builder builder = DeviceDefinition.Capability.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13591,7 +14482,11 @@ private DeviceDefinition.Capability parseDeviceDefinitionCapability(java.lang.St
                     builder.description(parseCodeableConcept("description", reader, descriptionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13608,6 +14503,7 @@ private DeviceDefinition.Capability parseDeviceDefinitionCapability(java.lang.St
     private DeviceDefinition.DeviceName parseDeviceDefinitionDeviceName(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceDefinition.DeviceName.Builder builder = DeviceDefinition.DeviceName.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13638,7 +14534,11 @@ private DeviceDefinition.DeviceName parseDeviceDefinitionDeviceName(java.lang.St
                     builder.type((DeviceNameType) parseString(DeviceNameType.builder(), "type", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13655,6 +14555,7 @@ private DeviceDefinition.DeviceName parseDeviceDefinitionDeviceName(java.lang.St
     private DeviceDefinition.Material parseDeviceDefinitionMaterial(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceDefinition.Material.Builder builder = DeviceDefinition.Material.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13689,7 +14590,11 @@ private DeviceDefinition.Material parseDeviceDefinitionMaterial(java.lang.String
                     builder.allergenicIndicator(parseBoolean("allergenicIndicator", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13706,6 +14611,7 @@ private DeviceDefinition.Material parseDeviceDefinitionMaterial(java.lang.String
     private DeviceDefinition.Property parseDeviceDefinitionProperty(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceDefinition.Property.Builder builder = DeviceDefinition.Property.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13740,7 +14646,11 @@ private DeviceDefinition.Property parseDeviceDefinitionProperty(java.lang.String
                     builder.valueCode(parseCodeableConcept("valueCode", reader, valueCodeElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13757,6 +14667,7 @@ private DeviceDefinition.Property parseDeviceDefinitionProperty(java.lang.String
     private DeviceDefinition.Specialization parseDeviceDefinitionSpecialization(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceDefinition.Specialization.Builder builder = DeviceDefinition.Specialization.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13787,7 +14698,11 @@ private DeviceDefinition.Specialization parseDeviceDefinitionSpecialization(java
                     builder.version(parseString("version", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13804,6 +14719,7 @@ private DeviceDefinition.Specialization parseDeviceDefinitionSpecialization(java
     private DeviceDefinition.UdiDeviceIdentifier parseDeviceDefinitionUdiDeviceIdentifier(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceDefinition.UdiDeviceIdentifier.Builder builder = DeviceDefinition.UdiDeviceIdentifier.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13838,7 +14754,11 @@ private DeviceDefinition.UdiDeviceIdentifier parseDeviceDefinitionUdiDeviceIdent
                     builder.jurisdiction(parseUri("jurisdiction", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13855,6 +14775,7 @@ private DeviceDefinition.UdiDeviceIdentifier parseDeviceDefinitionUdiDeviceIdent
     private DeviceMetric parseDeviceMetric(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceMetric.Builder builder = DeviceMetric.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, calibrationElementIndex = 0;
         while (reader.hasNext()) {
@@ -13937,7 +14858,11 @@ private DeviceMetric parseDeviceMetric(java.lang.String elementName, XMLStreamRe
                     builder.calibration(parseDeviceMetricCalibration("calibration", reader, calibrationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -13954,6 +14879,7 @@ private DeviceMetric parseDeviceMetric(java.lang.String elementName, XMLStreamRe
     private DeviceMetric.Calibration parseDeviceMetricCalibration(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceMetric.Calibration.Builder builder = DeviceMetric.Calibration.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -13988,7 +14914,11 @@ private DeviceMetric.Calibration parseDeviceMetricCalibration(java.lang.String e
                     builder.time(parseInstant("time", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14005,6 +14935,7 @@ private DeviceMetric.Calibration parseDeviceMetricCalibration(java.lang.String e
     private DeviceRequest parseDeviceRequest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceRequest.Builder builder = DeviceRequest.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, instantiatesCanonicalElementIndex = 0, instantiatesUriElementIndex = 0, basedOnElementIndex = 0, priorRequestElementIndex = 0, parameterElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, insuranceElementIndex = 0, supportingInfoElementIndex = 0, noteElementIndex = 0, relevantHistoryElementIndex = 0;
         while (reader.hasNext()) {
@@ -14155,7 +15086,11 @@ private DeviceRequest parseDeviceRequest(java.lang.String elementName, XMLStream
                     builder.relevantHistory(parseReference("relevantHistory", reader, relevantHistoryElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14172,6 +15107,7 @@ private DeviceRequest parseDeviceRequest(java.lang.String elementName, XMLStream
     private DeviceRequest.Parameter parseDeviceRequestParameter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceRequest.Parameter.Builder builder = DeviceRequest.Parameter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -14214,7 +15150,11 @@ private DeviceRequest.Parameter parseDeviceRequestParameter(java.lang.String ele
                     builder.value(parseBoolean("valueBoolean", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14231,6 +15171,7 @@ private DeviceRequest.Parameter parseDeviceRequestParameter(java.lang.String ele
     private DeviceUseStatement parseDeviceUseStatement(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DeviceUseStatement.Builder builder = DeviceUseStatement.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, basedOnElementIndex = 0, derivedFromElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -14333,7 +15274,11 @@ private DeviceUseStatement parseDeviceUseStatement(java.lang.String elementName,
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14350,6 +15295,7 @@ private DeviceUseStatement parseDeviceUseStatement(java.lang.String elementName,
     private DiagnosticReport parseDiagnosticReport(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DiagnosticReport.Builder builder = DiagnosticReport.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, basedOnElementIndex = 0, categoryElementIndex = 0, performerElementIndex = 0, resultsInterpreterElementIndex = 0, specimenElementIndex = 0, resultElementIndex = 0, imagingStudyElementIndex = 0, mediaElementIndex = 0, conclusionCodeElementIndex = 0, presentedFormElementIndex = 0;
         while (reader.hasNext()) {
@@ -14468,7 +15414,11 @@ private DiagnosticReport parseDiagnosticReport(java.lang.String elementName, XML
                     builder.presentedForm(parseAttachment("presentedForm", reader, presentedFormElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14485,6 +15435,7 @@ private DiagnosticReport parseDiagnosticReport(java.lang.String elementName, XML
     private DiagnosticReport.Media parseDiagnosticReportMedia(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DiagnosticReport.Media.Builder builder = DiagnosticReport.Media.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -14515,7 +15466,11 @@ private DiagnosticReport.Media parseDiagnosticReportMedia(java.lang.String eleme
                     builder.link(parseReference("link", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14532,6 +15487,7 @@ private DiagnosticReport.Media parseDiagnosticReportMedia(java.lang.String eleme
     private DocumentManifest parseDocumentManifest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DocumentManifest.Builder builder = DocumentManifest.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, authorElementIndex = 0, recipientElementIndex = 0, contentElementIndex = 0, relatedElementIndex = 0;
         while (reader.hasNext()) {
@@ -14622,7 +15578,11 @@ private DocumentManifest parseDocumentManifest(java.lang.String elementName, XML
                     builder.related(parseDocumentManifestRelated("related", reader, relatedElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14639,6 +15599,7 @@ private DocumentManifest parseDocumentManifest(java.lang.String elementName, XML
     private DocumentManifest.Related parseDocumentManifestRelated(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DocumentManifest.Related.Builder builder = DocumentManifest.Related.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -14669,7 +15630,11 @@ private DocumentManifest.Related parseDocumentManifestRelated(java.lang.String e
                     builder.ref(parseReference("ref", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14686,6 +15651,7 @@ private DocumentManifest.Related parseDocumentManifestRelated(java.lang.String e
     private DocumentReference parseDocumentReference(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DocumentReference.Builder builder = DocumentReference.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0, authorElementIndex = 0, relatesToElementIndex = 0, securityLabelElementIndex = 0, contentElementIndex = 0;
         while (reader.hasNext()) {
@@ -14792,7 +15758,11 @@ private DocumentReference parseDocumentReference(java.lang.String elementName, X
                     builder.context(parseDocumentReferenceContext("context", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14809,6 +15779,7 @@ private DocumentReference parseDocumentReference(java.lang.String elementName, X
     private DocumentReference.Content parseDocumentReferenceContent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DocumentReference.Content.Builder builder = DocumentReference.Content.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -14839,7 +15810,11 @@ private DocumentReference.Content parseDocumentReferenceContent(java.lang.String
                     builder.format(parseCoding("format", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14856,6 +15831,7 @@ private DocumentReference.Content parseDocumentReferenceContent(java.lang.String
     private DocumentReference.Context parseDocumentReferenceContext(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DocumentReference.Context.Builder builder = DocumentReference.Context.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -14906,7 +15882,11 @@ private DocumentReference.Context parseDocumentReferenceContext(java.lang.String
                     builder.related(parseReference("related", reader, relatedElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14923,6 +15903,7 @@ private DocumentReference.Context parseDocumentReferenceContext(java.lang.String
     private DocumentReference.RelatesTo parseDocumentReferenceRelatesTo(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         DocumentReference.RelatesTo.Builder builder = DocumentReference.RelatesTo.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -14953,7 +15934,11 @@ private DocumentReference.RelatesTo parseDocumentReferenceRelatesTo(java.lang.St
                     builder.target(parseReference("target", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -14970,6 +15955,7 @@ private DocumentReference.RelatesTo parseDocumentReferenceRelatesTo(java.lang.St
     private Dosage parseDosage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Dosage.Builder builder = Dosage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -15048,7 +16034,11 @@ private Dosage parseDosage(java.lang.String elementName, XMLStreamReader reader,
                     builder.maxDosePerLifetime((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "maxDosePerLifetime", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -15065,6 +16055,7 @@ private Dosage parseDosage(java.lang.String elementName, XMLStreamReader reader,
     private Dosage.DoseAndRate parseDosageDoseAndRate(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Dosage.DoseAndRate.Builder builder = Dosage.DoseAndRate.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -15111,7 +16102,11 @@ private Dosage.DoseAndRate parseDosageDoseAndRate(java.lang.String elementName,
                     builder.rate((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "rateQuantity", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -15128,6 +16123,7 @@ private Dosage.DoseAndRate parseDosageDoseAndRate(java.lang.String elementName,
     private EffectEvidenceSynthesis parseEffectEvidenceSynthesis(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EffectEvidenceSynthesis.Builder builder = EffectEvidenceSynthesis.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, noteElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, resultsByExposureElementIndex = 0, effectEstimateElementIndex = 0, certaintyElementIndex = 0;
         while (reader.hasNext()) {
@@ -15302,7 +16298,11 @@ private EffectEvidenceSynthesis parseEffectEvidenceSynthesis(java.lang.String el
                     builder.certainty(parseEffectEvidenceSynthesisCertainty("certainty", reader, certaintyElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -15319,6 +16319,7 @@ private EffectEvidenceSynthesis parseEffectEvidenceSynthesis(java.lang.String el
     private EffectEvidenceSynthesis.Certainty parseEffectEvidenceSynthesisCertainty(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EffectEvidenceSynthesis.Certainty.Builder builder = EffectEvidenceSynthesis.Certainty.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -15353,7 +16354,11 @@ private EffectEvidenceSynthesis.Certainty parseEffectEvidenceSynthesisCertainty(
                     builder.certaintySubcomponent(parseEffectEvidenceSynthesisCertaintyCertaintySubcomponent("certaintySubcomponent", reader, certaintySubcomponentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -15370,6 +16375,7 @@ private EffectEvidenceSynthesis.Certainty parseEffectEvidenceSynthesisCertainty(
     private EffectEvidenceSynthesis.Certainty.CertaintySubcomponent parseEffectEvidenceSynthesisCertaintyCertaintySubcomponent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EffectEvidenceSynthesis.Certainty.CertaintySubcomponent.Builder builder = EffectEvidenceSynthesis.Certainty.CertaintySubcomponent.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -15404,7 +16410,11 @@ private EffectEvidenceSynthesis.Certainty.CertaintySubcomponent parseEffectEvide
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -15421,6 +16431,7 @@ private EffectEvidenceSynthesis.Certainty.CertaintySubcomponent parseEffectEvide
     private EffectEvidenceSynthesis.EffectEstimate parseEffectEvidenceSynthesisEffectEstimate(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EffectEvidenceSynthesis.EffectEstimate.Builder builder = EffectEvidenceSynthesis.EffectEstimate.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -15467,7 +16478,11 @@ private EffectEvidenceSynthesis.EffectEstimate parseEffectEvidenceSynthesisEffec
                     builder.precisionEstimate(parseEffectEvidenceSynthesisEffectEstimatePrecisionEstimate("precisionEstimate", reader, precisionEstimateElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -15484,6 +16499,7 @@ private EffectEvidenceSynthesis.EffectEstimate parseEffectEvidenceSynthesisEffec
     private EffectEvidenceSynthesis.EffectEstimate.PrecisionEstimate parseEffectEvidenceSynthesisEffectEstimatePrecisionEstimate(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EffectEvidenceSynthesis.EffectEstimate.PrecisionEstimate.Builder builder = EffectEvidenceSynthesis.EffectEstimate.PrecisionEstimate.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -15522,7 +16538,11 @@ private EffectEvidenceSynthesis.EffectEstimate.PrecisionEstimate parseEffectEvid
                     builder.to(parseDecimal("to", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -15539,6 +16559,7 @@ private EffectEvidenceSynthesis.EffectEstimate.PrecisionEstimate parseEffectEvid
     private EffectEvidenceSynthesis.ResultsByExposure parseEffectEvidenceSynthesisResultsByExposure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EffectEvidenceSynthesis.ResultsByExposure.Builder builder = EffectEvidenceSynthesis.ResultsByExposure.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -15577,7 +16598,11 @@ private EffectEvidenceSynthesis.ResultsByExposure parseEffectEvidenceSynthesisRe
                     builder.riskEvidenceSynthesis(parseReference("riskEvidenceSynthesis", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -15594,6 +16619,7 @@ private EffectEvidenceSynthesis.ResultsByExposure parseEffectEvidenceSynthesisRe
     private EffectEvidenceSynthesis.SampleSize parseEffectEvidenceSynthesisSampleSize(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EffectEvidenceSynthesis.SampleSize.Builder builder = EffectEvidenceSynthesis.SampleSize.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -15628,7 +16654,11 @@ private EffectEvidenceSynthesis.SampleSize parseEffectEvidenceSynthesisSampleSiz
                     builder.numberOfParticipants(parseInteger("numberOfParticipants", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -15645,6 +16675,7 @@ private EffectEvidenceSynthesis.SampleSize parseEffectEvidenceSynthesisSampleSiz
     private ElementDefinition parseElementDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ElementDefinition.Builder builder = ElementDefinition.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -16455,7 +17486,11 @@ private ElementDefinition parseElementDefinition(java.lang.String elementName, X
                     builder.mapping(parseElementDefinitionMapping("mapping", reader, mappingElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -16472,6 +17507,7 @@ private ElementDefinition parseElementDefinition(java.lang.String elementName, X
     private ElementDefinition.Base parseElementDefinitionBase(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ElementDefinition.Base.Builder builder = ElementDefinition.Base.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -16506,7 +17542,11 @@ private ElementDefinition.Base parseElementDefinitionBase(java.lang.String eleme
                     builder.max(parseString("max", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -16523,6 +17563,7 @@ private ElementDefinition.Base parseElementDefinitionBase(java.lang.String eleme
     private ElementDefinition.Binding parseElementDefinitionBinding(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ElementDefinition.Binding.Builder builder = ElementDefinition.Binding.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -16557,7 +17598,11 @@ private ElementDefinition.Binding parseElementDefinitionBinding(java.lang.String
                     builder.valueSet((Canonical) parseUri(Canonical.builder(), "valueSet", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -16574,6 +17619,7 @@ private ElementDefinition.Binding parseElementDefinitionBinding(java.lang.String
     private ElementDefinition.Constraint parseElementDefinitionConstraint(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ElementDefinition.Constraint.Builder builder = ElementDefinition.Constraint.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -16624,7 +17670,11 @@ private ElementDefinition.Constraint parseElementDefinitionConstraint(java.lang.
                     builder.source((Canonical) parseUri(Canonical.builder(), "source", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -16641,6 +17691,7 @@ private ElementDefinition.Constraint parseElementDefinitionConstraint(java.lang.
     private ElementDefinition.Example parseElementDefinitionExample(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ElementDefinition.Example.Builder builder = ElementDefinition.Example.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -16867,7 +17918,11 @@ private ElementDefinition.Example parseElementDefinitionExample(java.lang.String
                     builder.value(parseMeta("valueMeta", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -16884,6 +17939,7 @@ private ElementDefinition.Example parseElementDefinitionExample(java.lang.String
     private ElementDefinition.Mapping parseElementDefinitionMapping(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ElementDefinition.Mapping.Builder builder = ElementDefinition.Mapping.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -16922,7 +17978,11 @@ private ElementDefinition.Mapping parseElementDefinitionMapping(java.lang.String
                     builder.comment(parseString("comment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -16939,6 +17999,7 @@ private ElementDefinition.Mapping parseElementDefinitionMapping(java.lang.String
     private ElementDefinition.Slicing parseElementDefinitionSlicing(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ElementDefinition.Slicing.Builder builder = ElementDefinition.Slicing.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -16977,7 +18038,11 @@ private ElementDefinition.Slicing parseElementDefinitionSlicing(java.lang.String
                     builder.rules((SlicingRules) parseString(SlicingRules.builder(), "rules", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -16994,6 +18059,7 @@ private ElementDefinition.Slicing parseElementDefinitionSlicing(java.lang.String
     private ElementDefinition.Slicing.Discriminator parseElementDefinitionSlicingDiscriminator(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ElementDefinition.Slicing.Discriminator.Builder builder = ElementDefinition.Slicing.Discriminator.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -17024,7 +18090,11 @@ private ElementDefinition.Slicing.Discriminator parseElementDefinitionSlicingDis
                     builder.path(parseString("path", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17041,6 +18111,7 @@ private ElementDefinition.Slicing.Discriminator parseElementDefinitionSlicingDis
     private ElementDefinition.Type parseElementDefinitionType(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ElementDefinition.Type.Builder builder = ElementDefinition.Type.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -17083,7 +18154,11 @@ private ElementDefinition.Type parseElementDefinitionType(java.lang.String eleme
                     builder.versioning((ReferenceVersionRules) parseString(ReferenceVersionRules.builder(), "versioning", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17100,6 +18175,7 @@ private ElementDefinition.Type parseElementDefinitionType(java.lang.String eleme
     private Encounter parseEncounter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Encounter.Builder builder = Encounter.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, statusHistoryElementIndex = 0, classHistoryElementIndex = 0, typeElementIndex = 0, episodeOfCareElementIndex = 0, basedOnElementIndex = 0, participantElementIndex = 0, appointmentElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, diagnosisElementIndex = 0, accountElementIndex = 0, locationElementIndex = 0;
         while (reader.hasNext()) {
@@ -17234,7 +18310,11 @@ private Encounter parseEncounter(java.lang.String elementName, XMLStreamReader r
                     builder.partOf(parseReference("partOf", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17251,6 +18331,7 @@ private Encounter parseEncounter(java.lang.String elementName, XMLStreamReader r
     private Encounter.ClassHistory parseEncounterClassHistory(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Encounter.ClassHistory.Builder builder = Encounter.ClassHistory.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -17281,7 +18362,11 @@ private Encounter.ClassHistory parseEncounterClassHistory(java.lang.String eleme
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17298,6 +18383,7 @@ private Encounter.ClassHistory parseEncounterClassHistory(java.lang.String eleme
     private Encounter.Diagnosis parseEncounterDiagnosis(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Encounter.Diagnosis.Builder builder = Encounter.Diagnosis.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -17332,7 +18418,11 @@ private Encounter.Diagnosis parseEncounterDiagnosis(java.lang.String elementName
                     builder.rank((PositiveInt) parseInteger(PositiveInt.builder(), "rank", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17349,6 +18439,7 @@ private Encounter.Diagnosis parseEncounterDiagnosis(java.lang.String elementName
     private Encounter.Hospitalization parseEncounterHospitalization(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Encounter.Hospitalization.Builder builder = Encounter.Hospitalization.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -17407,7 +18498,11 @@ private Encounter.Hospitalization parseEncounterHospitalization(java.lang.String
                     builder.dischargeDisposition(parseCodeableConcept("dischargeDisposition", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17424,6 +18519,7 @@ private Encounter.Hospitalization parseEncounterHospitalization(java.lang.String
     private Encounter.Location parseEncounterLocation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Encounter.Location.Builder builder = Encounter.Location.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -17462,7 +18558,11 @@ private Encounter.Location parseEncounterLocation(java.lang.String elementName,
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17479,6 +18579,7 @@ private Encounter.Location parseEncounterLocation(java.lang.String elementName,
     private Encounter.Participant parseEncounterParticipant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Encounter.Participant.Builder builder = Encounter.Participant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -17513,7 +18614,11 @@ private Encounter.Participant parseEncounterParticipant(java.lang.String element
                     builder.individual(parseReference("individual", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17530,6 +18635,7 @@ private Encounter.Participant parseEncounterParticipant(java.lang.String element
     private Encounter.StatusHistory parseEncounterStatusHistory(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Encounter.StatusHistory.Builder builder = Encounter.StatusHistory.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -17560,7 +18666,11 @@ private Encounter.StatusHistory parseEncounterStatusHistory(java.lang.String ele
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17577,6 +18687,7 @@ private Encounter.StatusHistory parseEncounterStatusHistory(java.lang.String ele
     private Endpoint parseEndpoint(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Endpoint.Builder builder = Endpoint.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, payloadTypeElementIndex = 0, payloadMimeTypeElementIndex = 0, headerElementIndex = 0;
         while (reader.hasNext()) {
@@ -17663,7 +18774,11 @@ private Endpoint parseEndpoint(java.lang.String elementName, XMLStreamReader rea
                     builder.header(parseString("header", reader, headerElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17680,6 +18795,7 @@ private Endpoint parseEndpoint(java.lang.String elementName, XMLStreamReader rea
     private EnrollmentRequest parseEnrollmentRequest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EnrollmentRequest.Builder builder = EnrollmentRequest.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0;
         while (reader.hasNext()) {
@@ -17750,7 +18866,11 @@ private EnrollmentRequest parseEnrollmentRequest(java.lang.String elementName, X
                     builder.coverage(parseReference("coverage", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17767,6 +18887,7 @@ private EnrollmentRequest parseEnrollmentRequest(java.lang.String elementName, X
     private EnrollmentResponse parseEnrollmentResponse(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EnrollmentResponse.Builder builder = EnrollmentResponse.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0;
         while (reader.hasNext()) {
@@ -17841,7 +18962,11 @@ private EnrollmentResponse parseEnrollmentResponse(java.lang.String elementName,
                     builder.requestProvider(parseReference("requestProvider", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17858,6 +18983,7 @@ private EnrollmentResponse parseEnrollmentResponse(java.lang.String elementName,
     private EpisodeOfCare parseEpisodeOfCare(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EpisodeOfCare.Builder builder = EpisodeOfCare.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, statusHistoryElementIndex = 0, typeElementIndex = 0, diagnosisElementIndex = 0, referralRequestElementIndex = 0, teamElementIndex = 0, accountElementIndex = 0;
         while (reader.hasNext()) {
@@ -17948,7 +19074,11 @@ private EpisodeOfCare parseEpisodeOfCare(java.lang.String elementName, XMLStream
                     builder.account(parseReference("account", reader, accountElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -17965,6 +19095,7 @@ private EpisodeOfCare parseEpisodeOfCare(java.lang.String elementName, XMLStream
     private EpisodeOfCare.Diagnosis parseEpisodeOfCareDiagnosis(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EpisodeOfCare.Diagnosis.Builder builder = EpisodeOfCare.Diagnosis.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -17999,7 +19130,11 @@ private EpisodeOfCare.Diagnosis parseEpisodeOfCareDiagnosis(java.lang.String ele
                     builder.rank((PositiveInt) parseInteger(PositiveInt.builder(), "rank", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18016,6 +19151,7 @@ private EpisodeOfCare.Diagnosis parseEpisodeOfCareDiagnosis(java.lang.String ele
     private EpisodeOfCare.StatusHistory parseEpisodeOfCareStatusHistory(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EpisodeOfCare.StatusHistory.Builder builder = EpisodeOfCare.StatusHistory.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -18046,7 +19182,11 @@ private EpisodeOfCare.StatusHistory parseEpisodeOfCareStatusHistory(java.lang.St
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18063,6 +19203,7 @@ private EpisodeOfCare.StatusHistory parseEpisodeOfCareStatusHistory(java.lang.St
     private EventDefinition parseEventDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EventDefinition.Builder builder = EventDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, triggerElementIndex = 0;
         while (reader.hasNext()) {
@@ -18221,7 +19362,11 @@ private EventDefinition parseEventDefinition(java.lang.String elementName, XMLSt
                     builder.trigger(parseTriggerDefinition("trigger", reader, triggerElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18238,6 +19383,7 @@ private EventDefinition parseEventDefinition(java.lang.String elementName, XMLSt
     private Evidence parseEvidence(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Evidence.Builder builder = Evidence.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, noteElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, exposureVariantElementIndex = 0, outcomeElementIndex = 0;
         while (reader.hasNext()) {
@@ -18392,7 +19538,11 @@ private Evidence parseEvidence(java.lang.String elementName, XMLStreamReader rea
                     builder.outcome(parseReference("outcome", reader, outcomeElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18409,6 +19559,7 @@ private Evidence parseEvidence(java.lang.String elementName, XMLStreamReader rea
     private EvidenceVariable parseEvidenceVariable(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EvidenceVariable.Builder builder = EvidenceVariable.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, noteElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, characteristicElementIndex = 0;
         while (reader.hasNext()) {
@@ -18559,7 +19710,11 @@ private EvidenceVariable parseEvidenceVariable(java.lang.String elementName, XML
                     builder.characteristic(parseEvidenceVariableCharacteristic("characteristic", reader, characteristicElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18576,6 +19731,7 @@ private EvidenceVariable parseEvidenceVariable(java.lang.String elementName, XML
     private EvidenceVariable.Characteristic parseEvidenceVariableCharacteristic(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         EvidenceVariable.Characteristic.Builder builder = EvidenceVariable.Characteristic.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -18658,7 +19814,11 @@ private EvidenceVariable.Characteristic parseEvidenceVariableCharacteristic(java
                     builder.groupMeasure((GroupMeasure) parseString(GroupMeasure.builder(), "groupMeasure", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18675,6 +19835,7 @@ private EvidenceVariable.Characteristic parseEvidenceVariableCharacteristic(java
     private ExampleScenario parseExampleScenario(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExampleScenario.Builder builder = ExampleScenario.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, actorElementIndex = 0, instanceElementIndex = 0, processElementIndex = 0, workflowElementIndex = 0;
         while (reader.hasNext()) {
@@ -18785,7 +19946,11 @@ private ExampleScenario parseExampleScenario(java.lang.String elementName, XMLSt
                     builder.workflow((Canonical) parseUri(Canonical.builder(), "workflow", reader, workflowElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18802,6 +19967,7 @@ private ExampleScenario parseExampleScenario(java.lang.String elementName, XMLSt
     private ExampleScenario.Actor parseExampleScenarioActor(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExampleScenario.Actor.Builder builder = ExampleScenario.Actor.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -18840,7 +20006,11 @@ private ExampleScenario.Actor parseExampleScenarioActor(java.lang.String element
                     builder.description((Markdown) parseString(Markdown.builder(), "description", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18857,6 +20027,7 @@ private ExampleScenario.Actor parseExampleScenarioActor(java.lang.String element
     private ExampleScenario.Instance parseExampleScenarioInstance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExampleScenario.Instance.Builder builder = ExampleScenario.Instance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -18903,7 +20074,11 @@ private ExampleScenario.Instance parseExampleScenarioInstance(java.lang.String e
                     builder.containedInstance(parseExampleScenarioInstanceContainedInstance("containedInstance", reader, containedInstanceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18920,6 +20095,7 @@ private ExampleScenario.Instance parseExampleScenarioInstance(java.lang.String e
     private ExampleScenario.Instance.ContainedInstance parseExampleScenarioInstanceContainedInstance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExampleScenario.Instance.ContainedInstance.Builder builder = ExampleScenario.Instance.ContainedInstance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -18950,7 +20126,11 @@ private ExampleScenario.Instance.ContainedInstance parseExampleScenarioInstanceC
                     builder.versionId(parseString("versionId", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -18967,6 +20147,7 @@ private ExampleScenario.Instance.ContainedInstance parseExampleScenarioInstanceC
     private ExampleScenario.Instance.Version parseExampleScenarioInstanceVersion(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExampleScenario.Instance.Version.Builder builder = ExampleScenario.Instance.Version.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -18997,7 +20178,11 @@ private ExampleScenario.Instance.Version parseExampleScenarioInstanceVersion(jav
                     builder.description((Markdown) parseString(Markdown.builder(), "description", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19014,6 +20199,7 @@ private ExampleScenario.Instance.Version parseExampleScenarioInstanceVersion(jav
     private ExampleScenario.Process parseExampleScenarioProcess(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExampleScenario.Process.Builder builder = ExampleScenario.Process.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19056,7 +20242,11 @@ private ExampleScenario.Process parseExampleScenarioProcess(java.lang.String ele
                     builder.step(parseExampleScenarioProcessStep("step", reader, stepElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19073,6 +20263,7 @@ private ExampleScenario.Process parseExampleScenarioProcess(java.lang.String ele
     private ExampleScenario.Process.Step parseExampleScenarioProcessStep(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExampleScenario.Process.Step.Builder builder = ExampleScenario.Process.Step.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19111,7 +20302,11 @@ private ExampleScenario.Process.Step parseExampleScenarioProcessStep(java.lang.S
                     builder.alternative(parseExampleScenarioProcessStepAlternative("alternative", reader, alternativeElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19128,6 +20323,7 @@ private ExampleScenario.Process.Step parseExampleScenarioProcessStep(java.lang.S
     private ExampleScenario.Process.Step.Alternative parseExampleScenarioProcessStepAlternative(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExampleScenario.Process.Step.Alternative.Builder builder = ExampleScenario.Process.Step.Alternative.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19162,7 +20358,11 @@ private ExampleScenario.Process.Step.Alternative parseExampleScenarioProcessStep
                     builder.step(parseExampleScenarioProcessStep("step", reader, stepElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19179,6 +20379,7 @@ private ExampleScenario.Process.Step.Alternative parseExampleScenarioProcessStep
     private ExampleScenario.Process.Step.Operation parseExampleScenarioProcessStepOperation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExampleScenario.Process.Step.Operation.Builder builder = ExampleScenario.Process.Step.Operation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19241,7 +20442,11 @@ private ExampleScenario.Process.Step.Operation parseExampleScenarioProcessStepOp
                     builder.response(parseExampleScenarioInstanceContainedInstance("response", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19258,6 +20463,7 @@ private ExampleScenario.Process.Step.Operation parseExampleScenarioProcessStepOp
     private ExplanationOfBenefit parseExplanationOfBenefit(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Builder builder = ExplanationOfBenefit.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, relatedElementIndex = 0, preAuthRefElementIndex = 0, preAuthRefPeriodElementIndex = 0, careTeamElementIndex = 0, supportingInfoElementIndex = 0, diagnosisElementIndex = 0, procedureElementIndex = 0, insuranceElementIndex = 0, itemElementIndex = 0, addItemElementIndex = 0, adjudicationElementIndex = 0, totalElementIndex = 0, processNoteElementIndex = 0, benefitBalanceElementIndex = 0;
         while (reader.hasNext()) {
@@ -19472,7 +20678,11 @@ private ExplanationOfBenefit parseExplanationOfBenefit(java.lang.String elementN
                     builder.benefitBalance(parseExplanationOfBenefitBenefitBalance("benefitBalance", reader, benefitBalanceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19489,6 +20699,7 @@ private ExplanationOfBenefit parseExplanationOfBenefit(java.lang.String elementN
     private ExplanationOfBenefit.Accident parseExplanationOfBenefitAccident(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Accident.Builder builder = ExplanationOfBenefit.Accident.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19527,7 +20738,11 @@ private ExplanationOfBenefit.Accident parseExplanationOfBenefitAccident(java.lan
                     builder.location(parseReference("locationReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19544,6 +20759,7 @@ private ExplanationOfBenefit.Accident parseExplanationOfBenefitAccident(java.lan
     private ExplanationOfBenefit.AddItem parseExplanationOfBenefitAddItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.AddItem.Builder builder = ExplanationOfBenefit.AddItem.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19650,7 +20866,11 @@ private ExplanationOfBenefit.AddItem parseExplanationOfBenefitAddItem(java.lang.
                     builder.detail(parseExplanationOfBenefitAddItemDetail("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19667,6 +20887,7 @@ private ExplanationOfBenefit.AddItem parseExplanationOfBenefitAddItem(java.lang.
     private ExplanationOfBenefit.AddItem.Detail parseExplanationOfBenefitAddItemDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.AddItem.Detail.Builder builder = ExplanationOfBenefit.AddItem.Detail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19725,7 +20946,11 @@ private ExplanationOfBenefit.AddItem.Detail parseExplanationOfBenefitAddItemDeta
                     builder.subDetail(parseExplanationOfBenefitAddItemDetailSubDetail("subDetail", reader, subDetailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19742,6 +20967,7 @@ private ExplanationOfBenefit.AddItem.Detail parseExplanationOfBenefitAddItemDeta
     private ExplanationOfBenefit.AddItem.Detail.SubDetail parseExplanationOfBenefitAddItemDetailSubDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.AddItem.Detail.SubDetail.Builder builder = ExplanationOfBenefit.AddItem.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19796,7 +21022,11 @@ private ExplanationOfBenefit.AddItem.Detail.SubDetail parseExplanationOfBenefitA
                     builder.adjudication(parseExplanationOfBenefitItemAdjudication("adjudication", reader, adjudicationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19813,6 +21043,7 @@ private ExplanationOfBenefit.AddItem.Detail.SubDetail parseExplanationOfBenefitA
     private ExplanationOfBenefit.BenefitBalance parseExplanationOfBenefitBenefitBalance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.BenefitBalance.Builder builder = ExplanationOfBenefit.BenefitBalance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19867,7 +21098,11 @@ private ExplanationOfBenefit.BenefitBalance parseExplanationOfBenefitBenefitBala
                     builder.financial(parseExplanationOfBenefitBenefitBalanceFinancial("financial", reader, financialElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19884,6 +21119,7 @@ private ExplanationOfBenefit.BenefitBalance parseExplanationOfBenefitBenefitBala
     private ExplanationOfBenefit.BenefitBalance.Financial parseExplanationOfBenefitBenefitBalanceFinancial(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.BenefitBalance.Financial.Builder builder = ExplanationOfBenefit.BenefitBalance.Financial.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19930,7 +21166,11 @@ private ExplanationOfBenefit.BenefitBalance.Financial parseExplanationOfBenefitB
                     builder.used(parseMoney("usedMoney", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -19947,6 +21187,7 @@ private ExplanationOfBenefit.BenefitBalance.Financial parseExplanationOfBenefitB
     private ExplanationOfBenefit.CareTeam parseExplanationOfBenefitCareTeam(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.CareTeam.Builder builder = ExplanationOfBenefit.CareTeam.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -19989,7 +21230,11 @@ private ExplanationOfBenefit.CareTeam parseExplanationOfBenefitCareTeam(java.lan
                     builder.qualification(parseCodeableConcept("qualification", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20006,6 +21251,7 @@ private ExplanationOfBenefit.CareTeam parseExplanationOfBenefitCareTeam(java.lan
     private ExplanationOfBenefit.Diagnosis parseExplanationOfBenefitDiagnosis(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Diagnosis.Builder builder = ExplanationOfBenefit.Diagnosis.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20052,7 +21298,11 @@ private ExplanationOfBenefit.Diagnosis parseExplanationOfBenefitDiagnosis(java.l
                     builder.packageCode(parseCodeableConcept("packageCode", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20069,6 +21319,7 @@ private ExplanationOfBenefit.Diagnosis parseExplanationOfBenefitDiagnosis(java.l
     private ExplanationOfBenefit.Insurance parseExplanationOfBenefitInsurance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Insurance.Builder builder = ExplanationOfBenefit.Insurance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20103,7 +21354,11 @@ private ExplanationOfBenefit.Insurance parseExplanationOfBenefitInsurance(java.l
                     builder.preAuthRef(parseString("preAuthRef", reader, preAuthRefElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20120,6 +21375,7 @@ private ExplanationOfBenefit.Insurance parseExplanationOfBenefitInsurance(java.l
     private ExplanationOfBenefit.Item parseExplanationOfBenefitItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Item.Builder builder = ExplanationOfBenefit.Item.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20246,7 +21502,11 @@ private ExplanationOfBenefit.Item parseExplanationOfBenefitItem(java.lang.String
                     builder.detail(parseExplanationOfBenefitItemDetail("detail", reader, detailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20263,6 +21523,7 @@ private ExplanationOfBenefit.Item parseExplanationOfBenefitItem(java.lang.String
     private ExplanationOfBenefit.Item.Adjudication parseExplanationOfBenefitItemAdjudication(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Item.Adjudication.Builder builder = ExplanationOfBenefit.Item.Adjudication.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20301,7 +21562,11 @@ private ExplanationOfBenefit.Item.Adjudication parseExplanationOfBenefitItemAdju
                     builder.value(parseDecimal("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20318,6 +21583,7 @@ private ExplanationOfBenefit.Item.Adjudication parseExplanationOfBenefitItemAdju
     private ExplanationOfBenefit.Item.Detail parseExplanationOfBenefitItemDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Item.Detail.Builder builder = ExplanationOfBenefit.Item.Detail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20396,7 +21662,11 @@ private ExplanationOfBenefit.Item.Detail parseExplanationOfBenefitItemDetail(jav
                     builder.subDetail(parseExplanationOfBenefitItemDetailSubDetail("subDetail", reader, subDetailElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20413,6 +21683,7 @@ private ExplanationOfBenefit.Item.Detail parseExplanationOfBenefitItemDetail(jav
     private ExplanationOfBenefit.Item.Detail.SubDetail parseExplanationOfBenefitItemDetailSubDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Item.Detail.SubDetail.Builder builder = ExplanationOfBenefit.Item.Detail.SubDetail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20487,7 +21758,11 @@ private ExplanationOfBenefit.Item.Detail.SubDetail parseExplanationOfBenefitItem
                     builder.adjudication(parseExplanationOfBenefitItemAdjudication("adjudication", reader, adjudicationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20504,6 +21779,7 @@ private ExplanationOfBenefit.Item.Detail.SubDetail parseExplanationOfBenefitItem
     private ExplanationOfBenefit.Payee parseExplanationOfBenefitPayee(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Payee.Builder builder = ExplanationOfBenefit.Payee.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20534,7 +21810,11 @@ private ExplanationOfBenefit.Payee parseExplanationOfBenefitPayee(java.lang.Stri
                     builder.party(parseReference("party", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20551,6 +21831,7 @@ private ExplanationOfBenefit.Payee parseExplanationOfBenefitPayee(java.lang.Stri
     private ExplanationOfBenefit.Payment parseExplanationOfBenefitPayment(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Payment.Builder builder = ExplanationOfBenefit.Payment.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20597,7 +21878,11 @@ private ExplanationOfBenefit.Payment parseExplanationOfBenefitPayment(java.lang.
                     builder.identifier(parseIdentifier("identifier", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20614,6 +21899,7 @@ private ExplanationOfBenefit.Payment parseExplanationOfBenefitPayment(java.lang.
     private ExplanationOfBenefit.Procedure parseExplanationOfBenefitProcedure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Procedure.Builder builder = ExplanationOfBenefit.Procedure.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20660,7 +21946,11 @@ private ExplanationOfBenefit.Procedure parseExplanationOfBenefitProcedure(java.l
                     builder.udi(parseReference("udi", reader, udiElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20677,6 +21967,7 @@ private ExplanationOfBenefit.Procedure parseExplanationOfBenefitProcedure(java.l
     private ExplanationOfBenefit.ProcessNote parseExplanationOfBenefitProcessNote(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.ProcessNote.Builder builder = ExplanationOfBenefit.ProcessNote.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20715,7 +22006,11 @@ private ExplanationOfBenefit.ProcessNote parseExplanationOfBenefitProcessNote(ja
                     builder.language(parseCodeableConcept("language", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20732,6 +22027,7 @@ private ExplanationOfBenefit.ProcessNote parseExplanationOfBenefitProcessNote(ja
     private ExplanationOfBenefit.Related parseExplanationOfBenefitRelated(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Related.Builder builder = ExplanationOfBenefit.Related.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20766,7 +22062,11 @@ private ExplanationOfBenefit.Related parseExplanationOfBenefitRelated(java.lang.
                     builder.reference(parseIdentifier("reference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20783,6 +22083,7 @@ private ExplanationOfBenefit.Related parseExplanationOfBenefitRelated(java.lang.
     private ExplanationOfBenefit.SupportingInfo parseExplanationOfBenefitSupportingInfo(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.SupportingInfo.Builder builder = ExplanationOfBenefit.SupportingInfo.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20849,7 +22150,11 @@ private ExplanationOfBenefit.SupportingInfo parseExplanationOfBenefitSupportingI
                     builder.reason(parseCoding("reason", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20866,6 +22171,7 @@ private ExplanationOfBenefit.SupportingInfo parseExplanationOfBenefitSupportingI
     private ExplanationOfBenefit.Total parseExplanationOfBenefitTotal(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ExplanationOfBenefit.Total.Builder builder = ExplanationOfBenefit.Total.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20896,7 +22202,11 @@ private ExplanationOfBenefit.Total parseExplanationOfBenefitTotal(java.lang.Stri
                     builder.amount(parseMoney("amount", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20913,6 +22223,7 @@ private ExplanationOfBenefit.Total parseExplanationOfBenefitTotal(java.lang.Stri
     private Expression parseExpression(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Expression.Builder builder = Expression.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -20951,7 +22262,11 @@ private Expression parseExpression(java.lang.String elementName, XMLStreamReader
                     builder.reference(parseUri("reference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -20968,6 +22283,7 @@ private Expression parseExpression(java.lang.String elementName, XMLStreamReader
     private Extension parseExtension(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Extension.Builder builder = Extension.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -21190,7 +22506,11 @@ private Extension parseExtension(java.lang.String elementName, XMLStreamReader r
                     builder.value(parseMeta("valueMeta", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -21207,6 +22527,7 @@ private Extension parseExtension(java.lang.String elementName, XMLStreamReader r
     private FamilyMemberHistory parseFamilyMemberHistory(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         FamilyMemberHistory.Builder builder = FamilyMemberHistory.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, instantiatesCanonicalElementIndex = 0, instantiatesUriElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, noteElementIndex = 0, conditionElementIndex = 0;
         while (reader.hasNext()) {
@@ -21353,7 +22674,11 @@ private FamilyMemberHistory parseFamilyMemberHistory(java.lang.String elementNam
                     builder.condition(parseFamilyMemberHistoryCondition("condition", reader, conditionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -21370,6 +22695,7 @@ private FamilyMemberHistory parseFamilyMemberHistory(java.lang.String elementNam
     private FamilyMemberHistory.Condition parseFamilyMemberHistoryCondition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         FamilyMemberHistory.Condition.Builder builder = FamilyMemberHistory.Condition.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -21424,7 +22750,11 @@ private FamilyMemberHistory.Condition parseFamilyMemberHistoryCondition(java.lan
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -21441,6 +22771,7 @@ private FamilyMemberHistory.Condition parseFamilyMemberHistoryCondition(java.lan
     private Flag parseFlag(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Flag.Builder builder = Flag.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0;
         while (reader.hasNext()) {
@@ -21515,7 +22846,11 @@ private Flag parseFlag(java.lang.String elementName, XMLStreamReader reader, int
                     builder.author(parseReference("author", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -21532,6 +22867,7 @@ private Flag parseFlag(java.lang.String elementName, XMLStreamReader reader, int
     private Goal parseGoal(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Goal.Builder builder = Goal.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0, targetElementIndex = 0, addressesElementIndex = 0, noteElementIndex = 0, outcomeCodeElementIndex = 0, outcomeReferenceElementIndex = 0;
         while (reader.hasNext()) {
@@ -21642,7 +22978,11 @@ private Goal parseGoal(java.lang.String elementName, XMLStreamReader reader, int
                     builder.outcomeReference(parseReference("outcomeReference", reader, outcomeReferenceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -21659,6 +22999,7 @@ private Goal parseGoal(java.lang.String elementName, XMLStreamReader reader, int
     private Goal.Target parseGoalTarget(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Goal.Target.Builder builder = Goal.Target.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -21721,7 +23062,11 @@ private Goal.Target parseGoalTarget(java.lang.String elementName, XMLStreamReade
                     builder.due((Duration) parseQuantity(Duration.builder(), "dueDuration", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -21738,6 +23083,7 @@ private Goal.Target parseGoalTarget(java.lang.String elementName, XMLStreamReade
     private GraphDefinition parseGraphDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         GraphDefinition.Builder builder = GraphDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, linkElementIndex = 0;
         while (reader.hasNext()) {
@@ -21840,7 +23186,11 @@ private GraphDefinition parseGraphDefinition(java.lang.String elementName, XMLSt
                     builder.link(parseGraphDefinitionLink("link", reader, linkElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -21857,6 +23207,7 @@ private GraphDefinition parseGraphDefinition(java.lang.String elementName, XMLSt
     private GraphDefinition.Link parseGraphDefinitionLink(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         GraphDefinition.Link.Builder builder = GraphDefinition.Link.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -21903,7 +23254,11 @@ private GraphDefinition.Link parseGraphDefinitionLink(java.lang.String elementNa
                     builder.target(parseGraphDefinitionLinkTarget("target", reader, targetElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -21920,6 +23275,7 @@ private GraphDefinition.Link parseGraphDefinitionLink(java.lang.String elementNa
     private GraphDefinition.Link.Target parseGraphDefinitionLinkTarget(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         GraphDefinition.Link.Target.Builder builder = GraphDefinition.Link.Target.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -21962,7 +23318,11 @@ private GraphDefinition.Link.Target parseGraphDefinitionLinkTarget(java.lang.Str
                     builder.link(parseGraphDefinitionLink("link", reader, linkElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -21979,6 +23339,7 @@ private GraphDefinition.Link.Target parseGraphDefinitionLinkTarget(java.lang.Str
     private GraphDefinition.Link.Target.Compartment parseGraphDefinitionLinkTargetCompartment(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         GraphDefinition.Link.Target.Compartment.Builder builder = GraphDefinition.Link.Target.Compartment.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -22021,7 +23382,11 @@ private GraphDefinition.Link.Target.Compartment parseGraphDefinitionLinkTargetCo
                     builder.description(parseString("description", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22038,6 +23403,7 @@ private GraphDefinition.Link.Target.Compartment parseGraphDefinitionLinkTargetCo
     private Group parseGroup(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Group.Builder builder = Group.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, characteristicElementIndex = 0, memberElementIndex = 0;
         while (reader.hasNext()) {
@@ -22120,7 +23486,11 @@ private Group parseGroup(java.lang.String elementName, XMLStreamReader reader, i
                     builder.member(parseGroupMember("member", reader, memberElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22137,6 +23507,7 @@ private Group parseGroup(java.lang.String elementName, XMLStreamReader reader, i
     private Group.Characteristic parseGroupCharacteristic(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Group.Characteristic.Builder builder = Group.Characteristic.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -22191,7 +23562,11 @@ private Group.Characteristic parseGroupCharacteristic(java.lang.String elementNa
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22208,6 +23583,7 @@ private Group.Characteristic parseGroupCharacteristic(java.lang.String elementNa
     private Group.Member parseGroupMember(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Group.Member.Builder builder = Group.Member.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -22242,7 +23618,11 @@ private Group.Member parseGroupMember(java.lang.String elementName, XMLStreamRea
                     builder.inactive(parseBoolean("inactive", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22259,6 +23639,7 @@ private Group.Member parseGroupMember(java.lang.String elementName, XMLStreamRea
     private GuidanceResponse parseGuidanceResponse(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         GuidanceResponse.Builder builder = GuidanceResponse.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, noteElementIndex = 0, evaluationMessageElementIndex = 0, dataRequirementElementIndex = 0;
         while (reader.hasNext()) {
@@ -22369,7 +23750,11 @@ private GuidanceResponse parseGuidanceResponse(java.lang.String elementName, XML
                     builder.dataRequirement(parseDataRequirement("dataRequirement", reader, dataRequirementElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22386,6 +23771,7 @@ private GuidanceResponse parseGuidanceResponse(java.lang.String elementName, XML
     private HealthcareService parseHealthcareService(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         HealthcareService.Builder builder = HealthcareService.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0, typeElementIndex = 0, specialtyElementIndex = 0, locationElementIndex = 0, telecomElementIndex = 0, coverageAreaElementIndex = 0, serviceProvisionCodeElementIndex = 0, eligibilityElementIndex = 0, programElementIndex = 0, characteristicElementIndex = 0, communicationElementIndex = 0, referralMethodElementIndex = 0, availableTimeElementIndex = 0, notAvailableElementIndex = 0, endpointElementIndex = 0;
         while (reader.hasNext()) {
@@ -22524,7 +23910,11 @@ private HealthcareService parseHealthcareService(java.lang.String elementName, X
                     builder.endpoint(parseReference("endpoint", reader, endpointElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22541,6 +23931,7 @@ private HealthcareService parseHealthcareService(java.lang.String elementName, X
     private HealthcareService.AvailableTime parseHealthcareServiceAvailableTime(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         HealthcareService.AvailableTime.Builder builder = HealthcareService.AvailableTime.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -22579,7 +23970,11 @@ private HealthcareService.AvailableTime parseHealthcareServiceAvailableTime(java
                     builder.availableEndTime(parseTime("availableEndTime", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22596,6 +23991,7 @@ private HealthcareService.AvailableTime parseHealthcareServiceAvailableTime(java
     private HealthcareService.Eligibility parseHealthcareServiceEligibility(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         HealthcareService.Eligibility.Builder builder = HealthcareService.Eligibility.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -22626,7 +24022,11 @@ private HealthcareService.Eligibility parseHealthcareServiceEligibility(java.lan
                     builder.comment((Markdown) parseString(Markdown.builder(), "comment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22643,6 +24043,7 @@ private HealthcareService.Eligibility parseHealthcareServiceEligibility(java.lan
     private HealthcareService.NotAvailable parseHealthcareServiceNotAvailable(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         HealthcareService.NotAvailable.Builder builder = HealthcareService.NotAvailable.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -22673,7 +24074,11 @@ private HealthcareService.NotAvailable parseHealthcareServiceNotAvailable(java.l
                     builder.during(parsePeriod("during", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22690,6 +24095,7 @@ private HealthcareService.NotAvailable parseHealthcareServiceNotAvailable(java.l
     private HumanName parseHumanName(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         HumanName.Builder builder = HumanName.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -22736,7 +24142,11 @@ private HumanName parseHumanName(java.lang.String elementName, XMLStreamReader r
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22753,6 +24163,7 @@ private HumanName parseHumanName(java.lang.String elementName, XMLStreamReader r
     private Identifier parseIdentifier(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Identifier.Builder builder = Identifier.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -22795,7 +24206,11 @@ private Identifier parseIdentifier(java.lang.String elementName, XMLStreamReader
                     builder.assigner(parseReference("assigner", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22812,6 +24227,7 @@ private Identifier parseIdentifier(java.lang.String elementName, XMLStreamReader
     private ImagingStudy parseImagingStudy(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImagingStudy.Builder builder = ImagingStudy.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, modalityElementIndex = 0, basedOnElementIndex = 0, interpreterElementIndex = 0, endpointElementIndex = 0, procedureCodeElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, noteElementIndex = 0, seriesElementIndex = 0;
         while (reader.hasNext()) {
@@ -22934,7 +24350,11 @@ private ImagingStudy parseImagingStudy(java.lang.String elementName, XMLStreamRe
                     builder.series(parseImagingStudySeries("series", reader, seriesElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -22951,6 +24371,7 @@ private ImagingStudy parseImagingStudy(java.lang.String elementName, XMLStreamRe
     private ImagingStudy.Series parseImagingStudySeries(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImagingStudy.Series.Builder builder = ImagingStudy.Series.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -23021,7 +24442,11 @@ private ImagingStudy.Series parseImagingStudySeries(java.lang.String elementName
                     builder.instance(parseImagingStudySeriesInstance("instance", reader, instanceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23038,6 +24463,7 @@ private ImagingStudy.Series parseImagingStudySeries(java.lang.String elementName
     private ImagingStudy.Series.Instance parseImagingStudySeriesInstance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImagingStudy.Series.Instance.Builder builder = ImagingStudy.Series.Instance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -23076,7 +24502,11 @@ private ImagingStudy.Series.Instance parseImagingStudySeriesInstance(java.lang.S
                     builder.title(parseString("title", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23093,6 +24523,7 @@ private ImagingStudy.Series.Instance parseImagingStudySeriesInstance(java.lang.S
     private ImagingStudy.Series.Performer parseImagingStudySeriesPerformer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImagingStudy.Series.Performer.Builder builder = ImagingStudy.Series.Performer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -23123,7 +24554,11 @@ private ImagingStudy.Series.Performer parseImagingStudySeriesPerformer(java.lang
                     builder.actor(parseReference("actor", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23140,6 +24575,7 @@ private ImagingStudy.Series.Performer parseImagingStudySeriesPerformer(java.lang
     private Immunization parseImmunization(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Immunization.Builder builder = Immunization.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, performerElementIndex = 0, noteElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, subpotentReasonElementIndex = 0, educationElementIndex = 0, programEligibilityElementIndex = 0, reactionElementIndex = 0, protocolAppliedElementIndex = 0;
         while (reader.hasNext()) {
@@ -23298,7 +24734,11 @@ private Immunization parseImmunization(java.lang.String elementName, XMLStreamRe
                     builder.protocolApplied(parseImmunizationProtocolApplied("protocolApplied", reader, protocolAppliedElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23315,6 +24755,7 @@ private Immunization parseImmunization(java.lang.String elementName, XMLStreamRe
     private Immunization.Education parseImmunizationEducation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Immunization.Education.Builder builder = Immunization.Education.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -23353,7 +24794,11 @@ private Immunization.Education parseImmunizationEducation(java.lang.String eleme
                     builder.presentationDate(parseDateTime("presentationDate", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23370,6 +24815,7 @@ private Immunization.Education parseImmunizationEducation(java.lang.String eleme
     private Immunization.Performer parseImmunizationPerformer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Immunization.Performer.Builder builder = Immunization.Performer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -23400,7 +24846,11 @@ private Immunization.Performer parseImmunizationPerformer(java.lang.String eleme
                     builder.actor(parseReference("actor", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23417,6 +24867,7 @@ private Immunization.Performer parseImmunizationPerformer(java.lang.String eleme
     private Immunization.ProtocolApplied parseImmunizationProtocolApplied(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Immunization.ProtocolApplied.Builder builder = Immunization.ProtocolApplied.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -23467,7 +24918,11 @@ private Immunization.ProtocolApplied parseImmunizationProtocolApplied(java.lang.
                     builder.seriesDoses(parseString("seriesDosesString", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23484,6 +24939,7 @@ private Immunization.ProtocolApplied parseImmunizationProtocolApplied(java.lang.
     private Immunization.Reaction parseImmunizationReaction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Immunization.Reaction.Builder builder = Immunization.Reaction.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -23518,7 +24974,11 @@ private Immunization.Reaction parseImmunizationReaction(java.lang.String element
                     builder.reported(parseBoolean("reported", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23535,6 +24995,7 @@ private Immunization.Reaction parseImmunizationReaction(java.lang.String element
     private ImmunizationEvaluation parseImmunizationEvaluation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImmunizationEvaluation.Builder builder = ImmunizationEvaluation.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, doseStatusReasonElementIndex = 0;
         while (reader.hasNext()) {
@@ -23637,7 +25098,11 @@ private ImmunizationEvaluation parseImmunizationEvaluation(java.lang.String elem
                     builder.seriesDoses(parseString("seriesDosesString", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23654,6 +25119,7 @@ private ImmunizationEvaluation parseImmunizationEvaluation(java.lang.String elem
     private ImmunizationRecommendation parseImmunizationRecommendation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImmunizationRecommendation.Builder builder = ImmunizationRecommendation.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, recommendationElementIndex = 0;
         while (reader.hasNext()) {
@@ -23716,7 +25182,11 @@ private ImmunizationRecommendation parseImmunizationRecommendation(java.lang.Str
                     builder.recommendation(parseImmunizationRecommendationRecommendation("recommendation", reader, recommendationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23733,6 +25203,7 @@ private ImmunizationRecommendation parseImmunizationRecommendation(java.lang.Str
     private ImmunizationRecommendation.Recommendation parseImmunizationRecommendationRecommendation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImmunizationRecommendation.Recommendation.Builder builder = ImmunizationRecommendation.Recommendation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -23811,7 +25282,11 @@ private ImmunizationRecommendation.Recommendation parseImmunizationRecommendatio
                     builder.supportingPatientInformation(parseReference("supportingPatientInformation", reader, supportingPatientInformationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23828,6 +25303,7 @@ private ImmunizationRecommendation.Recommendation parseImmunizationRecommendatio
     private ImmunizationRecommendation.Recommendation.DateCriterion parseImmunizationRecommendationRecommendationDateCriterion(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImmunizationRecommendation.Recommendation.DateCriterion.Builder builder = ImmunizationRecommendation.Recommendation.DateCriterion.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -23858,7 +25334,11 @@ private ImmunizationRecommendation.Recommendation.DateCriterion parseImmunizatio
                     builder.value(parseDateTime("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -23875,6 +25355,7 @@ private ImmunizationRecommendation.Recommendation.DateCriterion parseImmunizatio
     private ImplementationGuide parseImplementationGuide(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Builder builder = ImplementationGuide.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, fhirVersionElementIndex = 0, dependsOnElementIndex = 0, globalElementIndex = 0;
         while (reader.hasNext()) {
@@ -23997,7 +25478,11 @@ private ImplementationGuide parseImplementationGuide(java.lang.String elementNam
                     builder.manifest(parseImplementationGuideManifest("manifest", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24014,6 +25499,7 @@ private ImplementationGuide parseImplementationGuide(java.lang.String elementNam
     private ImplementationGuide.Definition parseImplementationGuideDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Definition.Builder builder = ImplementationGuide.Definition.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24056,7 +25542,11 @@ private ImplementationGuide.Definition parseImplementationGuideDefinition(java.l
                     builder.template(parseImplementationGuideDefinitionTemplate("template", reader, templateElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24073,6 +25563,7 @@ private ImplementationGuide.Definition parseImplementationGuideDefinition(java.l
     private ImplementationGuide.Definition.Grouping parseImplementationGuideDefinitionGrouping(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Definition.Grouping.Builder builder = ImplementationGuide.Definition.Grouping.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24103,7 +25594,11 @@ private ImplementationGuide.Definition.Grouping parseImplementationGuideDefiniti
                     builder.description(parseString("description", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24120,6 +25615,7 @@ private ImplementationGuide.Definition.Grouping parseImplementationGuideDefiniti
     private ImplementationGuide.Definition.Page parseImplementationGuideDefinitionPage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Definition.Page.Builder builder = ImplementationGuide.Definition.Page.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24162,7 +25658,11 @@ private ImplementationGuide.Definition.Page parseImplementationGuideDefinitionPa
                     builder.page(parseImplementationGuideDefinitionPage("page", reader, pageElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24179,6 +25679,7 @@ private ImplementationGuide.Definition.Page parseImplementationGuideDefinitionPa
     private ImplementationGuide.Definition.Parameter parseImplementationGuideDefinitionParameter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Definition.Parameter.Builder builder = ImplementationGuide.Definition.Parameter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24209,7 +25710,11 @@ private ImplementationGuide.Definition.Parameter parseImplementationGuideDefinit
                     builder.value(parseString("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24226,6 +25731,7 @@ private ImplementationGuide.Definition.Parameter parseImplementationGuideDefinit
     private ImplementationGuide.Definition.Resource parseImplementationGuideDefinitionResource(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Definition.Resource.Builder builder = ImplementationGuide.Definition.Resource.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24276,7 +25782,11 @@ private ImplementationGuide.Definition.Resource parseImplementationGuideDefiniti
                     builder.groupingId((Id) parseString(Id.builder(), "groupingId", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24293,6 +25803,7 @@ private ImplementationGuide.Definition.Resource parseImplementationGuideDefiniti
     private ImplementationGuide.Definition.Template parseImplementationGuideDefinitionTemplate(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Definition.Template.Builder builder = ImplementationGuide.Definition.Template.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24327,7 +25838,11 @@ private ImplementationGuide.Definition.Template parseImplementationGuideDefiniti
                     builder.scope(parseString("scope", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24344,6 +25859,7 @@ private ImplementationGuide.Definition.Template parseImplementationGuideDefiniti
     private ImplementationGuide.DependsOn parseImplementationGuideDependsOn(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.DependsOn.Builder builder = ImplementationGuide.DependsOn.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24378,7 +25894,11 @@ private ImplementationGuide.DependsOn parseImplementationGuideDependsOn(java.lan
                     builder.version(parseString("version", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24395,6 +25915,7 @@ private ImplementationGuide.DependsOn parseImplementationGuideDependsOn(java.lan
     private ImplementationGuide.Global parseImplementationGuideGlobal(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Global.Builder builder = ImplementationGuide.Global.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24425,7 +25946,11 @@ private ImplementationGuide.Global parseImplementationGuideGlobal(java.lang.Stri
                     builder.profile((Canonical) parseUri(Canonical.builder(), "profile", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24442,6 +25967,7 @@ private ImplementationGuide.Global parseImplementationGuideGlobal(java.lang.Stri
     private ImplementationGuide.Manifest parseImplementationGuideManifest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Manifest.Builder builder = ImplementationGuide.Manifest.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24484,7 +26010,11 @@ private ImplementationGuide.Manifest parseImplementationGuideManifest(java.lang.
                     builder.other(parseString("other", reader, otherElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24501,6 +26031,7 @@ private ImplementationGuide.Manifest parseImplementationGuideManifest(java.lang.
     private ImplementationGuide.Manifest.Page parseImplementationGuideManifestPage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Manifest.Page.Builder builder = ImplementationGuide.Manifest.Page.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24535,7 +26066,11 @@ private ImplementationGuide.Manifest.Page parseImplementationGuideManifestPage(j
                     builder.anchor(parseString("anchor", reader, anchorElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24552,6 +26087,7 @@ private ImplementationGuide.Manifest.Page parseImplementationGuideManifestPage(j
     private ImplementationGuide.Manifest.Resource parseImplementationGuideManifestResource(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ImplementationGuide.Manifest.Resource.Builder builder = ImplementationGuide.Manifest.Resource.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24590,7 +26126,11 @@ private ImplementationGuide.Manifest.Resource parseImplementationGuideManifestRe
                     builder.relativePath((Url) parseUri(Url.builder(), "relativePath", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24607,6 +26147,7 @@ private ImplementationGuide.Manifest.Resource parseImplementationGuideManifestRe
     private Instant parseInstant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Instant.Builder builder = Instant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24629,7 +26170,11 @@ private Instant parseInstant(java.lang.String elementName, XMLStreamReader reade
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24646,6 +26191,7 @@ private Instant parseInstant(java.lang.String elementName, XMLStreamReader reade
     private InsurancePlan parseInsurancePlan(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Builder builder = InsurancePlan.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, typeElementIndex = 0, aliasElementIndex = 0, coverageAreaElementIndex = 0, contactElementIndex = 0, endpointElementIndex = 0, networkElementIndex = 0, coverageElementIndex = 0, planElementIndex = 0;
         while (reader.hasNext()) {
@@ -24744,7 +26290,11 @@ private InsurancePlan parseInsurancePlan(java.lang.String elementName, XMLStream
                     builder.plan(parseInsurancePlanPlan("plan", reader, planElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24761,6 +26311,7 @@ private InsurancePlan parseInsurancePlan(java.lang.String elementName, XMLStream
     private InsurancePlan.Contact parseInsurancePlanContact(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Contact.Builder builder = InsurancePlan.Contact.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24799,7 +26350,11 @@ private InsurancePlan.Contact parseInsurancePlanContact(java.lang.String element
                     builder.address(parseAddress("address", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24816,6 +26371,7 @@ private InsurancePlan.Contact parseInsurancePlanContact(java.lang.String element
     private InsurancePlan.Coverage parseInsurancePlanCoverage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Coverage.Builder builder = InsurancePlan.Coverage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24850,7 +26406,11 @@ private InsurancePlan.Coverage parseInsurancePlanCoverage(java.lang.String eleme
                     builder.benefit(parseInsurancePlanCoverageBenefit("benefit", reader, benefitElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24867,6 +26427,7 @@ private InsurancePlan.Coverage parseInsurancePlanCoverage(java.lang.String eleme
     private InsurancePlan.Coverage.Benefit parseInsurancePlanCoverageBenefit(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Coverage.Benefit.Builder builder = InsurancePlan.Coverage.Benefit.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24901,7 +26462,11 @@ private InsurancePlan.Coverage.Benefit parseInsurancePlanCoverageBenefit(java.la
                     builder.limit(parseInsurancePlanCoverageBenefitLimit("limit", reader, limitElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24918,6 +26483,7 @@ private InsurancePlan.Coverage.Benefit parseInsurancePlanCoverageBenefit(java.la
     private InsurancePlan.Coverage.Benefit.Limit parseInsurancePlanCoverageBenefitLimit(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Coverage.Benefit.Limit.Builder builder = InsurancePlan.Coverage.Benefit.Limit.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -24948,7 +26514,11 @@ private InsurancePlan.Coverage.Benefit.Limit parseInsurancePlanCoverageBenefitLi
                     builder.code(parseCodeableConcept("code", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -24965,6 +26535,7 @@ private InsurancePlan.Coverage.Benefit.Limit parseInsurancePlanCoverageBenefitLi
     private InsurancePlan.Plan parseInsurancePlanPlan(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Plan.Builder builder = InsurancePlan.Plan.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25011,7 +26582,11 @@ private InsurancePlan.Plan parseInsurancePlanPlan(java.lang.String elementName,
                     builder.specificCost(parseInsurancePlanPlanSpecificCost("specificCost", reader, specificCostElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25028,6 +26603,7 @@ private InsurancePlan.Plan parseInsurancePlanPlan(java.lang.String elementName,
     private InsurancePlan.Plan.GeneralCost parseInsurancePlanPlanGeneralCost(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Plan.GeneralCost.Builder builder = InsurancePlan.Plan.GeneralCost.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25066,7 +26642,11 @@ private InsurancePlan.Plan.GeneralCost parseInsurancePlanPlanGeneralCost(java.la
                     builder.comment(parseString("comment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25083,6 +26663,7 @@ private InsurancePlan.Plan.GeneralCost parseInsurancePlanPlanGeneralCost(java.la
     private InsurancePlan.Plan.SpecificCost parseInsurancePlanPlanSpecificCost(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Plan.SpecificCost.Builder builder = InsurancePlan.Plan.SpecificCost.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25113,7 +26694,11 @@ private InsurancePlan.Plan.SpecificCost parseInsurancePlanPlanSpecificCost(java.
                     builder.benefit(parseInsurancePlanPlanSpecificCostBenefit("benefit", reader, benefitElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25130,6 +26715,7 @@ private InsurancePlan.Plan.SpecificCost parseInsurancePlanPlanSpecificCost(java.
     private InsurancePlan.Plan.SpecificCost.Benefit parseInsurancePlanPlanSpecificCostBenefit(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Plan.SpecificCost.Benefit.Builder builder = InsurancePlan.Plan.SpecificCost.Benefit.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25160,7 +26746,11 @@ private InsurancePlan.Plan.SpecificCost.Benefit parseInsurancePlanPlanSpecificCo
                     builder.cost(parseInsurancePlanPlanSpecificCostBenefitCost("cost", reader, costElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25177,6 +26767,7 @@ private InsurancePlan.Plan.SpecificCost.Benefit parseInsurancePlanPlanSpecificCo
     private InsurancePlan.Plan.SpecificCost.Benefit.Cost parseInsurancePlanPlanSpecificCostBenefitCost(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         InsurancePlan.Plan.SpecificCost.Benefit.Cost.Builder builder = InsurancePlan.Plan.SpecificCost.Benefit.Cost.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25215,7 +26806,11 @@ private InsurancePlan.Plan.SpecificCost.Benefit.Cost parseInsurancePlanPlanSpeci
                     builder.value(parseQuantity("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25231,6 +26826,7 @@ private InsurancePlan.Plan.SpecificCost.Benefit.Cost parseInsurancePlanPlanSpeci
 
     private Integer parseInteger(Integer.Builder builder, java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25253,7 +26849,11 @@ private Integer parseInteger(Integer.Builder builder, java.lang.String elementNa
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25274,6 +26874,7 @@ private Integer parseInteger(java.lang.String elementName, XMLStreamReader reade
     private Invoice parseInvoice(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Invoice.Builder builder = Invoice.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, participantElementIndex = 0, lineItemElementIndex = 0, totalPriceComponentElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -25380,7 +26981,11 @@ private Invoice parseInvoice(java.lang.String elementName, XMLStreamReader reade
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25397,6 +27002,7 @@ private Invoice parseInvoice(java.lang.String elementName, XMLStreamReader reade
     private Invoice.LineItem parseInvoiceLineItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Invoice.LineItem.Builder builder = Invoice.LineItem.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25435,7 +27041,11 @@ private Invoice.LineItem parseInvoiceLineItem(java.lang.String elementName, XMLS
                     builder.priceComponent(parseInvoiceLineItemPriceComponent("priceComponent", reader, priceComponentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25452,6 +27062,7 @@ private Invoice.LineItem parseInvoiceLineItem(java.lang.String elementName, XMLS
     private Invoice.LineItem.PriceComponent parseInvoiceLineItemPriceComponent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Invoice.LineItem.PriceComponent.Builder builder = Invoice.LineItem.PriceComponent.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25490,7 +27101,11 @@ private Invoice.LineItem.PriceComponent parseInvoiceLineItemPriceComponent(java.
                     builder.amount(parseMoney("amount", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25507,6 +27122,7 @@ private Invoice.LineItem.PriceComponent parseInvoiceLineItemPriceComponent(java.
     private Invoice.Participant parseInvoiceParticipant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Invoice.Participant.Builder builder = Invoice.Participant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25537,7 +27153,11 @@ private Invoice.Participant parseInvoiceParticipant(java.lang.String elementName
                     builder.actor(parseReference("actor", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25554,6 +27174,7 @@ private Invoice.Participant parseInvoiceParticipant(java.lang.String elementName
     private Library parseLibrary(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Library.Builder builder = Library.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, parameterElementIndex = 0, dataRequirementElementIndex = 0, contentElementIndex = 0;
         while (reader.hasNext()) {
@@ -25724,7 +27345,11 @@ private Library parseLibrary(java.lang.String elementName, XMLStreamReader reade
                     builder.content(parseAttachment("content", reader, contentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25741,6 +27366,7 @@ private Library parseLibrary(java.lang.String elementName, XMLStreamReader reade
     private Linkage parseLinkage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Linkage.Builder builder = Linkage.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, itemElementIndex = 0;
         while (reader.hasNext()) {
@@ -25795,7 +27421,11 @@ private Linkage parseLinkage(java.lang.String elementName, XMLStreamReader reade
                     builder.item(parseLinkageItem("item", reader, itemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25812,6 +27442,7 @@ private Linkage parseLinkage(java.lang.String elementName, XMLStreamReader reade
     private Linkage.Item parseLinkageItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Linkage.Item.Builder builder = Linkage.Item.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -25842,7 +27473,11 @@ private Linkage.Item parseLinkageItem(java.lang.String elementName, XMLStreamRea
                     builder.resource(parseReference("resource", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25859,6 +27494,7 @@ private Linkage.Item parseLinkageItem(java.lang.String elementName, XMLStreamRea
     private List parseList(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         List.Builder builder = List.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, noteElementIndex = 0, entryElementIndex = 0;
         while (reader.hasNext()) {
@@ -25953,7 +27589,11 @@ private List parseList(java.lang.String elementName, XMLStreamReader reader, int
                     builder.emptyReason(parseCodeableConcept("emptyReason", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -25970,6 +27610,7 @@ private List parseList(java.lang.String elementName, XMLStreamReader reader, int
     private List.Entry parseListEntry(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         List.Entry.Builder builder = List.Entry.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26008,7 +27649,11 @@ private List.Entry parseListEntry(java.lang.String elementName, XMLStreamReader
                     builder.item(parseReference("item", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26025,6 +27670,7 @@ private List.Entry parseListEntry(java.lang.String elementName, XMLStreamReader
     private Location parseLocation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Location.Builder builder = Location.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, aliasElementIndex = 0, typeElementIndex = 0, telecomElementIndex = 0, hoursOfOperationElementIndex = 0, endpointElementIndex = 0;
         while (reader.hasNext()) {
@@ -26135,7 +27781,11 @@ private Location parseLocation(java.lang.String elementName, XMLStreamReader rea
                     builder.endpoint(parseReference("endpoint", reader, endpointElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26152,6 +27802,7 @@ private Location parseLocation(java.lang.String elementName, XMLStreamReader rea
     private Location.HoursOfOperation parseLocationHoursOfOperation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Location.HoursOfOperation.Builder builder = Location.HoursOfOperation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26190,7 +27841,11 @@ private Location.HoursOfOperation parseLocationHoursOfOperation(java.lang.String
                     builder.closingTime(parseTime("closingTime", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26207,6 +27862,7 @@ private Location.HoursOfOperation parseLocationHoursOfOperation(java.lang.String
     private Location.Position parseLocationPosition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Location.Position.Builder builder = Location.Position.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26241,7 +27897,11 @@ private Location.Position parseLocationPosition(java.lang.String elementName, XM
                     builder.altitude(parseDecimal("altitude", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26258,6 +27918,7 @@ private Location.Position parseLocationPosition(java.lang.String elementName, XM
     private MarketingStatus parseMarketingStatus(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MarketingStatus.Builder builder = MarketingStatus.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26300,7 +27961,11 @@ private MarketingStatus parseMarketingStatus(java.lang.String elementName, XMLSt
                     builder.restoreDate(parseDateTime("restoreDate", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26317,6 +27982,7 @@ private MarketingStatus parseMarketingStatus(java.lang.String elementName, XMLSt
     private Measure parseMeasure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Measure.Builder builder = Measure.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, libraryElementIndex = 0, typeElementIndex = 0, definitionElementIndex = 0, groupElementIndex = 0, supplementalDataElementIndex = 0;
         while (reader.hasNext()) {
@@ -26527,7 +28193,11 @@ private Measure parseMeasure(java.lang.String elementName, XMLStreamReader reade
                     builder.supplementalData(parseMeasureSupplementalData("supplementalData", reader, supplementalDataElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26544,6 +28214,7 @@ private Measure parseMeasure(java.lang.String elementName, XMLStreamReader reade
     private Measure.Group parseMeasureGroup(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Measure.Group.Builder builder = Measure.Group.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26582,7 +28253,11 @@ private Measure.Group parseMeasureGroup(java.lang.String elementName, XMLStreamR
                     builder.stratifier(parseMeasureGroupStratifier("stratifier", reader, stratifierElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26599,6 +28274,7 @@ private Measure.Group parseMeasureGroup(java.lang.String elementName, XMLStreamR
     private Measure.Group.Population parseMeasureGroupPopulation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Measure.Group.Population.Builder builder = Measure.Group.Population.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26633,7 +28309,11 @@ private Measure.Group.Population parseMeasureGroupPopulation(java.lang.String el
                     builder.criteria(parseExpression("criteria", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26650,6 +28330,7 @@ private Measure.Group.Population parseMeasureGroupPopulation(java.lang.String el
     private Measure.Group.Stratifier parseMeasureGroupStratifier(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Measure.Group.Stratifier.Builder builder = Measure.Group.Stratifier.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26688,7 +28369,11 @@ private Measure.Group.Stratifier parseMeasureGroupStratifier(java.lang.String el
                     builder.component(parseMeasureGroupStratifierComponent("component", reader, componentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26705,6 +28390,7 @@ private Measure.Group.Stratifier parseMeasureGroupStratifier(java.lang.String el
     private Measure.Group.Stratifier.Component parseMeasureGroupStratifierComponent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Measure.Group.Stratifier.Component.Builder builder = Measure.Group.Stratifier.Component.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26739,7 +28425,11 @@ private Measure.Group.Stratifier.Component parseMeasureGroupStratifierComponent(
                     builder.criteria(parseExpression("criteria", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26756,6 +28446,7 @@ private Measure.Group.Stratifier.Component parseMeasureGroupStratifierComponent(
     private Measure.SupplementalData parseMeasureSupplementalData(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Measure.SupplementalData.Builder builder = Measure.SupplementalData.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26794,7 +28485,11 @@ private Measure.SupplementalData parseMeasureSupplementalData(java.lang.String e
                     builder.criteria(parseExpression("criteria", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26811,6 +28506,7 @@ private Measure.SupplementalData parseMeasureSupplementalData(java.lang.String e
     private MeasureReport parseMeasureReport(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MeasureReport.Builder builder = MeasureReport.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, groupElementIndex = 0, evaluatedResourceElementIndex = 0;
         while (reader.hasNext()) {
@@ -26897,7 +28593,11 @@ private MeasureReport parseMeasureReport(java.lang.String elementName, XMLStream
                     builder.evaluatedResource(parseReference("evaluatedResource", reader, evaluatedResourceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26914,6 +28614,7 @@ private MeasureReport parseMeasureReport(java.lang.String elementName, XMLStream
     private MeasureReport.Group parseMeasureReportGroup(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MeasureReport.Group.Builder builder = MeasureReport.Group.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -26952,7 +28653,11 @@ private MeasureReport.Group parseMeasureReportGroup(java.lang.String elementName
                     builder.stratifier(parseMeasureReportGroupStratifier("stratifier", reader, stratifierElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -26969,6 +28674,7 @@ private MeasureReport.Group parseMeasureReportGroup(java.lang.String elementName
     private MeasureReport.Group.Population parseMeasureReportGroupPopulation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MeasureReport.Group.Population.Builder builder = MeasureReport.Group.Population.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -27003,7 +28709,11 @@ private MeasureReport.Group.Population parseMeasureReportGroupPopulation(java.la
                     builder.subjectResults(parseReference("subjectResults", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27020,6 +28730,7 @@ private MeasureReport.Group.Population parseMeasureReportGroupPopulation(java.la
     private MeasureReport.Group.Stratifier parseMeasureReportGroupStratifier(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MeasureReport.Group.Stratifier.Builder builder = MeasureReport.Group.Stratifier.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -27050,7 +28761,11 @@ private MeasureReport.Group.Stratifier parseMeasureReportGroupStratifier(java.la
                     builder.stratum(parseMeasureReportGroupStratifierStratum("stratum", reader, stratumElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27067,6 +28782,7 @@ private MeasureReport.Group.Stratifier parseMeasureReportGroupStratifier(java.la
     private MeasureReport.Group.Stratifier.Stratum parseMeasureReportGroupStratifierStratum(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MeasureReport.Group.Stratifier.Stratum.Builder builder = MeasureReport.Group.Stratifier.Stratum.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -27105,7 +28821,11 @@ private MeasureReport.Group.Stratifier.Stratum parseMeasureReportGroupStratifier
                     builder.measureScore(parseQuantity("measureScore", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27122,6 +28842,7 @@ private MeasureReport.Group.Stratifier.Stratum parseMeasureReportGroupStratifier
     private MeasureReport.Group.Stratifier.Stratum.Component parseMeasureReportGroupStratifierStratumComponent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MeasureReport.Group.Stratifier.Stratum.Component.Builder builder = MeasureReport.Group.Stratifier.Stratum.Component.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -27152,7 +28873,11 @@ private MeasureReport.Group.Stratifier.Stratum.Component parseMeasureReportGroup
                     builder.value(parseCodeableConcept("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27169,6 +28894,7 @@ private MeasureReport.Group.Stratifier.Stratum.Component parseMeasureReportGroup
     private MeasureReport.Group.Stratifier.Stratum.Population parseMeasureReportGroupStratifierStratumPopulation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MeasureReport.Group.Stratifier.Stratum.Population.Builder builder = MeasureReport.Group.Stratifier.Stratum.Population.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -27203,7 +28929,11 @@ private MeasureReport.Group.Stratifier.Stratum.Population parseMeasureReportGrou
                     builder.subjectResults(parseReference("subjectResults", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27220,6 +28950,7 @@ private MeasureReport.Group.Stratifier.Stratum.Population parseMeasureReportGrou
     private Media parseMedia(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Media.Builder builder = Media.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, basedOnElementIndex = 0, partOfElementIndex = 0, reasonCodeElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -27354,7 +29085,11 @@ private Media parseMedia(java.lang.String elementName, XMLStreamReader reader, i
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27371,6 +29106,7 @@ private Media parseMedia(java.lang.String elementName, XMLStreamReader reader, i
     private Medication parseMedication(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Medication.Builder builder = Medication.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, ingredientElementIndex = 0;
         while (reader.hasNext()) {
@@ -27445,7 +29181,11 @@ private Medication parseMedication(java.lang.String elementName, XMLStreamReader
                     builder.batch(parseMedicationBatch("batch", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27462,6 +29202,7 @@ private Medication parseMedication(java.lang.String elementName, XMLStreamReader
     private Medication.Batch parseMedicationBatch(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Medication.Batch.Builder builder = Medication.Batch.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -27492,7 +29233,11 @@ private Medication.Batch parseMedicationBatch(java.lang.String elementName, XMLS
                     builder.expirationDate(parseDateTime("expirationDate", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27509,6 +29254,7 @@ private Medication.Batch parseMedicationBatch(java.lang.String elementName, XMLS
     private Medication.Ingredient parseMedicationIngredient(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Medication.Ingredient.Builder builder = Medication.Ingredient.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -27547,7 +29293,11 @@ private Medication.Ingredient parseMedicationIngredient(java.lang.String element
                     builder.strength(parseRatio("strength", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27564,6 +29314,7 @@ private Medication.Ingredient parseMedicationIngredient(java.lang.String element
     private MedicationAdministration parseMedicationAdministration(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationAdministration.Builder builder = MedicationAdministration.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, instantiatesElementIndex = 0, partOfElementIndex = 0, statusReasonElementIndex = 0, supportingInformationElementIndex = 0, performerElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, deviceElementIndex = 0, noteElementIndex = 0, eventHistoryElementIndex = 0;
         while (reader.hasNext()) {
@@ -27690,7 +29441,11 @@ private MedicationAdministration parseMedicationAdministration(java.lang.String
                     builder.eventHistory(parseReference("eventHistory", reader, eventHistoryElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27707,6 +29462,7 @@ private MedicationAdministration parseMedicationAdministration(java.lang.String
     private MedicationAdministration.Dosage parseMedicationAdministrationDosage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationAdministration.Dosage.Builder builder = MedicationAdministration.Dosage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -27757,7 +29513,11 @@ private MedicationAdministration.Dosage parseMedicationAdministrationDosage(java
                     builder.rate((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "rateQuantity", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27774,6 +29534,7 @@ private MedicationAdministration.Dosage parseMedicationAdministrationDosage(java
     private MedicationAdministration.Performer parseMedicationAdministrationPerformer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationAdministration.Performer.Builder builder = MedicationAdministration.Performer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -27804,7 +29565,11 @@ private MedicationAdministration.Performer parseMedicationAdministrationPerforme
                     builder.actor(parseReference("actor", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27821,6 +29586,7 @@ private MedicationAdministration.Performer parseMedicationAdministrationPerforme
     private MedicationDispense parseMedicationDispense(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationDispense.Builder builder = MedicationDispense.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, partOfElementIndex = 0, supportingInformationElementIndex = 0, performerElementIndex = 0, authorizingPrescriptionElementIndex = 0, receiverElementIndex = 0, noteElementIndex = 0, dosageInstructionElementIndex = 0, detectedIssueElementIndex = 0, eventHistoryElementIndex = 0;
         while (reader.hasNext()) {
@@ -27967,7 +29733,11 @@ private MedicationDispense parseMedicationDispense(java.lang.String elementName,
                     builder.eventHistory(parseReference("eventHistory", reader, eventHistoryElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -27984,6 +29754,7 @@ private MedicationDispense parseMedicationDispense(java.lang.String elementName,
     private MedicationDispense.Performer parseMedicationDispensePerformer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationDispense.Performer.Builder builder = MedicationDispense.Performer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28014,7 +29785,11 @@ private MedicationDispense.Performer parseMedicationDispensePerformer(java.lang.
                     builder.actor(parseReference("actor", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28031,6 +29806,7 @@ private MedicationDispense.Performer parseMedicationDispensePerformer(java.lang.
     private MedicationDispense.Substitution parseMedicationDispenseSubstitution(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationDispense.Substitution.Builder builder = MedicationDispense.Substitution.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28069,7 +29845,11 @@ private MedicationDispense.Substitution parseMedicationDispenseSubstitution(java
                     builder.responsibleParty(parseReference("responsibleParty", reader, responsiblePartyElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28086,6 +29866,7 @@ private MedicationDispense.Substitution parseMedicationDispenseSubstitution(java
     private MedicationKnowledge parseMedicationKnowledge(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Builder builder = MedicationKnowledge.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, synonymElementIndex = 0, relatedMedicationKnowledgeElementIndex = 0, associatedMedicationElementIndex = 0, productTypeElementIndex = 0, monographElementIndex = 0, ingredientElementIndex = 0, intendedRouteElementIndex = 0, costElementIndex = 0, monitoringProgramElementIndex = 0, administrationGuidelinesElementIndex = 0, medicineClassificationElementIndex = 0, drugCharacteristicElementIndex = 0, contraindicationElementIndex = 0, regulatoryElementIndex = 0, kineticsElementIndex = 0;
         while (reader.hasNext()) {
@@ -28216,7 +29997,11 @@ private MedicationKnowledge parseMedicationKnowledge(java.lang.String elementNam
                     builder.kinetics(parseMedicationKnowledgeKinetics("kinetics", reader, kineticsElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28233,6 +30018,7 @@ private MedicationKnowledge parseMedicationKnowledge(java.lang.String elementNam
     private MedicationKnowledge.AdministrationGuidelines parseMedicationKnowledgeAdministrationGuidelines(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.AdministrationGuidelines.Builder builder = MedicationKnowledge.AdministrationGuidelines.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28271,7 +30057,11 @@ private MedicationKnowledge.AdministrationGuidelines parseMedicationKnowledgeAdm
                     builder.patientCharacteristics(parseMedicationKnowledgeAdministrationGuidelinesPatientCharacteristics("patientCharacteristics", reader, patientCharacteristicsElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28288,6 +30078,7 @@ private MedicationKnowledge.AdministrationGuidelines parseMedicationKnowledgeAdm
     private MedicationKnowledge.AdministrationGuidelines.Dosage parseMedicationKnowledgeAdministrationGuidelinesDosage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.AdministrationGuidelines.Dosage.Builder builder = MedicationKnowledge.AdministrationGuidelines.Dosage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28318,7 +30109,11 @@ private MedicationKnowledge.AdministrationGuidelines.Dosage parseMedicationKnowl
                     builder.dosage(parseDosage("dosage", reader, dosageElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28335,6 +30130,7 @@ private MedicationKnowledge.AdministrationGuidelines.Dosage parseMedicationKnowl
     private MedicationKnowledge.AdministrationGuidelines.PatientCharacteristics parseMedicationKnowledgeAdministrationGuidelinesPatientCharacteristics(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.AdministrationGuidelines.PatientCharacteristics.Builder builder = MedicationKnowledge.AdministrationGuidelines.PatientCharacteristics.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28369,7 +30165,11 @@ private MedicationKnowledge.AdministrationGuidelines.PatientCharacteristics pars
                     builder.value(parseString("value", reader, valueElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28386,6 +30186,7 @@ private MedicationKnowledge.AdministrationGuidelines.PatientCharacteristics pars
     private MedicationKnowledge.Cost parseMedicationKnowledgeCost(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Cost.Builder builder = MedicationKnowledge.Cost.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28420,7 +30221,11 @@ private MedicationKnowledge.Cost parseMedicationKnowledgeCost(java.lang.String e
                     builder.cost(parseMoney("cost", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28437,6 +30242,7 @@ private MedicationKnowledge.Cost parseMedicationKnowledgeCost(java.lang.String e
     private MedicationKnowledge.DrugCharacteristic parseMedicationKnowledgeDrugCharacteristic(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.DrugCharacteristic.Builder builder = MedicationKnowledge.DrugCharacteristic.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28479,7 +30285,11 @@ private MedicationKnowledge.DrugCharacteristic parseMedicationKnowledgeDrugChara
                     builder.value(parseBase64Binary("valueBase64Binary", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28496,6 +30306,7 @@ private MedicationKnowledge.DrugCharacteristic parseMedicationKnowledgeDrugChara
     private MedicationKnowledge.Ingredient parseMedicationKnowledgeIngredient(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Ingredient.Builder builder = MedicationKnowledge.Ingredient.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28534,7 +30345,11 @@ private MedicationKnowledge.Ingredient parseMedicationKnowledgeIngredient(java.l
                     builder.strength(parseRatio("strength", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28551,6 +30366,7 @@ private MedicationKnowledge.Ingredient parseMedicationKnowledgeIngredient(java.l
     private MedicationKnowledge.Kinetics parseMedicationKnowledgeKinetics(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Kinetics.Builder builder = MedicationKnowledge.Kinetics.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28585,7 +30401,11 @@ private MedicationKnowledge.Kinetics parseMedicationKnowledgeKinetics(java.lang.
                     builder.halfLifePeriod((Duration) parseQuantity(Duration.builder(), "halfLifePeriod", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28602,6 +30422,7 @@ private MedicationKnowledge.Kinetics parseMedicationKnowledgeKinetics(java.lang.
     private MedicationKnowledge.MedicineClassification parseMedicationKnowledgeMedicineClassification(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.MedicineClassification.Builder builder = MedicationKnowledge.MedicineClassification.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28632,7 +30453,11 @@ private MedicationKnowledge.MedicineClassification parseMedicationKnowledgeMedic
                     builder.classification(parseCodeableConcept("classification", reader, classificationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28649,6 +30474,7 @@ private MedicationKnowledge.MedicineClassification parseMedicationKnowledgeMedic
     private MedicationKnowledge.MonitoringProgram parseMedicationKnowledgeMonitoringProgram(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.MonitoringProgram.Builder builder = MedicationKnowledge.MonitoringProgram.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28679,7 +30505,11 @@ private MedicationKnowledge.MonitoringProgram parseMedicationKnowledgeMonitoring
                     builder.name(parseString("name", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28696,6 +30526,7 @@ private MedicationKnowledge.MonitoringProgram parseMedicationKnowledgeMonitoring
     private MedicationKnowledge.Monograph parseMedicationKnowledgeMonograph(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Monograph.Builder builder = MedicationKnowledge.Monograph.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28726,7 +30557,11 @@ private MedicationKnowledge.Monograph parseMedicationKnowledgeMonograph(java.lan
                     builder.source(parseReference("source", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28743,6 +30578,7 @@ private MedicationKnowledge.Monograph parseMedicationKnowledgeMonograph(java.lan
     private MedicationKnowledge.Packaging parseMedicationKnowledgePackaging(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Packaging.Builder builder = MedicationKnowledge.Packaging.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28773,7 +30609,11 @@ private MedicationKnowledge.Packaging parseMedicationKnowledgePackaging(java.lan
                     builder.quantity((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "quantity", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28790,6 +30630,7 @@ private MedicationKnowledge.Packaging parseMedicationKnowledgePackaging(java.lan
     private MedicationKnowledge.Regulatory parseMedicationKnowledgeRegulatory(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Regulatory.Builder builder = MedicationKnowledge.Regulatory.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28828,7 +30669,11 @@ private MedicationKnowledge.Regulatory parseMedicationKnowledgeRegulatory(java.l
                     builder.maxDispense(parseMedicationKnowledgeRegulatoryMaxDispense("maxDispense", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28845,6 +30690,7 @@ private MedicationKnowledge.Regulatory parseMedicationKnowledgeRegulatory(java.l
     private MedicationKnowledge.Regulatory.MaxDispense parseMedicationKnowledgeRegulatoryMaxDispense(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Regulatory.MaxDispense.Builder builder = MedicationKnowledge.Regulatory.MaxDispense.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28875,7 +30721,11 @@ private MedicationKnowledge.Regulatory.MaxDispense parseMedicationKnowledgeRegul
                     builder.period((Duration) parseQuantity(Duration.builder(), "period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28892,6 +30742,7 @@ private MedicationKnowledge.Regulatory.MaxDispense parseMedicationKnowledgeRegul
     private MedicationKnowledge.Regulatory.Schedule parseMedicationKnowledgeRegulatorySchedule(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Regulatory.Schedule.Builder builder = MedicationKnowledge.Regulatory.Schedule.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28918,7 +30769,11 @@ private MedicationKnowledge.Regulatory.Schedule parseMedicationKnowledgeRegulato
                     builder.schedule(parseCodeableConcept("schedule", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28935,6 +30790,7 @@ private MedicationKnowledge.Regulatory.Schedule parseMedicationKnowledgeRegulato
     private MedicationKnowledge.Regulatory.Substitution parseMedicationKnowledgeRegulatorySubstitution(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.Regulatory.Substitution.Builder builder = MedicationKnowledge.Regulatory.Substitution.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -28965,7 +30821,11 @@ private MedicationKnowledge.Regulatory.Substitution parseMedicationKnowledgeRegu
                     builder.allowed(parseBoolean("allowed", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -28982,6 +30842,7 @@ private MedicationKnowledge.Regulatory.Substitution parseMedicationKnowledgeRegu
     private MedicationKnowledge.RelatedMedicationKnowledge parseMedicationKnowledgeRelatedMedicationKnowledge(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationKnowledge.RelatedMedicationKnowledge.Builder builder = MedicationKnowledge.RelatedMedicationKnowledge.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -29012,7 +30873,11 @@ private MedicationKnowledge.RelatedMedicationKnowledge parseMedicationKnowledgeR
                     builder.reference(parseReference("reference", reader, referenceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29029,6 +30894,7 @@ private MedicationKnowledge.RelatedMedicationKnowledge parseMedicationKnowledgeR
     private MedicationRequest parseMedicationRequest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationRequest.Builder builder = MedicationRequest.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0, supportingInformationElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, instantiatesCanonicalElementIndex = 0, instantiatesUriElementIndex = 0, basedOnElementIndex = 0, insuranceElementIndex = 0, noteElementIndex = 0, dosageInstructionElementIndex = 0, detectedIssueElementIndex = 0, eventHistoryElementIndex = 0;
         while (reader.hasNext()) {
@@ -29207,7 +31073,11 @@ private MedicationRequest parseMedicationRequest(java.lang.String elementName, X
                     builder.eventHistory(parseReference("eventHistory", reader, eventHistoryElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29224,6 +31094,7 @@ private MedicationRequest parseMedicationRequest(java.lang.String elementName, X
     private MedicationRequest.DispenseRequest parseMedicationRequestDispenseRequest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationRequest.DispenseRequest.Builder builder = MedicationRequest.DispenseRequest.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -29274,7 +31145,11 @@ private MedicationRequest.DispenseRequest parseMedicationRequestDispenseRequest(
                     builder.performer(parseReference("performer", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29291,6 +31166,7 @@ private MedicationRequest.DispenseRequest parseMedicationRequestDispenseRequest(
     private MedicationRequest.DispenseRequest.InitialFill parseMedicationRequestDispenseRequestInitialFill(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationRequest.DispenseRequest.InitialFill.Builder builder = MedicationRequest.DispenseRequest.InitialFill.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -29321,7 +31197,11 @@ private MedicationRequest.DispenseRequest.InitialFill parseMedicationRequestDisp
                     builder.duration((Duration) parseQuantity(Duration.builder(), "duration", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29338,6 +31218,7 @@ private MedicationRequest.DispenseRequest.InitialFill parseMedicationRequestDisp
     private MedicationRequest.Substitution parseMedicationRequestSubstitution(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationRequest.Substitution.Builder builder = MedicationRequest.Substitution.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -29372,7 +31253,11 @@ private MedicationRequest.Substitution parseMedicationRequestSubstitution(java.l
                     builder.reason(parseCodeableConcept("reason", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29389,6 +31274,7 @@ private MedicationRequest.Substitution parseMedicationRequestSubstitution(java.l
     private MedicationStatement parseMedicationStatement(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicationStatement.Builder builder = MedicationStatement.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, basedOnElementIndex = 0, partOfElementIndex = 0, statusReasonElementIndex = 0, derivedFromElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, noteElementIndex = 0, dosageElementIndex = 0;
         while (reader.hasNext()) {
@@ -29507,7 +31393,11 @@ private MedicationStatement parseMedicationStatement(java.lang.String elementNam
                     builder.dosage(parseDosage("dosage", reader, dosageElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29524,6 +31414,7 @@ private MedicationStatement parseMedicationStatement(java.lang.String elementNam
     private MedicinalProduct parseMedicinalProduct(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProduct.Builder builder = MedicinalProduct.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, specialMeasuresElementIndex = 0, productClassificationElementIndex = 0, marketingStatusElementIndex = 0, pharmaceuticalProductElementIndex = 0, packagedMedicinalProductElementIndex = 0, attachedDocumentElementIndex = 0, masterFileElementIndex = 0, contactElementIndex = 0, clinicalTrialElementIndex = 0, nameElementIndex = 0, crossReferenceElementIndex = 0, manufacturingBusinessOperationElementIndex = 0, specialDesignationElementIndex = 0;
         while (reader.hasNext()) {
@@ -29646,7 +31537,11 @@ private MedicinalProduct parseMedicinalProduct(java.lang.String elementName, XML
                     builder.specialDesignation(parseMedicinalProductSpecialDesignation("specialDesignation", reader, specialDesignationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29663,6 +31558,7 @@ private MedicinalProduct parseMedicinalProduct(java.lang.String elementName, XML
     private MedicinalProduct.ManufacturingBusinessOperation parseMedicinalProductManufacturingBusinessOperation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProduct.ManufacturingBusinessOperation.Builder builder = MedicinalProduct.ManufacturingBusinessOperation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -29709,7 +31605,11 @@ private MedicinalProduct.ManufacturingBusinessOperation parseMedicinalProductMan
                     builder.regulator(parseReference("regulator", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29726,6 +31626,7 @@ private MedicinalProduct.ManufacturingBusinessOperation parseMedicinalProductMan
     private MedicinalProduct.Name parseMedicinalProductName(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProduct.Name.Builder builder = MedicinalProduct.Name.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -29760,7 +31661,11 @@ private MedicinalProduct.Name parseMedicinalProductName(java.lang.String element
                     builder.countryLanguage(parseMedicinalProductNameCountryLanguage("countryLanguage", reader, countryLanguageElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29777,6 +31682,7 @@ private MedicinalProduct.Name parseMedicinalProductName(java.lang.String element
     private MedicinalProduct.Name.CountryLanguage parseMedicinalProductNameCountryLanguage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProduct.Name.CountryLanguage.Builder builder = MedicinalProduct.Name.CountryLanguage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -29811,7 +31717,11 @@ private MedicinalProduct.Name.CountryLanguage parseMedicinalProductNameCountryLa
                     builder.language(parseCodeableConcept("language", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29828,6 +31738,7 @@ private MedicinalProduct.Name.CountryLanguage parseMedicinalProductNameCountryLa
     private MedicinalProduct.Name.NamePart parseMedicinalProductNameNamePart(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProduct.Name.NamePart.Builder builder = MedicinalProduct.Name.NamePart.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -29858,7 +31769,11 @@ private MedicinalProduct.Name.NamePart parseMedicinalProductNameNamePart(java.la
                     builder.type(parseCoding("type", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29875,6 +31790,7 @@ private MedicinalProduct.Name.NamePart parseMedicinalProductNameNamePart(java.la
     private MedicinalProduct.SpecialDesignation parseMedicinalProductSpecialDesignation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProduct.SpecialDesignation.Builder builder = MedicinalProduct.SpecialDesignation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -29929,7 +31845,11 @@ private MedicinalProduct.SpecialDesignation parseMedicinalProductSpecialDesignat
                     builder.species(parseCodeableConcept("species", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -29946,6 +31866,7 @@ private MedicinalProduct.SpecialDesignation parseMedicinalProductSpecialDesignat
     private MedicinalProductAuthorization parseMedicinalProductAuthorization(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductAuthorization.Builder builder = MedicinalProductAuthorization.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, countryElementIndex = 0, jurisdictionElementIndex = 0, jurisdictionalAuthorizationElementIndex = 0;
         while (reader.hasNext()) {
@@ -30052,7 +31973,11 @@ private MedicinalProductAuthorization parseMedicinalProductAuthorization(java.la
                     builder.procedure(parseMedicinalProductAuthorizationProcedure("procedure", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30069,6 +31994,7 @@ private MedicinalProductAuthorization parseMedicinalProductAuthorization(java.la
     private MedicinalProductAuthorization.JurisdictionalAuthorization parseMedicinalProductAuthorizationJurisdictionalAuthorization(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductAuthorization.JurisdictionalAuthorization.Builder builder = MedicinalProductAuthorization.JurisdictionalAuthorization.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -30111,7 +32037,11 @@ private MedicinalProductAuthorization.JurisdictionalAuthorization parseMedicinal
                     builder.validityPeriod(parsePeriod("validityPeriod", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30128,6 +32058,7 @@ private MedicinalProductAuthorization.JurisdictionalAuthorization parseMedicinal
     private MedicinalProductAuthorization.Procedure parseMedicinalProductAuthorizationProcedure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductAuthorization.Procedure.Builder builder = MedicinalProductAuthorization.Procedure.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -30170,7 +32101,11 @@ private MedicinalProductAuthorization.Procedure parseMedicinalProductAuthorizati
                     builder.application(parseMedicinalProductAuthorizationProcedure("application", reader, applicationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30187,6 +32122,7 @@ private MedicinalProductAuthorization.Procedure parseMedicinalProductAuthorizati
     private MedicinalProductContraindication parseMedicinalProductContraindication(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductContraindication.Builder builder = MedicinalProductContraindication.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, subjectElementIndex = 0, comorbidityElementIndex = 0, therapeuticIndicationElementIndex = 0, otherTherapyElementIndex = 0, populationElementIndex = 0;
         while (reader.hasNext()) {
@@ -30257,7 +32193,11 @@ private MedicinalProductContraindication parseMedicinalProductContraindication(j
                     builder.population(parsePopulation("population", reader, populationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30274,6 +32214,7 @@ private MedicinalProductContraindication parseMedicinalProductContraindication(j
     private MedicinalProductContraindication.OtherTherapy parseMedicinalProductContraindicationOtherTherapy(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductContraindication.OtherTherapy.Builder builder = MedicinalProductContraindication.OtherTherapy.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -30308,7 +32249,11 @@ private MedicinalProductContraindication.OtherTherapy parseMedicinalProductContr
                     builder.medication(parseReference("medicationReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30325,6 +32270,7 @@ private MedicinalProductContraindication.OtherTherapy parseMedicinalProductContr
     private MedicinalProductIndication parseMedicinalProductIndication(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductIndication.Builder builder = MedicinalProductIndication.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, subjectElementIndex = 0, comorbidityElementIndex = 0, otherTherapyElementIndex = 0, undesirableEffectElementIndex = 0, populationElementIndex = 0;
         while (reader.hasNext()) {
@@ -30403,7 +32349,11 @@ private MedicinalProductIndication parseMedicinalProductIndication(java.lang.Str
                     builder.population(parsePopulation("population", reader, populationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30420,6 +32370,7 @@ private MedicinalProductIndication parseMedicinalProductIndication(java.lang.Str
     private MedicinalProductIndication.OtherTherapy parseMedicinalProductIndicationOtherTherapy(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductIndication.OtherTherapy.Builder builder = MedicinalProductIndication.OtherTherapy.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -30454,7 +32405,11 @@ private MedicinalProductIndication.OtherTherapy parseMedicinalProductIndicationO
                     builder.medication(parseReference("medicationReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30471,6 +32426,7 @@ private MedicinalProductIndication.OtherTherapy parseMedicinalProductIndicationO
     private MedicinalProductIngredient parseMedicinalProductIngredient(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductIngredient.Builder builder = MedicinalProductIngredient.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, manufacturerElementIndex = 0, specifiedSubstanceElementIndex = 0;
         while (reader.hasNext()) {
@@ -30537,7 +32493,11 @@ private MedicinalProductIngredient parseMedicinalProductIngredient(java.lang.Str
                     builder.substance(parseMedicinalProductIngredientSubstance("substance", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30554,6 +32514,7 @@ private MedicinalProductIngredient parseMedicinalProductIngredient(java.lang.Str
     private MedicinalProductIngredient.SpecifiedSubstance parseMedicinalProductIngredientSpecifiedSubstance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductIngredient.SpecifiedSubstance.Builder builder = MedicinalProductIngredient.SpecifiedSubstance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -30592,7 +32553,11 @@ private MedicinalProductIngredient.SpecifiedSubstance parseMedicinalProductIngre
                     builder.strength(parseMedicinalProductIngredientSpecifiedSubstanceStrength("strength", reader, strengthElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30609,6 +32574,7 @@ private MedicinalProductIngredient.SpecifiedSubstance parseMedicinalProductIngre
     private MedicinalProductIngredient.SpecifiedSubstance.Strength parseMedicinalProductIngredientSpecifiedSubstanceStrength(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductIngredient.SpecifiedSubstance.Strength.Builder builder = MedicinalProductIngredient.SpecifiedSubstance.Strength.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -30659,7 +32625,11 @@ private MedicinalProductIngredient.SpecifiedSubstance.Strength parseMedicinalPro
                     builder.referenceStrength(parseMedicinalProductIngredientSpecifiedSubstanceStrengthReferenceStrength("referenceStrength", reader, referenceStrengthElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30676,6 +32646,7 @@ private MedicinalProductIngredient.SpecifiedSubstance.Strength parseMedicinalPro
     private MedicinalProductIngredient.SpecifiedSubstance.Strength.ReferenceStrength parseMedicinalProductIngredientSpecifiedSubstanceStrengthReferenceStrength(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductIngredient.SpecifiedSubstance.Strength.ReferenceStrength.Builder builder = MedicinalProductIngredient.SpecifiedSubstance.Strength.ReferenceStrength.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -30718,7 +32689,11 @@ private MedicinalProductIngredient.SpecifiedSubstance.Strength.ReferenceStrength
                     builder.country(parseCodeableConcept("country", reader, countryElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30735,6 +32710,7 @@ private MedicinalProductIngredient.SpecifiedSubstance.Strength.ReferenceStrength
     private MedicinalProductIngredient.Substance parseMedicinalProductIngredientSubstance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductIngredient.Substance.Builder builder = MedicinalProductIngredient.Substance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -30765,7 +32741,11 @@ private MedicinalProductIngredient.Substance parseMedicinalProductIngredientSubs
                     builder.strength(parseMedicinalProductIngredientSpecifiedSubstanceStrength("strength", reader, strengthElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30782,6 +32762,7 @@ private MedicinalProductIngredient.Substance parseMedicinalProductIngredientSubs
     private MedicinalProductInteraction parseMedicinalProductInteraction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductInteraction.Builder builder = MedicinalProductInteraction.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, subjectElementIndex = 0, interactantElementIndex = 0;
         while (reader.hasNext()) {
@@ -30852,7 +32833,11 @@ private MedicinalProductInteraction parseMedicinalProductInteraction(java.lang.S
                     builder.management(parseCodeableConcept("management", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30869,6 +32854,7 @@ private MedicinalProductInteraction parseMedicinalProductInteraction(java.lang.S
     private MedicinalProductInteraction.Interactant parseMedicinalProductInteractionInteractant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductInteraction.Interactant.Builder builder = MedicinalProductInteraction.Interactant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -30899,7 +32885,11 @@ private MedicinalProductInteraction.Interactant parseMedicinalProductInteraction
                     builder.item(parseCodeableConcept("itemCodeableConcept", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -30916,6 +32906,7 @@ private MedicinalProductInteraction.Interactant parseMedicinalProductInteraction
     private MedicinalProductManufactured parseMedicinalProductManufactured(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductManufactured.Builder builder = MedicinalProductManufactured.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, manufacturerElementIndex = 0, ingredientElementIndex = 0, otherCharacteristicsElementIndex = 0;
         while (reader.hasNext()) {
@@ -30986,7 +32977,11 @@ private MedicinalProductManufactured parseMedicinalProductManufactured(java.lang
                     builder.otherCharacteristics(parseCodeableConcept("otherCharacteristics", reader, otherCharacteristicsElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31003,6 +32998,7 @@ private MedicinalProductManufactured parseMedicinalProductManufactured(java.lang
     private MedicinalProductPackaged parseMedicinalProductPackaged(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductPackaged.Builder builder = MedicinalProductPackaged.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, subjectElementIndex = 0, marketingStatusElementIndex = 0, manufacturerElementIndex = 0, batchIdentifierElementIndex = 0, packageItemElementIndex = 0;
         while (reader.hasNext()) {
@@ -31081,7 +33077,11 @@ private MedicinalProductPackaged parseMedicinalProductPackaged(java.lang.String
                     builder.packageItem(parseMedicinalProductPackagedPackageItem("packageItem", reader, packageItemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31098,6 +33098,7 @@ private MedicinalProductPackaged parseMedicinalProductPackaged(java.lang.String
     private MedicinalProductPackaged.BatchIdentifier parseMedicinalProductPackagedBatchIdentifier(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductPackaged.BatchIdentifier.Builder builder = MedicinalProductPackaged.BatchIdentifier.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -31128,7 +33129,11 @@ private MedicinalProductPackaged.BatchIdentifier parseMedicinalProductPackagedBa
                     builder.immediatePackaging(parseIdentifier("immediatePackaging", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31145,6 +33150,7 @@ private MedicinalProductPackaged.BatchIdentifier parseMedicinalProductPackagedBa
     private MedicinalProductPackaged.PackageItem parseMedicinalProductPackagedPackageItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductPackaged.PackageItem.Builder builder = MedicinalProductPackaged.PackageItem.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -31215,7 +33221,11 @@ private MedicinalProductPackaged.PackageItem parseMedicinalProductPackagedPackag
                     builder.manufacturer(parseReference("manufacturer", reader, manufacturerElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31232,6 +33242,7 @@ private MedicinalProductPackaged.PackageItem parseMedicinalProductPackagedPackag
     private MedicinalProductPharmaceutical parseMedicinalProductPharmaceutical(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductPharmaceutical.Builder builder = MedicinalProductPharmaceutical.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, ingredientElementIndex = 0, deviceElementIndex = 0, characteristicsElementIndex = 0, routeOfAdministrationElementIndex = 0;
         while (reader.hasNext()) {
@@ -31302,7 +33313,11 @@ private MedicinalProductPharmaceutical parseMedicinalProductPharmaceutical(java.
                     builder.routeOfAdministration(parseMedicinalProductPharmaceuticalRouteOfAdministration("routeOfAdministration", reader, routeOfAdministrationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31319,6 +33334,7 @@ private MedicinalProductPharmaceutical parseMedicinalProductPharmaceutical(java.
     private MedicinalProductPharmaceutical.Characteristics parseMedicinalProductPharmaceuticalCharacteristics(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductPharmaceutical.Characteristics.Builder builder = MedicinalProductPharmaceutical.Characteristics.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -31349,7 +33365,11 @@ private MedicinalProductPharmaceutical.Characteristics parseMedicinalProductPhar
                     builder.status(parseCodeableConcept("status", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31366,6 +33386,7 @@ private MedicinalProductPharmaceutical.Characteristics parseMedicinalProductPhar
     private MedicinalProductPharmaceutical.RouteOfAdministration parseMedicinalProductPharmaceuticalRouteOfAdministration(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductPharmaceutical.RouteOfAdministration.Builder builder = MedicinalProductPharmaceutical.RouteOfAdministration.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -31416,7 +33437,11 @@ private MedicinalProductPharmaceutical.RouteOfAdministration parseMedicinalProdu
                     builder.targetSpecies(parseMedicinalProductPharmaceuticalRouteOfAdministrationTargetSpecies("targetSpecies", reader, targetSpeciesElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31433,6 +33458,7 @@ private MedicinalProductPharmaceutical.RouteOfAdministration parseMedicinalProdu
     private MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies parseMedicinalProductPharmaceuticalRouteOfAdministrationTargetSpecies(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.Builder builder = MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -31463,7 +33489,11 @@ private MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies parse
                     builder.withdrawalPeriod(parseMedicinalProductPharmaceuticalRouteOfAdministrationTargetSpeciesWithdrawalPeriod("withdrawalPeriod", reader, withdrawalPeriodElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31480,6 +33510,7 @@ private MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies parse
     private MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.WithdrawalPeriod parseMedicinalProductPharmaceuticalRouteOfAdministrationTargetSpeciesWithdrawalPeriod(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.WithdrawalPeriod.Builder builder = MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.WithdrawalPeriod.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -31514,7 +33545,11 @@ private MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.Withd
                     builder.supportingInformation(parseString("supportingInformation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31531,6 +33566,7 @@ private MedicinalProductPharmaceutical.RouteOfAdministration.TargetSpecies.Withd
     private MedicinalProductUndesirableEffect parseMedicinalProductUndesirableEffect(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MedicinalProductUndesirableEffect.Builder builder = MedicinalProductUndesirableEffect.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, subjectElementIndex = 0, populationElementIndex = 0;
         while (reader.hasNext()) {
@@ -31593,7 +33629,11 @@ private MedicinalProductUndesirableEffect parseMedicinalProductUndesirableEffect
                     builder.population(parsePopulation("population", reader, populationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31610,6 +33650,7 @@ private MedicinalProductUndesirableEffect parseMedicinalProductUndesirableEffect
     private MessageDefinition parseMessageDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MessageDefinition.Builder builder = MessageDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, replacesElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, parentElementIndex = 0, focusElementIndex = 0, allowedResponseElementIndex = 0, graphElementIndex = 0;
         while (reader.hasNext()) {
@@ -31752,7 +33793,11 @@ private MessageDefinition parseMessageDefinition(java.lang.String elementName, X
                     builder.graph((Canonical) parseUri(Canonical.builder(), "graph", reader, graphElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31769,6 +33814,7 @@ private MessageDefinition parseMessageDefinition(java.lang.String elementName, X
     private MessageDefinition.AllowedResponse parseMessageDefinitionAllowedResponse(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MessageDefinition.AllowedResponse.Builder builder = MessageDefinition.AllowedResponse.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -31799,7 +33845,11 @@ private MessageDefinition.AllowedResponse parseMessageDefinitionAllowedResponse(
                     builder.situation((Markdown) parseString(Markdown.builder(), "situation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31816,6 +33866,7 @@ private MessageDefinition.AllowedResponse parseMessageDefinitionAllowedResponse(
     private MessageDefinition.Focus parseMessageDefinitionFocus(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MessageDefinition.Focus.Builder builder = MessageDefinition.Focus.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -31854,7 +33905,11 @@ private MessageDefinition.Focus parseMessageDefinitionFocus(java.lang.String ele
                     builder.max(parseString("max", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31871,6 +33926,7 @@ private MessageDefinition.Focus parseMessageDefinitionFocus(java.lang.String ele
     private MessageHeader parseMessageHeader(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MessageHeader.Builder builder = MessageHeader.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, destinationElementIndex = 0, focusElementIndex = 0;
         while (reader.hasNext()) {
@@ -31961,7 +34017,11 @@ private MessageHeader parseMessageHeader(java.lang.String elementName, XMLStream
                     builder.definition((Canonical) parseUri(Canonical.builder(), "definition", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -31978,6 +34038,7 @@ private MessageHeader parseMessageHeader(java.lang.String elementName, XMLStream
     private MessageHeader.Destination parseMessageHeaderDestination(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MessageHeader.Destination.Builder builder = MessageHeader.Destination.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32016,7 +34077,11 @@ private MessageHeader.Destination parseMessageHeaderDestination(java.lang.String
                     builder.receiver(parseReference("receiver", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32033,6 +34098,7 @@ private MessageHeader.Destination parseMessageHeaderDestination(java.lang.String
     private MessageHeader.Response parseMessageHeaderResponse(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MessageHeader.Response.Builder builder = MessageHeader.Response.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32067,7 +34133,11 @@ private MessageHeader.Response parseMessageHeaderResponse(java.lang.String eleme
                     builder.details(parseReference("details", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32084,6 +34154,7 @@ private MessageHeader.Response parseMessageHeaderResponse(java.lang.String eleme
     private MessageHeader.Source parseMessageHeaderSource(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MessageHeader.Source.Builder builder = MessageHeader.Source.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32126,7 +34197,11 @@ private MessageHeader.Source parseMessageHeaderSource(java.lang.String elementNa
                     builder.endpoint((Url) parseUri(Url.builder(), "endpoint", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32143,6 +34218,7 @@ private MessageHeader.Source parseMessageHeaderSource(java.lang.String elementNa
     private Meta parseMeta(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Meta.Builder builder = Meta.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32185,7 +34261,11 @@ private Meta parseMeta(java.lang.String elementName, XMLStreamReader reader, int
                     builder.tag(parseCoding("tag", reader, tagElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32202,6 +34282,7 @@ private Meta parseMeta(java.lang.String elementName, XMLStreamReader reader, int
     private MolecularSequence parseMolecularSequence(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MolecularSequence.Builder builder = MolecularSequence.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, variantElementIndex = 0, qualityElementIndex = 0, repositoryElementIndex = 0, pointerElementIndex = 0, structureVariantElementIndex = 0;
         while (reader.hasNext()) {
@@ -32308,7 +34389,11 @@ private MolecularSequence parseMolecularSequence(java.lang.String elementName, X
                     builder.structureVariant(parseMolecularSequenceStructureVariant("structureVariant", reader, structureVariantElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32325,6 +34410,7 @@ private MolecularSequence parseMolecularSequence(java.lang.String elementName, X
     private MolecularSequence.Quality parseMolecularSequenceQuality(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MolecularSequence.Quality.Builder builder = MolecularSequence.Quality.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32407,7 +34493,11 @@ private MolecularSequence.Quality parseMolecularSequenceQuality(java.lang.String
                     builder.roc(parseMolecularSequenceQualityRoc("roc", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32424,6 +34514,7 @@ private MolecularSequence.Quality parseMolecularSequenceQuality(java.lang.String
     private MolecularSequence.Quality.Roc parseMolecularSequenceQualityRoc(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MolecularSequence.Quality.Roc.Builder builder = MolecularSequence.Quality.Roc.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32474,7 +34565,11 @@ private MolecularSequence.Quality.Roc parseMolecularSequenceQualityRoc(java.lang
                     builder.fMeasure(parseDecimal("fMeasure", reader, fMeasureElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32491,6 +34586,7 @@ private MolecularSequence.Quality.Roc parseMolecularSequenceQualityRoc(java.lang
     private MolecularSequence.ReferenceSeq parseMolecularSequenceReferenceSeq(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MolecularSequence.ReferenceSeq.Builder builder = MolecularSequence.ReferenceSeq.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32549,7 +34645,11 @@ private MolecularSequence.ReferenceSeq parseMolecularSequenceReferenceSeq(java.l
                     builder.windowEnd(parseInteger("windowEnd", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32566,6 +34666,7 @@ private MolecularSequence.ReferenceSeq parseMolecularSequenceReferenceSeq(java.l
     private MolecularSequence.Repository parseMolecularSequenceRepository(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MolecularSequence.Repository.Builder builder = MolecularSequence.Repository.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32612,7 +34713,11 @@ private MolecularSequence.Repository parseMolecularSequenceRepository(java.lang.
                     builder.readsetId(parseString("readsetId", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32629,6 +34734,7 @@ private MolecularSequence.Repository parseMolecularSequenceRepository(java.lang.
     private MolecularSequence.StructureVariant parseMolecularSequenceStructureVariant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MolecularSequence.StructureVariant.Builder builder = MolecularSequence.StructureVariant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32671,7 +34777,11 @@ private MolecularSequence.StructureVariant parseMolecularSequenceStructureVarian
                     builder.inner(parseMolecularSequenceStructureVariantInner("inner", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32688,6 +34798,7 @@ private MolecularSequence.StructureVariant parseMolecularSequenceStructureVarian
     private MolecularSequence.StructureVariant.Inner parseMolecularSequenceStructureVariantInner(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MolecularSequence.StructureVariant.Inner.Builder builder = MolecularSequence.StructureVariant.Inner.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32718,7 +34829,11 @@ private MolecularSequence.StructureVariant.Inner parseMolecularSequenceStructure
                     builder.end(parseInteger("end", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32735,6 +34850,7 @@ private MolecularSequence.StructureVariant.Inner parseMolecularSequenceStructure
     private MolecularSequence.StructureVariant.Outer parseMolecularSequenceStructureVariantOuter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MolecularSequence.StructureVariant.Outer.Builder builder = MolecularSequence.StructureVariant.Outer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32765,7 +34881,11 @@ private MolecularSequence.StructureVariant.Outer parseMolecularSequenceStructure
                     builder.end(parseInteger("end", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32782,6 +34902,7 @@ private MolecularSequence.StructureVariant.Outer parseMolecularSequenceStructure
     private MolecularSequence.Variant parseMolecularSequenceVariant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         MolecularSequence.Variant.Builder builder = MolecularSequence.Variant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32828,7 +34949,11 @@ private MolecularSequence.Variant parseMolecularSequenceVariant(java.lang.String
                     builder.variantPointer(parseReference("variantPointer", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32845,6 +34970,7 @@ private MolecularSequence.Variant parseMolecularSequenceVariant(java.lang.String
     private Money parseMoney(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Money.Builder builder = Money.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -32871,7 +34997,11 @@ private Money parseMoney(java.lang.String elementName, XMLStreamReader reader, i
                     builder.currency((Code) parseString(Code.builder(), "currency", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32888,6 +35018,7 @@ private Money parseMoney(java.lang.String elementName, XMLStreamReader reader, i
     private NamingSystem parseNamingSystem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         NamingSystem.Builder builder = NamingSystem.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, uniqueIdElementIndex = 0;
         while (reader.hasNext()) {
@@ -32982,7 +35113,11 @@ private NamingSystem parseNamingSystem(java.lang.String elementName, XMLStreamRe
                     builder.uniqueId(parseNamingSystemUniqueId("uniqueId", reader, uniqueIdElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -32999,6 +35134,7 @@ private NamingSystem parseNamingSystem(java.lang.String elementName, XMLStreamRe
     private NamingSystem.UniqueId parseNamingSystemUniqueId(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         NamingSystem.UniqueId.Builder builder = NamingSystem.UniqueId.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33041,7 +35177,11 @@ private NamingSystem.UniqueId parseNamingSystemUniqueId(java.lang.String element
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33058,6 +35198,7 @@ private NamingSystem.UniqueId parseNamingSystemUniqueId(java.lang.String element
     private Narrative parseNarrative(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Narrative.Builder builder = Narrative.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33088,7 +35229,11 @@ private Narrative parseNarrative(java.lang.String elementName, XMLStreamReader r
                     builder.div(parseXhtml("div", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33105,6 +35250,7 @@ private Narrative parseNarrative(java.lang.String elementName, XMLStreamReader r
     private NutritionOrder parseNutritionOrder(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         NutritionOrder.Builder builder = NutritionOrder.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, instantiatesCanonicalElementIndex = 0, instantiatesUriElementIndex = 0, instantiatesElementIndex = 0, allergyIntoleranceElementIndex = 0, foodPreferenceModifierElementIndex = 0, excludeFoodModifierElementIndex = 0, supplementElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -33215,7 +35361,11 @@ private NutritionOrder parseNutritionOrder(java.lang.String elementName, XMLStre
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33232,6 +35382,7 @@ private NutritionOrder parseNutritionOrder(java.lang.String elementName, XMLStre
     private NutritionOrder.EnteralFormula parseNutritionOrderEnteralFormula(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         NutritionOrder.EnteralFormula.Builder builder = NutritionOrder.EnteralFormula.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33290,7 +35441,11 @@ private NutritionOrder.EnteralFormula parseNutritionOrderEnteralFormula(java.lan
                     builder.administrationInstruction(parseString("administrationInstruction", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33307,6 +35462,7 @@ private NutritionOrder.EnteralFormula parseNutritionOrderEnteralFormula(java.lan
     private NutritionOrder.EnteralFormula.Administration parseNutritionOrderEnteralFormulaAdministration(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         NutritionOrder.EnteralFormula.Administration.Builder builder = NutritionOrder.EnteralFormula.Administration.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33345,7 +35501,11 @@ private NutritionOrder.EnteralFormula.Administration parseNutritionOrderEnteralF
                     builder.rate(parseRatio("rateRatio", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33362,6 +35522,7 @@ private NutritionOrder.EnteralFormula.Administration parseNutritionOrderEnteralF
     private NutritionOrder.OralDiet parseNutritionOrderOralDiet(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         NutritionOrder.OralDiet.Builder builder = NutritionOrder.OralDiet.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33408,7 +35569,11 @@ private NutritionOrder.OralDiet parseNutritionOrderOralDiet(java.lang.String ele
                     builder.instruction(parseString("instruction", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33425,6 +35590,7 @@ private NutritionOrder.OralDiet parseNutritionOrderOralDiet(java.lang.String ele
     private NutritionOrder.OralDiet.Nutrient parseNutritionOrderOralDietNutrient(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         NutritionOrder.OralDiet.Nutrient.Builder builder = NutritionOrder.OralDiet.Nutrient.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33455,7 +35621,11 @@ private NutritionOrder.OralDiet.Nutrient parseNutritionOrderOralDietNutrient(jav
                     builder.amount((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "amount", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33472,6 +35642,7 @@ private NutritionOrder.OralDiet.Nutrient parseNutritionOrderOralDietNutrient(jav
     private NutritionOrder.OralDiet.Texture parseNutritionOrderOralDietTexture(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         NutritionOrder.OralDiet.Texture.Builder builder = NutritionOrder.OralDiet.Texture.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33502,7 +35673,11 @@ private NutritionOrder.OralDiet.Texture parseNutritionOrderOralDietTexture(java.
                     builder.foodType(parseCodeableConcept("foodType", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33519,6 +35694,7 @@ private NutritionOrder.OralDiet.Texture parseNutritionOrderOralDietTexture(java.
     private NutritionOrder.Supplement parseNutritionOrderSupplement(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         NutritionOrder.Supplement.Builder builder = NutritionOrder.Supplement.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33561,7 +35737,11 @@ private NutritionOrder.Supplement parseNutritionOrderSupplement(java.lang.String
                     builder.instruction(parseString("instruction", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33578,6 +35758,7 @@ private NutritionOrder.Supplement parseNutritionOrderSupplement(java.lang.String
     private Observation parseObservation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Observation.Builder builder = Observation.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, basedOnElementIndex = 0, partOfElementIndex = 0, categoryElementIndex = 0, focusElementIndex = 0, performerElementIndex = 0, interpretationElementIndex = 0, noteElementIndex = 0, referenceRangeElementIndex = 0, hasMemberElementIndex = 0, derivedFromElementIndex = 0, componentElementIndex = 0;
         while (reader.hasNext()) {
@@ -33768,7 +35949,11 @@ private Observation parseObservation(java.lang.String elementName, XMLStreamRead
                     builder.component(parseObservationComponent("component", reader, componentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33785,6 +35970,7 @@ private Observation parseObservation(java.lang.String elementName, XMLStreamRead
     private Observation.Component parseObservationComponent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Observation.Component.Builder builder = Observation.Component.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33867,7 +36053,11 @@ private Observation.Component parseObservationComponent(java.lang.String element
                     builder.referenceRange(parseObservationReferenceRange("referenceRange", reader, referenceRangeElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33884,6 +36074,7 @@ private Observation.Component parseObservationComponent(java.lang.String element
     private Observation.ReferenceRange parseObservationReferenceRange(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Observation.ReferenceRange.Builder builder = Observation.ReferenceRange.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -33930,7 +36121,11 @@ private Observation.ReferenceRange parseObservationReferenceRange(java.lang.Stri
                     builder.text(parseString("text", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -33947,6 +36142,7 @@ private Observation.ReferenceRange parseObservationReferenceRange(java.lang.Stri
     private ObservationDefinition parseObservationDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ObservationDefinition.Builder builder = ObservationDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, categoryElementIndex = 0, identifierElementIndex = 0, permittedDataTypeElementIndex = 0, qualifiedIntervalElementIndex = 0;
         while (reader.hasNext()) {
@@ -34041,7 +36237,11 @@ private ObservationDefinition parseObservationDefinition(java.lang.String elemen
                     builder.criticalCodedValueSet(parseReference("criticalCodedValueSet", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34058,6 +36258,7 @@ private ObservationDefinition parseObservationDefinition(java.lang.String elemen
     private ObservationDefinition.QualifiedInterval parseObservationDefinitionQualifiedInterval(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ObservationDefinition.QualifiedInterval.Builder builder = ObservationDefinition.QualifiedInterval.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -34112,7 +36313,11 @@ private ObservationDefinition.QualifiedInterval parseObservationDefinitionQualif
                     builder.condition(parseString("condition", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34129,6 +36334,7 @@ private ObservationDefinition.QualifiedInterval parseObservationDefinitionQualif
     private ObservationDefinition.QuantitativeDetails parseObservationDefinitionQuantitativeDetails(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ObservationDefinition.QuantitativeDetails.Builder builder = ObservationDefinition.QuantitativeDetails.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -34167,7 +36373,11 @@ private ObservationDefinition.QuantitativeDetails parseObservationDefinitionQuan
                     builder.decimalPrecision(parseInteger("decimalPrecision", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34184,6 +36394,7 @@ private ObservationDefinition.QuantitativeDetails parseObservationDefinitionQuan
     private OperationDefinition parseOperationDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         OperationDefinition.Builder builder = OperationDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, resourceElementIndex = 0, parameterElementIndex = 0, overloadElementIndex = 0;
         while (reader.hasNext()) {
@@ -34330,7 +36541,11 @@ private OperationDefinition parseOperationDefinition(java.lang.String elementNam
                     builder.overload(parseOperationDefinitionOverload("overload", reader, overloadElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34347,6 +36562,7 @@ private OperationDefinition parseOperationDefinition(java.lang.String elementNam
     private OperationDefinition.Overload parseOperationDefinitionOverload(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         OperationDefinition.Overload.Builder builder = OperationDefinition.Overload.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -34377,7 +36593,11 @@ private OperationDefinition.Overload parseOperationDefinitionOverload(java.lang.
                     builder.comment(parseString("comment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34394,6 +36614,7 @@ private OperationDefinition.Overload parseOperationDefinitionOverload(java.lang.
     private OperationDefinition.Parameter parseOperationDefinitionParameter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         OperationDefinition.Parameter.Builder builder = OperationDefinition.Parameter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -34460,7 +36681,11 @@ private OperationDefinition.Parameter parseOperationDefinitionParameter(java.lan
                     builder.part(parseOperationDefinitionParameter("part", reader, partElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34477,6 +36702,7 @@ private OperationDefinition.Parameter parseOperationDefinitionParameter(java.lan
     private OperationDefinition.Parameter.Binding parseOperationDefinitionParameterBinding(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         OperationDefinition.Parameter.Binding.Builder builder = OperationDefinition.Parameter.Binding.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -34507,7 +36733,11 @@ private OperationDefinition.Parameter.Binding parseOperationDefinitionParameterB
                     builder.valueSet((Canonical) parseUri(Canonical.builder(), "valueSet", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34524,6 +36754,7 @@ private OperationDefinition.Parameter.Binding parseOperationDefinitionParameterB
     private OperationDefinition.Parameter.ReferencedFrom parseOperationDefinitionParameterReferencedFrom(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         OperationDefinition.Parameter.ReferencedFrom.Builder builder = OperationDefinition.Parameter.ReferencedFrom.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -34554,7 +36785,11 @@ private OperationDefinition.Parameter.ReferencedFrom parseOperationDefinitionPar
                     builder.sourceId(parseString("sourceId", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34571,6 +36806,7 @@ private OperationDefinition.Parameter.ReferencedFrom parseOperationDefinitionPar
     private OperationOutcome parseOperationOutcome(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         OperationOutcome.Builder builder = OperationOutcome.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, issueElementIndex = 0;
         while (reader.hasNext()) {
@@ -34617,7 +36853,11 @@ private OperationOutcome parseOperationOutcome(java.lang.String elementName, XML
                     builder.issue(parseOperationOutcomeIssue("issue", reader, issueElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34634,6 +36874,7 @@ private OperationOutcome parseOperationOutcome(java.lang.String elementName, XML
     private OperationOutcome.Issue parseOperationOutcomeIssue(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         OperationOutcome.Issue.Builder builder = OperationOutcome.Issue.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -34680,7 +36921,11 @@ private OperationOutcome.Issue parseOperationOutcomeIssue(java.lang.String eleme
                     builder.expression(parseString("expression", reader, expressionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34697,6 +36942,7 @@ private OperationOutcome.Issue parseOperationOutcomeIssue(java.lang.String eleme
     private Organization parseOrganization(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Organization.Builder builder = Organization.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, typeElementIndex = 0, aliasElementIndex = 0, telecomElementIndex = 0, addressElementIndex = 0, contactElementIndex = 0, endpointElementIndex = 0;
         while (reader.hasNext()) {
@@ -34779,7 +37025,11 @@ private Organization parseOrganization(java.lang.String elementName, XMLStreamRe
                     builder.endpoint(parseReference("endpoint", reader, endpointElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34796,6 +37046,7 @@ private Organization parseOrganization(java.lang.String elementName, XMLStreamRe
     private Organization.Contact parseOrganizationContact(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Organization.Contact.Builder builder = Organization.Contact.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -34834,7 +37085,11 @@ private Organization.Contact parseOrganizationContact(java.lang.String elementNa
                     builder.address(parseAddress("address", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34851,6 +37106,7 @@ private Organization.Contact parseOrganizationContact(java.lang.String elementNa
     private OrganizationAffiliation parseOrganizationAffiliation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         OrganizationAffiliation.Builder builder = OrganizationAffiliation.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, networkElementIndex = 0, codeElementIndex = 0, specialtyElementIndex = 0, locationElementIndex = 0, healthcareServiceElementIndex = 0, telecomElementIndex = 0, endpointElementIndex = 0;
         while (reader.hasNext()) {
@@ -34941,7 +37197,11 @@ private OrganizationAffiliation parseOrganizationAffiliation(java.lang.String el
                     builder.endpoint(parseReference("endpoint", reader, endpointElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -34958,6 +37218,7 @@ private OrganizationAffiliation parseOrganizationAffiliation(java.lang.String el
     private ParameterDefinition parseParameterDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ParameterDefinition.Builder builder = ParameterDefinition.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -35004,7 +37265,11 @@ private ParameterDefinition parseParameterDefinition(java.lang.String elementNam
                     builder.profile((Canonical) parseUri(Canonical.builder(), "profile", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35021,6 +37286,7 @@ private ParameterDefinition parseParameterDefinition(java.lang.String elementNam
     private Parameters parseParameters(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Parameters.Builder builder = Parameters.builder();
+        builder.setValidating(validating);
         int position = -1;
         int parameterElementIndex = 0;
         while (reader.hasNext()) {
@@ -35051,7 +37317,11 @@ private Parameters parseParameters(java.lang.String elementName, XMLStreamReader
                     builder.parameter(parseParametersParameter("parameter", reader, parameterElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35068,6 +37338,7 @@ private Parameters parseParameters(java.lang.String elementName, XMLStreamReader
     private Parameters.Parameter parseParametersParameter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Parameters.Parameter.Builder builder = Parameters.Parameter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -35302,7 +37573,11 @@ private Parameters.Parameter parseParametersParameter(java.lang.String elementNa
                     builder.part(parseParametersParameter("part", reader, partElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35319,6 +37594,7 @@ private Parameters.Parameter parseParametersParameter(java.lang.String elementNa
     private Patient parsePatient(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Patient.Builder builder = Patient.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, nameElementIndex = 0, telecomElementIndex = 0, addressElementIndex = 0, photoElementIndex = 0, contactElementIndex = 0, communicationElementIndex = 0, generalPractitionerElementIndex = 0, linkElementIndex = 0;
         while (reader.hasNext()) {
@@ -35433,7 +37709,11 @@ private Patient parsePatient(java.lang.String elementName, XMLStreamReader reade
                     builder.link(parsePatientLink("link", reader, linkElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35450,6 +37730,7 @@ private Patient parsePatient(java.lang.String elementName, XMLStreamReader reade
     private Patient.Communication parsePatientCommunication(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Patient.Communication.Builder builder = Patient.Communication.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -35480,7 +37761,11 @@ private Patient.Communication parsePatientCommunication(java.lang.String element
                     builder.preferred(parseBoolean("preferred", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35497,6 +37782,7 @@ private Patient.Communication parsePatientCommunication(java.lang.String element
     private Patient.Contact parsePatientContact(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Patient.Contact.Builder builder = Patient.Contact.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -35547,7 +37833,11 @@ private Patient.Contact parsePatientContact(java.lang.String elementName, XMLStr
                     builder.period(parsePeriod("period", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35564,6 +37854,7 @@ private Patient.Contact parsePatientContact(java.lang.String elementName, XMLStr
     private Patient.Link parsePatientLink(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Patient.Link.Builder builder = Patient.Link.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -35594,7 +37885,11 @@ private Patient.Link parsePatientLink(java.lang.String elementName, XMLStreamRea
                     builder.type((LinkType) parseString(LinkType.builder(), "type", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35611,6 +37906,7 @@ private Patient.Link parsePatientLink(java.lang.String elementName, XMLStreamRea
     private PaymentNotice parsePaymentNotice(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PaymentNotice.Builder builder = PaymentNotice.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0;
         while (reader.hasNext()) {
@@ -35701,7 +37997,11 @@ private PaymentNotice parsePaymentNotice(java.lang.String elementName, XMLStream
                     builder.paymentStatus(parseCodeableConcept("paymentStatus", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35718,6 +38018,7 @@ private PaymentNotice parsePaymentNotice(java.lang.String elementName, XMLStream
     private PaymentReconciliation parsePaymentReconciliation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PaymentReconciliation.Builder builder = PaymentReconciliation.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, detailElementIndex = 0, processNoteElementIndex = 0;
         while (reader.hasNext()) {
@@ -35820,7 +38121,11 @@ private PaymentReconciliation parsePaymentReconciliation(java.lang.String elemen
                     builder.processNote(parsePaymentReconciliationProcessNote("processNote", reader, processNoteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35837,6 +38142,7 @@ private PaymentReconciliation parsePaymentReconciliation(java.lang.String elemen
     private PaymentReconciliation.Detail parsePaymentReconciliationDetail(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PaymentReconciliation.Detail.Builder builder = PaymentReconciliation.Detail.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -35899,7 +38205,11 @@ private PaymentReconciliation.Detail parsePaymentReconciliationDetail(java.lang.
                     builder.amount(parseMoney("amount", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35916,6 +38226,7 @@ private PaymentReconciliation.Detail parsePaymentReconciliationDetail(java.lang.
     private PaymentReconciliation.ProcessNote parsePaymentReconciliationProcessNote(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PaymentReconciliation.ProcessNote.Builder builder = PaymentReconciliation.ProcessNote.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -35946,7 +38257,11 @@ private PaymentReconciliation.ProcessNote parsePaymentReconciliationProcessNote(
                     builder.text(parseString("text", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -35963,6 +38278,7 @@ private PaymentReconciliation.ProcessNote parsePaymentReconciliationProcessNote(
     private Period parsePeriod(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Period.Builder builder = Period.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -35989,7 +38305,11 @@ private Period parsePeriod(java.lang.String elementName, XMLStreamReader reader,
                     builder.end(parseDateTime("end", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36006,6 +38326,7 @@ private Period parsePeriod(java.lang.String elementName, XMLStreamReader reader,
     private Person parsePerson(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Person.Builder builder = Person.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, nameElementIndex = 0, telecomElementIndex = 0, addressElementIndex = 0, linkElementIndex = 0;
         while (reader.hasNext()) {
@@ -36088,7 +38409,11 @@ private Person parsePerson(java.lang.String elementName, XMLStreamReader reader,
                     builder.link(parsePersonLink("link", reader, linkElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36105,6 +38430,7 @@ private Person parsePerson(java.lang.String elementName, XMLStreamReader reader,
     private Person.Link parsePersonLink(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Person.Link.Builder builder = Person.Link.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -36135,7 +38461,11 @@ private Person.Link parsePersonLink(java.lang.String elementName, XMLStreamReade
                     builder.assurance((IdentityAssuranceLevel) parseString(IdentityAssuranceLevel.builder(), "assurance", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36152,6 +38482,7 @@ private Person.Link parsePersonLink(java.lang.String elementName, XMLStreamReade
     private PlanDefinition parsePlanDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PlanDefinition.Builder builder = PlanDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, libraryElementIndex = 0, goalElementIndex = 0, actionElementIndex = 0;
         while (reader.hasNext()) {
@@ -36322,7 +38653,11 @@ private PlanDefinition parsePlanDefinition(java.lang.String elementName, XMLStre
                     builder.action(parsePlanDefinitionAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36339,6 +38674,7 @@ private PlanDefinition parsePlanDefinition(java.lang.String elementName, XMLStre
     private PlanDefinition.Action parsePlanDefinitionAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PlanDefinition.Action.Builder builder = PlanDefinition.Action.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -36497,7 +38833,11 @@ private PlanDefinition.Action parsePlanDefinitionAction(java.lang.String element
                     builder.action(parsePlanDefinitionAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36514,6 +38854,7 @@ private PlanDefinition.Action parsePlanDefinitionAction(java.lang.String element
     private PlanDefinition.Action.Condition parsePlanDefinitionActionCondition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PlanDefinition.Action.Condition.Builder builder = PlanDefinition.Action.Condition.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -36544,7 +38885,11 @@ private PlanDefinition.Action.Condition parsePlanDefinitionActionCondition(java.
                     builder.expression(parseExpression("expression", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36561,6 +38906,7 @@ private PlanDefinition.Action.Condition parsePlanDefinitionActionCondition(java.
     private PlanDefinition.Action.DynamicValue parsePlanDefinitionActionDynamicValue(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PlanDefinition.Action.DynamicValue.Builder builder = PlanDefinition.Action.DynamicValue.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -36591,7 +38937,11 @@ private PlanDefinition.Action.DynamicValue parsePlanDefinitionActionDynamicValue
                     builder.expression(parseExpression("expression", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36608,6 +38958,7 @@ private PlanDefinition.Action.DynamicValue parsePlanDefinitionActionDynamicValue
     private PlanDefinition.Action.Participant parsePlanDefinitionActionParticipant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PlanDefinition.Action.Participant.Builder builder = PlanDefinition.Action.Participant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -36638,7 +38989,11 @@ private PlanDefinition.Action.Participant parsePlanDefinitionActionParticipant(j
                     builder.role(parseCodeableConcept("role", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36655,6 +39010,7 @@ private PlanDefinition.Action.Participant parsePlanDefinitionActionParticipant(j
     private PlanDefinition.Action.RelatedAction parsePlanDefinitionActionRelatedAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PlanDefinition.Action.RelatedAction.Builder builder = PlanDefinition.Action.RelatedAction.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -36693,7 +39049,11 @@ private PlanDefinition.Action.RelatedAction parsePlanDefinitionActionRelatedActi
                     builder.offset(parseRange("offsetRange", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36710,6 +39070,7 @@ private PlanDefinition.Action.RelatedAction parsePlanDefinitionActionRelatedActi
     private PlanDefinition.Goal parsePlanDefinitionGoal(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PlanDefinition.Goal.Builder builder = PlanDefinition.Goal.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -36760,7 +39121,11 @@ private PlanDefinition.Goal parsePlanDefinitionGoal(java.lang.String elementName
                     builder.target(parsePlanDefinitionGoalTarget("target", reader, targetElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36777,6 +39142,7 @@ private PlanDefinition.Goal parsePlanDefinitionGoal(java.lang.String elementName
     private PlanDefinition.Goal.Target parsePlanDefinitionGoalTarget(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PlanDefinition.Goal.Target.Builder builder = PlanDefinition.Goal.Target.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -36819,7 +39185,11 @@ private PlanDefinition.Goal.Target parsePlanDefinitionGoalTarget(java.lang.Strin
                     builder.due((Duration) parseQuantity(Duration.builder(), "due", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36836,6 +39206,7 @@ private PlanDefinition.Goal.Target parsePlanDefinitionGoalTarget(java.lang.Strin
     private Population parsePopulation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Population.Builder builder = Population.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -36878,7 +39249,11 @@ private Population parsePopulation(java.lang.String elementName, XMLStreamReader
                     builder.physiologicalCondition(parseCodeableConcept("physiologicalCondition", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36895,6 +39270,7 @@ private Population parsePopulation(java.lang.String elementName, XMLStreamReader
     private Practitioner parsePractitioner(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Practitioner.Builder builder = Practitioner.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, nameElementIndex = 0, telecomElementIndex = 0, addressElementIndex = 0, photoElementIndex = 0, qualificationElementIndex = 0, communicationElementIndex = 0;
         while (reader.hasNext()) {
@@ -36977,7 +39353,11 @@ private Practitioner parsePractitioner(java.lang.String elementName, XMLStreamRe
                     builder.communication(parseCodeableConcept("communication", reader, communicationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -36994,6 +39374,7 @@ private Practitioner parsePractitioner(java.lang.String elementName, XMLStreamRe
     private Practitioner.Qualification parsePractitionerQualification(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Practitioner.Qualification.Builder builder = Practitioner.Qualification.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37032,7 +39413,11 @@ private Practitioner.Qualification parsePractitionerQualification(java.lang.Stri
                     builder.issuer(parseReference("issuer", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37049,6 +39434,7 @@ private Practitioner.Qualification parsePractitionerQualification(java.lang.Stri
     private PractitionerRole parsePractitionerRole(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PractitionerRole.Builder builder = PractitionerRole.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, codeElementIndex = 0, specialtyElementIndex = 0, locationElementIndex = 0, healthcareServiceElementIndex = 0, telecomElementIndex = 0, availableTimeElementIndex = 0, notAvailableElementIndex = 0, endpointElementIndex = 0;
         while (reader.hasNext()) {
@@ -37147,7 +39533,11 @@ private PractitionerRole parsePractitionerRole(java.lang.String elementName, XML
                     builder.endpoint(parseReference("endpoint", reader, endpointElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37164,6 +39554,7 @@ private PractitionerRole parsePractitionerRole(java.lang.String elementName, XML
     private PractitionerRole.AvailableTime parsePractitionerRoleAvailableTime(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PractitionerRole.AvailableTime.Builder builder = PractitionerRole.AvailableTime.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37202,7 +39593,11 @@ private PractitionerRole.AvailableTime parsePractitionerRoleAvailableTime(java.l
                     builder.availableEndTime(parseTime("availableEndTime", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37219,6 +39614,7 @@ private PractitionerRole.AvailableTime parsePractitionerRoleAvailableTime(java.l
     private PractitionerRole.NotAvailable parsePractitionerRoleNotAvailable(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         PractitionerRole.NotAvailable.Builder builder = PractitionerRole.NotAvailable.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37249,7 +39645,11 @@ private PractitionerRole.NotAvailable parsePractitionerRoleNotAvailable(java.lan
                     builder.during(parsePeriod("during", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37266,6 +39666,7 @@ private PractitionerRole.NotAvailable parsePractitionerRoleNotAvailable(java.lan
     private Procedure parseProcedure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Procedure.Builder builder = Procedure.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, instantiatesCanonicalElementIndex = 0, instantiatesUriElementIndex = 0, basedOnElementIndex = 0, partOfElementIndex = 0, performerElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, bodySiteElementIndex = 0, reportElementIndex = 0, complicationElementIndex = 0, complicationDetailElementIndex = 0, followUpElementIndex = 0, noteElementIndex = 0, focalDeviceElementIndex = 0, usedReferenceElementIndex = 0, usedCodeElementIndex = 0;
         while (reader.hasNext()) {
@@ -37436,7 +39837,11 @@ private Procedure parseProcedure(java.lang.String elementName, XMLStreamReader r
                     builder.usedCode(parseCodeableConcept("usedCode", reader, usedCodeElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37453,6 +39858,7 @@ private Procedure parseProcedure(java.lang.String elementName, XMLStreamReader r
     private Procedure.FocalDevice parseProcedureFocalDevice(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Procedure.FocalDevice.Builder builder = Procedure.FocalDevice.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37483,7 +39889,11 @@ private Procedure.FocalDevice parseProcedureFocalDevice(java.lang.String element
                     builder.manipulated(parseReference("manipulated", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37500,6 +39910,7 @@ private Procedure.FocalDevice parseProcedureFocalDevice(java.lang.String element
     private Procedure.Performer parseProcedurePerformer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Procedure.Performer.Builder builder = Procedure.Performer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37534,7 +39945,11 @@ private Procedure.Performer parseProcedurePerformer(java.lang.String elementName
                     builder.onBehalfOf(parseReference("onBehalfOf", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37551,6 +39966,7 @@ private Procedure.Performer parseProcedurePerformer(java.lang.String elementName
     private ProdCharacteristic parseProdCharacteristic(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ProdCharacteristic.Builder builder = ProdCharacteristic.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37617,7 +40033,11 @@ private ProdCharacteristic parseProdCharacteristic(java.lang.String elementName,
                     builder.scoring(parseCodeableConcept("scoring", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37634,6 +40054,7 @@ private ProdCharacteristic parseProdCharacteristic(java.lang.String elementName,
     private ProductShelfLife parseProductShelfLife(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ProductShelfLife.Builder builder = ProductShelfLife.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37672,7 +40093,11 @@ private ProductShelfLife parseProductShelfLife(java.lang.String elementName, XML
                     builder.specialPrecautionsForStorage(parseCodeableConcept("specialPrecautionsForStorage", reader, specialPrecautionsForStorageElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37689,6 +40114,7 @@ private ProductShelfLife parseProductShelfLife(java.lang.String elementName, XML
     private Provenance parseProvenance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Provenance.Builder builder = Provenance.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, targetElementIndex = 0, policyElementIndex = 0, reasonElementIndex = 0, agentElementIndex = 0, entityElementIndex = 0, signatureElementIndex = 0;
         while (reader.hasNext()) {
@@ -37775,7 +40201,11 @@ private Provenance parseProvenance(java.lang.String elementName, XMLStreamReader
                     builder.signature(parseSignature("signature", reader, signatureElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37792,6 +40222,7 @@ private Provenance parseProvenance(java.lang.String elementName, XMLStreamReader
     private Provenance.Agent parseProvenanceAgent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Provenance.Agent.Builder builder = Provenance.Agent.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37830,7 +40261,11 @@ private Provenance.Agent parseProvenanceAgent(java.lang.String elementName, XMLS
                     builder.onBehalfOf(parseReference("onBehalfOf", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37847,6 +40282,7 @@ private Provenance.Agent parseProvenanceAgent(java.lang.String elementName, XMLS
     private Provenance.Entity parseProvenanceEntity(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Provenance.Entity.Builder builder = Provenance.Entity.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37881,7 +40317,11 @@ private Provenance.Entity parseProvenanceEntity(java.lang.String elementName, XM
                     builder.agent(parseProvenanceAgent("agent", reader, agentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37897,6 +40337,7 @@ private Provenance.Entity parseProvenanceEntity(java.lang.String elementName, XM
 
     private Quantity parseQuantity(Quantity.Builder builder, java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -37935,7 +40376,11 @@ private Quantity parseQuantity(Quantity.Builder builder, java.lang.String elemen
                     builder.code((Code) parseString(Code.builder(), "code", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -37956,6 +40401,7 @@ private Quantity parseQuantity(java.lang.String elementName, XMLStreamReader rea
     private Questionnaire parseQuestionnaire(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Questionnaire.Builder builder = Questionnaire.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, derivedFromElementIndex = 0, subjectTypeElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, codeElementIndex = 0, itemElementIndex = 0;
         while (reader.hasNext()) {
@@ -38086,7 +40532,11 @@ private Questionnaire parseQuestionnaire(java.lang.String elementName, XMLStream
                     builder.item(parseQuestionnaireItem("item", reader, itemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38103,6 +40553,7 @@ private Questionnaire parseQuestionnaire(java.lang.String elementName, XMLStream
     private Questionnaire.Item parseQuestionnaireItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Questionnaire.Item.Builder builder = Questionnaire.Item.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38189,7 +40640,11 @@ private Questionnaire.Item parseQuestionnaireItem(java.lang.String elementName,
                     builder.item(parseQuestionnaireItem("item", reader, itemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38206,6 +40661,7 @@ private Questionnaire.Item parseQuestionnaireItem(java.lang.String elementName,
     private Questionnaire.Item.AnswerOption parseQuestionnaireItemAnswerOption(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Questionnaire.Item.AnswerOption.Builder builder = Questionnaire.Item.AnswerOption.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38256,7 +40712,11 @@ private Questionnaire.Item.AnswerOption parseQuestionnaireItemAnswerOption(java.
                     builder.initialSelected(parseBoolean("initialSelected", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38273,6 +40733,7 @@ private Questionnaire.Item.AnswerOption parseQuestionnaireItemAnswerOption(java.
     private Questionnaire.Item.EnableWhen parseQuestionnaireItemEnableWhen(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Questionnaire.Item.EnableWhen.Builder builder = Questionnaire.Item.EnableWhen.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38343,7 +40804,11 @@ private Questionnaire.Item.EnableWhen parseQuestionnaireItemEnableWhen(java.lang
                     builder.answer(parseReference("answerReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38360,6 +40825,7 @@ private Questionnaire.Item.EnableWhen parseQuestionnaireItemEnableWhen(java.lang
     private Questionnaire.Item.Initial parseQuestionnaireItemInitial(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Questionnaire.Item.Initial.Builder builder = Questionnaire.Item.Initial.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38430,7 +40896,11 @@ private Questionnaire.Item.Initial parseQuestionnaireItemInitial(java.lang.Strin
                     builder.value(parseReference("valueReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38447,6 +40917,7 @@ private Questionnaire.Item.Initial parseQuestionnaireItemInitial(java.lang.Strin
     private QuestionnaireResponse parseQuestionnaireResponse(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         QuestionnaireResponse.Builder builder = QuestionnaireResponse.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, basedOnElementIndex = 0, partOfElementIndex = 0, itemElementIndex = 0;
         while (reader.hasNext()) {
@@ -38533,7 +41004,11 @@ private QuestionnaireResponse parseQuestionnaireResponse(java.lang.String elemen
                     builder.item(parseQuestionnaireResponseItem("item", reader, itemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38550,6 +41025,7 @@ private QuestionnaireResponse parseQuestionnaireResponse(java.lang.String elemen
     private QuestionnaireResponse.Item parseQuestionnaireResponseItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         QuestionnaireResponse.Item.Builder builder = QuestionnaireResponse.Item.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38592,7 +41068,11 @@ private QuestionnaireResponse.Item parseQuestionnaireResponseItem(java.lang.Stri
                     builder.item(parseQuestionnaireResponseItem("item", reader, itemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38609,6 +41089,7 @@ private QuestionnaireResponse.Item parseQuestionnaireResponseItem(java.lang.Stri
     private QuestionnaireResponse.Item.Answer parseQuestionnaireResponseItemAnswer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         QuestionnaireResponse.Item.Answer.Builder builder = QuestionnaireResponse.Item.Answer.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38683,7 +41164,11 @@ private QuestionnaireResponse.Item.Answer parseQuestionnaireResponseItemAnswer(j
                     builder.item(parseQuestionnaireResponseItem("item", reader, itemElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38700,6 +41185,7 @@ private QuestionnaireResponse.Item.Answer parseQuestionnaireResponseItemAnswer(j
     private Range parseRange(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Range.Builder builder = Range.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38726,7 +41212,11 @@ private Range parseRange(java.lang.String elementName, XMLStreamReader reader, i
                     builder.high((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "high", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38743,6 +41233,7 @@ private Range parseRange(java.lang.String elementName, XMLStreamReader reader, i
     private Ratio parseRatio(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Ratio.Builder builder = Ratio.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38769,7 +41260,11 @@ private Ratio parseRatio(java.lang.String elementName, XMLStreamReader reader, i
                     builder.denominator(parseQuantity("denominator", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38786,6 +41281,7 @@ private Ratio parseRatio(java.lang.String elementName, XMLStreamReader reader, i
     private Reference parseReference(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Reference.Builder builder = Reference.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38820,7 +41316,11 @@ private Reference parseReference(java.lang.String elementName, XMLStreamReader r
                     builder.display(parseString("display", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38837,6 +41337,7 @@ private Reference parseReference(java.lang.String elementName, XMLStreamReader r
     private RelatedArtifact parseRelatedArtifact(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RelatedArtifact.Builder builder = RelatedArtifact.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -38883,7 +41384,11 @@ private RelatedArtifact parseRelatedArtifact(java.lang.String elementName, XMLSt
                     builder.resource((Canonical) parseUri(Canonical.builder(), "resource", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -38900,6 +41405,7 @@ private RelatedArtifact parseRelatedArtifact(java.lang.String elementName, XMLSt
     private RelatedPerson parseRelatedPerson(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RelatedPerson.Builder builder = RelatedPerson.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, relationshipElementIndex = 0, nameElementIndex = 0, telecomElementIndex = 0, addressElementIndex = 0, photoElementIndex = 0, communicationElementIndex = 0;
         while (reader.hasNext()) {
@@ -38990,7 +41496,11 @@ private RelatedPerson parseRelatedPerson(java.lang.String elementName, XMLStream
                     builder.communication(parseRelatedPersonCommunication("communication", reader, communicationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -39007,6 +41517,7 @@ private RelatedPerson parseRelatedPerson(java.lang.String elementName, XMLStream
     private RelatedPerson.Communication parseRelatedPersonCommunication(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RelatedPerson.Communication.Builder builder = RelatedPerson.Communication.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -39037,7 +41548,11 @@ private RelatedPerson.Communication parseRelatedPersonCommunication(java.lang.St
                     builder.preferred(parseBoolean("preferred", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -39054,6 +41569,7 @@ private RelatedPerson.Communication parseRelatedPersonCommunication(java.lang.St
     private RequestGroup parseRequestGroup(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RequestGroup.Builder builder = RequestGroup.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, instantiatesCanonicalElementIndex = 0, instantiatesUriElementIndex = 0, basedOnElementIndex = 0, replacesElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, noteElementIndex = 0, actionElementIndex = 0;
         while (reader.hasNext()) {
@@ -39168,7 +41684,11 @@ private RequestGroup parseRequestGroup(java.lang.String elementName, XMLStreamRe
                     builder.action(parseRequestGroupAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -39185,6 +41705,7 @@ private RequestGroup parseRequestGroup(java.lang.String elementName, XMLStreamRe
     private RequestGroup.Action parseRequestGroupAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RequestGroup.Action.Builder builder = RequestGroup.Action.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -39303,7 +41824,11 @@ private RequestGroup.Action parseRequestGroupAction(java.lang.String elementName
                     builder.action(parseRequestGroupAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -39320,6 +41845,7 @@ private RequestGroup.Action parseRequestGroupAction(java.lang.String elementName
     private RequestGroup.Action.Condition parseRequestGroupActionCondition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RequestGroup.Action.Condition.Builder builder = RequestGroup.Action.Condition.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -39350,7 +41876,11 @@ private RequestGroup.Action.Condition parseRequestGroupActionCondition(java.lang
                     builder.expression(parseExpression("expression", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -39367,6 +41897,7 @@ private RequestGroup.Action.Condition parseRequestGroupActionCondition(java.lang
     private RequestGroup.Action.RelatedAction parseRequestGroupActionRelatedAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RequestGroup.Action.RelatedAction.Builder builder = RequestGroup.Action.RelatedAction.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -39405,7 +41936,11 @@ private RequestGroup.Action.RelatedAction parseRequestGroupActionRelatedAction(j
                     builder.offset(parseRange("offsetRange", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -39422,6 +41957,7 @@ private RequestGroup.Action.RelatedAction parseRequestGroupActionRelatedAction(j
     private ResearchDefinition parseResearchDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ResearchDefinition.Builder builder = ResearchDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, commentElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, libraryElementIndex = 0;
         while (reader.hasNext()) {
@@ -39604,7 +42140,11 @@ private ResearchDefinition parseResearchDefinition(java.lang.String elementName,
                     builder.outcome(parseReference("outcome", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -39621,6 +42161,7 @@ private ResearchDefinition parseResearchDefinition(java.lang.String elementName,
     private ResearchElementDefinition parseResearchElementDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ResearchElementDefinition.Builder builder = ResearchElementDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, commentElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, libraryElementIndex = 0, characteristicElementIndex = 0;
         while (reader.hasNext()) {
@@ -39799,7 +42340,11 @@ private ResearchElementDefinition parseResearchElementDefinition(java.lang.Strin
                     builder.characteristic(parseResearchElementDefinitionCharacteristic("characteristic", reader, characteristicElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -39816,6 +42361,7 @@ private ResearchElementDefinition parseResearchElementDefinition(java.lang.Strin
     private ResearchElementDefinition.Characteristic parseResearchElementDefinitionCharacteristic(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ResearchElementDefinition.Characteristic.Builder builder = ResearchElementDefinition.Characteristic.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -39922,7 +42468,11 @@ private ResearchElementDefinition.Characteristic parseResearchElementDefinitionC
                     builder.participantEffectiveGroupMeasure((GroupMeasure) parseString(GroupMeasure.builder(), "participantEffectiveGroupMeasure", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -39939,6 +42489,7 @@ private ResearchElementDefinition.Characteristic parseResearchElementDefinitionC
     private ResearchStudy parseResearchStudy(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ResearchStudy.Builder builder = ResearchStudy.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, protocolElementIndex = 0, partOfElementIndex = 0, categoryElementIndex = 0, focusElementIndex = 0, conditionElementIndex = 0, contactElementIndex = 0, relatedArtifactElementIndex = 0, keywordElementIndex = 0, locationElementIndex = 0, enrollmentElementIndex = 0, siteElementIndex = 0, noteElementIndex = 0, armElementIndex = 0, objectiveElementIndex = 0;
         while (reader.hasNext()) {
@@ -40077,7 +42628,11 @@ private ResearchStudy parseResearchStudy(java.lang.String elementName, XMLStream
                     builder.objective(parseResearchStudyObjective("objective", reader, objectiveElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40094,6 +42649,7 @@ private ResearchStudy parseResearchStudy(java.lang.String elementName, XMLStream
     private ResearchStudy.Arm parseResearchStudyArm(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ResearchStudy.Arm.Builder builder = ResearchStudy.Arm.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -40128,7 +42684,11 @@ private ResearchStudy.Arm parseResearchStudyArm(java.lang.String elementName, XM
                     builder.description(parseString("description", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40145,6 +42705,7 @@ private ResearchStudy.Arm parseResearchStudyArm(java.lang.String elementName, XM
     private ResearchStudy.Objective parseResearchStudyObjective(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ResearchStudy.Objective.Builder builder = ResearchStudy.Objective.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -40175,7 +42736,11 @@ private ResearchStudy.Objective parseResearchStudyObjective(java.lang.String ele
                     builder.type(parseCodeableConcept("type", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40192,6 +42757,7 @@ private ResearchStudy.Objective parseResearchStudyObjective(java.lang.String ele
     private ResearchSubject parseResearchSubject(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ResearchSubject.Builder builder = ResearchSubject.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0;
         while (reader.hasNext()) {
@@ -40266,7 +42832,11 @@ private ResearchSubject parseResearchSubject(java.lang.String elementName, XMLSt
                     builder.consent(parseReference("consent", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40283,6 +42853,7 @@ private ResearchSubject parseResearchSubject(java.lang.String elementName, XMLSt
     private RiskAssessment parseRiskAssessment(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RiskAssessment.Builder builder = RiskAssessment.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, basisElementIndex = 0, predictionElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -40397,7 +42968,11 @@ private RiskAssessment parseRiskAssessment(java.lang.String elementName, XMLStre
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40414,6 +42989,7 @@ private RiskAssessment parseRiskAssessment(java.lang.String elementName, XMLStre
     private RiskAssessment.Prediction parseRiskAssessmentPrediction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RiskAssessment.Prediction.Builder builder = RiskAssessment.Prediction.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -40468,7 +43044,11 @@ private RiskAssessment.Prediction parseRiskAssessmentPrediction(java.lang.String
                     builder.rationale(parseString("rationale", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40485,6 +43065,7 @@ private RiskAssessment.Prediction parseRiskAssessmentPrediction(java.lang.String
     private RiskEvidenceSynthesis parseRiskEvidenceSynthesis(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RiskEvidenceSynthesis.Builder builder = RiskEvidenceSynthesis.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, noteElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, topicElementIndex = 0, authorElementIndex = 0, editorElementIndex = 0, reviewerElementIndex = 0, endorserElementIndex = 0, relatedArtifactElementIndex = 0, certaintyElementIndex = 0;
         while (reader.hasNext()) {
@@ -40651,7 +43232,11 @@ private RiskEvidenceSynthesis parseRiskEvidenceSynthesis(java.lang.String elemen
                     builder.certainty(parseRiskEvidenceSynthesisCertainty("certainty", reader, certaintyElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40668,6 +43253,7 @@ private RiskEvidenceSynthesis parseRiskEvidenceSynthesis(java.lang.String elemen
     private RiskEvidenceSynthesis.Certainty parseRiskEvidenceSynthesisCertainty(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RiskEvidenceSynthesis.Certainty.Builder builder = RiskEvidenceSynthesis.Certainty.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -40702,7 +43288,11 @@ private RiskEvidenceSynthesis.Certainty parseRiskEvidenceSynthesisCertainty(java
                     builder.certaintySubcomponent(parseRiskEvidenceSynthesisCertaintyCertaintySubcomponent("certaintySubcomponent", reader, certaintySubcomponentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40719,6 +43309,7 @@ private RiskEvidenceSynthesis.Certainty parseRiskEvidenceSynthesisCertainty(java
     private RiskEvidenceSynthesis.Certainty.CertaintySubcomponent parseRiskEvidenceSynthesisCertaintyCertaintySubcomponent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RiskEvidenceSynthesis.Certainty.CertaintySubcomponent.Builder builder = RiskEvidenceSynthesis.Certainty.CertaintySubcomponent.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -40753,7 +43344,11 @@ private RiskEvidenceSynthesis.Certainty.CertaintySubcomponent parseRiskEvidenceS
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40770,6 +43365,7 @@ private RiskEvidenceSynthesis.Certainty.CertaintySubcomponent parseRiskEvidenceS
     private RiskEvidenceSynthesis.RiskEstimate parseRiskEvidenceSynthesisRiskEstimate(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RiskEvidenceSynthesis.RiskEstimate.Builder builder = RiskEvidenceSynthesis.RiskEstimate.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -40820,7 +43416,11 @@ private RiskEvidenceSynthesis.RiskEstimate parseRiskEvidenceSynthesisRiskEstimat
                     builder.precisionEstimate(parseRiskEvidenceSynthesisRiskEstimatePrecisionEstimate("precisionEstimate", reader, precisionEstimateElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40837,6 +43437,7 @@ private RiskEvidenceSynthesis.RiskEstimate parseRiskEvidenceSynthesisRiskEstimat
     private RiskEvidenceSynthesis.RiskEstimate.PrecisionEstimate parseRiskEvidenceSynthesisRiskEstimatePrecisionEstimate(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RiskEvidenceSynthesis.RiskEstimate.PrecisionEstimate.Builder builder = RiskEvidenceSynthesis.RiskEstimate.PrecisionEstimate.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -40875,7 +43476,11 @@ private RiskEvidenceSynthesis.RiskEstimate.PrecisionEstimate parseRiskEvidenceSy
                     builder.to(parseDecimal("to", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40892,6 +43497,7 @@ private RiskEvidenceSynthesis.RiskEstimate.PrecisionEstimate parseRiskEvidenceSy
     private RiskEvidenceSynthesis.SampleSize parseRiskEvidenceSynthesisSampleSize(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         RiskEvidenceSynthesis.SampleSize.Builder builder = RiskEvidenceSynthesis.SampleSize.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -40926,7 +43532,11 @@ private RiskEvidenceSynthesis.SampleSize parseRiskEvidenceSynthesisSampleSize(ja
                     builder.numberOfParticipants(parseInteger("numberOfParticipants", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -40943,6 +43553,7 @@ private RiskEvidenceSynthesis.SampleSize parseRiskEvidenceSynthesisSampleSize(ja
     private SampledData parseSampledData(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SampledData.Builder builder = SampledData.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -40989,7 +43600,11 @@ private SampledData parseSampledData(java.lang.String elementName, XMLStreamRead
                     builder.data(parseString("data", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41006,6 +43621,7 @@ private SampledData parseSampledData(java.lang.String elementName, XMLStreamRead
     private Schedule parseSchedule(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Schedule.Builder builder = Schedule.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, serviceCategoryElementIndex = 0, serviceTypeElementIndex = 0, specialtyElementIndex = 0, actorElementIndex = 0;
         while (reader.hasNext()) {
@@ -41080,7 +43696,11 @@ private Schedule parseSchedule(java.lang.String elementName, XMLStreamReader rea
                     builder.comment(parseString("comment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41097,6 +43717,7 @@ private Schedule parseSchedule(java.lang.String elementName, XMLStreamReader rea
     private SearchParameter parseSearchParameter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SearchParameter.Builder builder = SearchParameter.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, baseElementIndex = 0, targetElementIndex = 0, comparatorElementIndex = 0, modifierElementIndex = 0, chainElementIndex = 0, componentElementIndex = 0;
         while (reader.hasNext()) {
@@ -41243,7 +43864,11 @@ private SearchParameter parseSearchParameter(java.lang.String elementName, XMLSt
                     builder.component(parseSearchParameterComponent("component", reader, componentElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41260,6 +43885,7 @@ private SearchParameter parseSearchParameter(java.lang.String elementName, XMLSt
     private SearchParameter.Component parseSearchParameterComponent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SearchParameter.Component.Builder builder = SearchParameter.Component.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -41290,7 +43916,11 @@ private SearchParameter.Component parseSearchParameterComponent(java.lang.String
                     builder.expression(parseString("expression", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41307,6 +43937,7 @@ private SearchParameter.Component parseSearchParameterComponent(java.lang.String
     private ServiceRequest parseServiceRequest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ServiceRequest.Builder builder = ServiceRequest.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, instantiatesCanonicalElementIndex = 0, instantiatesUriElementIndex = 0, basedOnElementIndex = 0, replacesElementIndex = 0, categoryElementIndex = 0, orderDetailElementIndex = 0, performerElementIndex = 0, locationCodeElementIndex = 0, locationReferenceElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0, insuranceElementIndex = 0, supportingInfoElementIndex = 0, specimenElementIndex = 0, bodySiteElementIndex = 0, noteElementIndex = 0, relevantHistoryElementIndex = 0;
         while (reader.hasNext()) {
@@ -41501,7 +44132,11 @@ private ServiceRequest parseServiceRequest(java.lang.String elementName, XMLStre
                     builder.relevantHistory(parseReference("relevantHistory", reader, relevantHistoryElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41518,6 +44153,7 @@ private ServiceRequest parseServiceRequest(java.lang.String elementName, XMLStre
     private Signature parseSignature(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Signature.Builder builder = Signature.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -41564,7 +44200,11 @@ private Signature parseSignature(java.lang.String elementName, XMLStreamReader r
                     builder.data(parseBase64Binary("data", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41581,6 +44221,7 @@ private Signature parseSignature(java.lang.String elementName, XMLStreamReader r
     private Slot parseSlot(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Slot.Builder builder = Slot.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, serviceCategoryElementIndex = 0, serviceTypeElementIndex = 0, specialtyElementIndex = 0;
         while (reader.hasNext()) {
@@ -41667,7 +44308,11 @@ private Slot parseSlot(java.lang.String elementName, XMLStreamReader reader, int
                     builder.comment(parseString("comment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41684,6 +44329,7 @@ private Slot parseSlot(java.lang.String elementName, XMLStreamReader reader, int
     private Specimen parseSpecimen(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Specimen.Builder builder = Specimen.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, parentElementIndex = 0, requestElementIndex = 0, processingElementIndex = 0, containerElementIndex = 0, conditionElementIndex = 0, noteElementIndex = 0;
         while (reader.hasNext()) {
@@ -41778,7 +44424,11 @@ private Specimen parseSpecimen(java.lang.String elementName, XMLStreamReader rea
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41795,6 +44445,7 @@ private Specimen parseSpecimen(java.lang.String elementName, XMLStreamReader rea
     private Specimen.Collection parseSpecimenCollection(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Specimen.Collection.Builder builder = Specimen.Collection.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -41853,7 +44504,11 @@ private Specimen.Collection parseSpecimenCollection(java.lang.String elementName
                     builder.fastingStatus((Duration) parseQuantity(Duration.builder(), "fastingStatusDuration", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41870,6 +44525,7 @@ private Specimen.Collection parseSpecimenCollection(java.lang.String elementName
     private Specimen.Container parseSpecimenContainer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Specimen.Container.Builder builder = Specimen.Container.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -41920,7 +44576,11 @@ private Specimen.Container parseSpecimenContainer(java.lang.String elementName,
                     builder.additive(parseReference("additiveReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41937,6 +44597,7 @@ private Specimen.Container parseSpecimenContainer(java.lang.String elementName,
     private Specimen.Processing parseSpecimenProcessing(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Specimen.Processing.Builder builder = Specimen.Processing.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -41979,7 +44640,11 @@ private Specimen.Processing parseSpecimenProcessing(java.lang.String elementName
                     builder.time(parsePeriod("timePeriod", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -41996,6 +44661,7 @@ private Specimen.Processing parseSpecimenProcessing(java.lang.String elementName
     private SpecimenDefinition parseSpecimenDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SpecimenDefinition.Builder builder = SpecimenDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, patientPreparationElementIndex = 0, collectionElementIndex = 0, typeTestedElementIndex = 0;
         while (reader.hasNext()) {
@@ -42062,7 +44728,11 @@ private SpecimenDefinition parseSpecimenDefinition(java.lang.String elementName,
                     builder.typeTested(parseSpecimenDefinitionTypeTested("typeTested", reader, typeTestedElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42079,6 +44749,7 @@ private SpecimenDefinition parseSpecimenDefinition(java.lang.String elementName,
     private SpecimenDefinition.TypeTested parseSpecimenDefinitionTypeTested(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SpecimenDefinition.TypeTested.Builder builder = SpecimenDefinition.TypeTested.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42133,7 +44804,11 @@ private SpecimenDefinition.TypeTested parseSpecimenDefinitionTypeTested(java.lan
                     builder.handling(parseSpecimenDefinitionTypeTestedHandling("handling", reader, handlingElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42150,6 +44825,7 @@ private SpecimenDefinition.TypeTested parseSpecimenDefinitionTypeTested(java.lan
     private SpecimenDefinition.TypeTested.Container parseSpecimenDefinitionTypeTestedContainer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SpecimenDefinition.TypeTested.Container.Builder builder = SpecimenDefinition.TypeTested.Container.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42208,7 +44884,11 @@ private SpecimenDefinition.TypeTested.Container parseSpecimenDefinitionTypeTeste
                     builder.preparation(parseString("preparation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42225,6 +44905,7 @@ private SpecimenDefinition.TypeTested.Container parseSpecimenDefinitionTypeTeste
     private SpecimenDefinition.TypeTested.Container.Additive parseSpecimenDefinitionTypeTestedContainerAdditive(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SpecimenDefinition.TypeTested.Container.Additive.Builder builder = SpecimenDefinition.TypeTested.Container.Additive.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42255,7 +44936,11 @@ private SpecimenDefinition.TypeTested.Container.Additive parseSpecimenDefinition
                     builder.additive(parseReference("additiveReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42272,6 +44957,7 @@ private SpecimenDefinition.TypeTested.Container.Additive parseSpecimenDefinition
     private SpecimenDefinition.TypeTested.Handling parseSpecimenDefinitionTypeTestedHandling(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SpecimenDefinition.TypeTested.Handling.Builder builder = SpecimenDefinition.TypeTested.Handling.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42310,7 +44996,11 @@ private SpecimenDefinition.TypeTested.Handling parseSpecimenDefinitionTypeTested
                     builder.instruction(parseString("instruction", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42326,6 +45016,7 @@ private SpecimenDefinition.TypeTested.Handling parseSpecimenDefinitionTypeTested
 
     private String parseString(String.Builder builder, java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42348,7 +45039,11 @@ private String parseString(String.Builder builder, java.lang.String elementName,
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42369,6 +45064,7 @@ private String parseString(java.lang.String elementName, XMLStreamReader reader,
     private StructureDefinition parseStructureDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureDefinition.Builder builder = StructureDefinition.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, keywordElementIndex = 0, mappingElementIndex = 0, contextElementIndex = 0, contextInvariantElementIndex = 0;
         while (reader.hasNext()) {
@@ -42519,7 +45215,11 @@ private StructureDefinition parseStructureDefinition(java.lang.String elementNam
                     builder.differential(parseStructureDefinitionDifferential("differential", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42536,6 +45236,7 @@ private StructureDefinition parseStructureDefinition(java.lang.String elementNam
     private StructureDefinition.Context parseStructureDefinitionContext(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureDefinition.Context.Builder builder = StructureDefinition.Context.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42566,7 +45267,11 @@ private StructureDefinition.Context parseStructureDefinitionContext(java.lang.St
                     builder.expression(parseString("expression", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42583,6 +45288,7 @@ private StructureDefinition.Context parseStructureDefinitionContext(java.lang.St
     private StructureDefinition.Differential parseStructureDefinitionDifferential(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureDefinition.Differential.Builder builder = StructureDefinition.Differential.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42609,7 +45315,11 @@ private StructureDefinition.Differential parseStructureDefinitionDifferential(ja
                     builder.element(parseElementDefinition("element", reader, elementElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42626,6 +45336,7 @@ private StructureDefinition.Differential parseStructureDefinitionDifferential(ja
     private StructureDefinition.Mapping parseStructureDefinitionMapping(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureDefinition.Mapping.Builder builder = StructureDefinition.Mapping.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42664,7 +45375,11 @@ private StructureDefinition.Mapping parseStructureDefinitionMapping(java.lang.St
                     builder.comment(parseString("comment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42681,6 +45396,7 @@ private StructureDefinition.Mapping parseStructureDefinitionMapping(java.lang.St
     private StructureDefinition.Snapshot parseStructureDefinitionSnapshot(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureDefinition.Snapshot.Builder builder = StructureDefinition.Snapshot.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42707,7 +45423,11 @@ private StructureDefinition.Snapshot parseStructureDefinitionSnapshot(java.lang.
                     builder.element(parseElementDefinition("element", reader, elementElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42724,6 +45444,7 @@ private StructureDefinition.Snapshot parseStructureDefinitionSnapshot(java.lang.
     private StructureMap parseStructureMap(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureMap.Builder builder = StructureMap.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, structureElementIndex = 0, importElementIndex = 0, groupElementIndex = 0;
         while (reader.hasNext()) {
@@ -42838,7 +45559,11 @@ private StructureMap parseStructureMap(java.lang.String elementName, XMLStreamRe
                     builder.group(parseStructureMapGroup("group", reader, groupElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42855,6 +45580,7 @@ private StructureMap parseStructureMap(java.lang.String elementName, XMLStreamRe
     private StructureMap.Group parseStructureMapGroup(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureMap.Group.Builder builder = StructureMap.Group.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42901,7 +45627,11 @@ private StructureMap.Group parseStructureMapGroup(java.lang.String elementName,
                     builder.rule(parseStructureMapGroupRule("rule", reader, ruleElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42918,6 +45648,7 @@ private StructureMap.Group parseStructureMapGroup(java.lang.String elementName,
     private StructureMap.Group.Input parseStructureMapGroupInput(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureMap.Group.Input.Builder builder = StructureMap.Group.Input.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -42956,7 +45687,11 @@ private StructureMap.Group.Input parseStructureMapGroupInput(java.lang.String el
                     builder.documentation(parseString("documentation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -42973,6 +45708,7 @@ private StructureMap.Group.Input parseStructureMapGroupInput(java.lang.String el
     private StructureMap.Group.Rule parseStructureMapGroupRule(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureMap.Group.Rule.Builder builder = StructureMap.Group.Rule.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43019,7 +45755,11 @@ private StructureMap.Group.Rule parseStructureMapGroupRule(java.lang.String elem
                     builder.documentation(parseString("documentation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43036,6 +45776,7 @@ private StructureMap.Group.Rule parseStructureMapGroupRule(java.lang.String elem
     private StructureMap.Group.Rule.Dependent parseStructureMapGroupRuleDependent(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureMap.Group.Rule.Dependent.Builder builder = StructureMap.Group.Rule.Dependent.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43066,7 +45807,11 @@ private StructureMap.Group.Rule.Dependent parseStructureMapGroupRuleDependent(ja
                     builder.variable(parseString("variable", reader, variableElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43083,6 +45828,7 @@ private StructureMap.Group.Rule.Dependent parseStructureMapGroupRuleDependent(ja
     private StructureMap.Group.Rule.Source parseStructureMapGroupRuleSource(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureMap.Group.Rule.Source.Builder builder = StructureMap.Group.Rule.Source.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43345,7 +46091,11 @@ private StructureMap.Group.Rule.Source parseStructureMapGroupRuleSource(java.lan
                     builder.logMessage(parseString("logMessage", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43362,6 +46112,7 @@ private StructureMap.Group.Rule.Source parseStructureMapGroupRuleSource(java.lan
     private StructureMap.Group.Rule.Target parseStructureMapGroupRuleTarget(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureMap.Group.Rule.Target.Builder builder = StructureMap.Group.Rule.Target.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43416,7 +46167,11 @@ private StructureMap.Group.Rule.Target parseStructureMapGroupRuleTarget(java.lan
                     builder.parameter(parseStructureMapGroupRuleTargetParameter("parameter", reader, parameterElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43433,6 +46188,7 @@ private StructureMap.Group.Rule.Target parseStructureMapGroupRuleTarget(java.lan
     private StructureMap.Group.Rule.Target.Parameter parseStructureMapGroupRuleTargetParameter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureMap.Group.Rule.Target.Parameter.Builder builder = StructureMap.Group.Rule.Target.Parameter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43475,7 +46231,11 @@ private StructureMap.Group.Rule.Target.Parameter parseStructureMapGroupRuleTarge
                     builder.value(parseDecimal("valueDecimal", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43492,6 +46252,7 @@ private StructureMap.Group.Rule.Target.Parameter parseStructureMapGroupRuleTarge
     private StructureMap.Structure parseStructureMapStructure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         StructureMap.Structure.Builder builder = StructureMap.Structure.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43530,7 +46291,11 @@ private StructureMap.Structure parseStructureMapStructure(java.lang.String eleme
                     builder.documentation(parseString("documentation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43547,6 +46312,7 @@ private StructureMap.Structure parseStructureMapStructure(java.lang.String eleme
     private Subscription parseSubscription(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Subscription.Builder builder = Subscription.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0;
         while (reader.hasNext()) {
@@ -43617,7 +46383,11 @@ private Subscription parseSubscription(java.lang.String elementName, XMLStreamRe
                     builder.channel(parseSubscriptionChannel("channel", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43634,6 +46404,7 @@ private Subscription parseSubscription(java.lang.String elementName, XMLStreamRe
     private Subscription.Channel parseSubscriptionChannel(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Subscription.Channel.Builder builder = Subscription.Channel.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43672,7 +46443,11 @@ private Subscription.Channel parseSubscriptionChannel(java.lang.String elementNa
                     builder.header(parseString("header", reader, headerElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43689,6 +46464,7 @@ private Subscription.Channel parseSubscriptionChannel(java.lang.String elementNa
     private Substance parseSubstance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Substance.Builder builder = Substance.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, categoryElementIndex = 0, instanceElementIndex = 0, ingredientElementIndex = 0;
         while (reader.hasNext()) {
@@ -43759,7 +46535,11 @@ private Substance parseSubstance(java.lang.String elementName, XMLStreamReader r
                     builder.ingredient(parseSubstanceIngredient("ingredient", reader, ingredientElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43776,6 +46556,7 @@ private Substance parseSubstance(java.lang.String elementName, XMLStreamReader r
     private Substance.Ingredient parseSubstanceIngredient(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Substance.Ingredient.Builder builder = Substance.Ingredient.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43810,7 +46591,11 @@ private Substance.Ingredient parseSubstanceIngredient(java.lang.String elementNa
                     builder.substance(parseReference("substanceReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43827,6 +46612,7 @@ private Substance.Ingredient parseSubstanceIngredient(java.lang.String elementNa
     private Substance.Instance parseSubstanceInstance(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Substance.Instance.Builder builder = Substance.Instance.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43861,7 +46647,11 @@ private Substance.Instance parseSubstanceInstance(java.lang.String elementName,
                     builder.quantity((SimpleQuantity) parseQuantity(SimpleQuantity.builder(), "quantity", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43878,6 +46668,7 @@ private Substance.Instance parseSubstanceInstance(java.lang.String elementName,
     private SubstanceAmount parseSubstanceAmount(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceAmount.Builder builder = SubstanceAmount.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43924,7 +46715,11 @@ private SubstanceAmount parseSubstanceAmount(java.lang.String elementName, XMLSt
                     builder.referenceRange(parseSubstanceAmountReferenceRange("referenceRange", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43941,6 +46736,7 @@ private SubstanceAmount parseSubstanceAmount(java.lang.String elementName, XMLSt
     private SubstanceAmount.ReferenceRange parseSubstanceAmountReferenceRange(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceAmount.ReferenceRange.Builder builder = SubstanceAmount.ReferenceRange.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -43971,7 +46767,11 @@ private SubstanceAmount.ReferenceRange parseSubstanceAmountReferenceRange(java.l
                     builder.highLimit(parseQuantity("highLimit", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -43988,6 +46788,7 @@ private SubstanceAmount.ReferenceRange parseSubstanceAmountReferenceRange(java.l
     private SubstanceNucleicAcid parseSubstanceNucleicAcid(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceNucleicAcid.Builder builder = SubstanceNucleicAcid.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, subunitElementIndex = 0;
         while (reader.hasNext()) {
@@ -44050,7 +46851,11 @@ private SubstanceNucleicAcid parseSubstanceNucleicAcid(java.lang.String elementN
                     builder.subunit(parseSubstanceNucleicAcidSubunit("subunit", reader, subunitElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44067,6 +46872,7 @@ private SubstanceNucleicAcid parseSubstanceNucleicAcid(java.lang.String elementN
     private SubstanceNucleicAcid.Subunit parseSubstanceNucleicAcidSubunit(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceNucleicAcid.Subunit.Builder builder = SubstanceNucleicAcid.Subunit.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44121,7 +46927,11 @@ private SubstanceNucleicAcid.Subunit parseSubstanceNucleicAcidSubunit(java.lang.
                     builder.sugar(parseSubstanceNucleicAcidSubunitSugar("sugar", reader, sugarElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44138,6 +46948,7 @@ private SubstanceNucleicAcid.Subunit parseSubstanceNucleicAcidSubunit(java.lang.
     private SubstanceNucleicAcid.Subunit.Linkage parseSubstanceNucleicAcidSubunitLinkage(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceNucleicAcid.Subunit.Linkage.Builder builder = SubstanceNucleicAcid.Subunit.Linkage.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44176,7 +46987,11 @@ private SubstanceNucleicAcid.Subunit.Linkage parseSubstanceNucleicAcidSubunitLin
                     builder.residueSite(parseString("residueSite", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44193,6 +47008,7 @@ private SubstanceNucleicAcid.Subunit.Linkage parseSubstanceNucleicAcidSubunitLin
     private SubstanceNucleicAcid.Subunit.Sugar parseSubstanceNucleicAcidSubunitSugar(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceNucleicAcid.Subunit.Sugar.Builder builder = SubstanceNucleicAcid.Subunit.Sugar.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44227,7 +47043,11 @@ private SubstanceNucleicAcid.Subunit.Sugar parseSubstanceNucleicAcidSubunitSugar
                     builder.residueSite(parseString("residueSite", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44244,6 +47064,7 @@ private SubstanceNucleicAcid.Subunit.Sugar parseSubstanceNucleicAcidSubunitSugar
     private SubstancePolymer parseSubstancePolymer(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstancePolymer.Builder builder = SubstancePolymer.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, copolymerConnectivityElementIndex = 0, modificationElementIndex = 0, monomerSetElementIndex = 0, repeatElementIndex = 0;
         while (reader.hasNext()) {
@@ -44310,7 +47131,11 @@ private SubstancePolymer parseSubstancePolymer(java.lang.String elementName, XML
                     builder.repeat(parseSubstancePolymerRepeat("repeat", reader, repeatElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44327,6 +47152,7 @@ private SubstancePolymer parseSubstancePolymer(java.lang.String elementName, XML
     private SubstancePolymer.MonomerSet parseSubstancePolymerMonomerSet(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstancePolymer.MonomerSet.Builder builder = SubstancePolymer.MonomerSet.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44357,7 +47183,11 @@ private SubstancePolymer.MonomerSet parseSubstancePolymerMonomerSet(java.lang.St
                     builder.startingMaterial(parseSubstancePolymerMonomerSetStartingMaterial("startingMaterial", reader, startingMaterialElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44374,6 +47204,7 @@ private SubstancePolymer.MonomerSet parseSubstancePolymerMonomerSet(java.lang.St
     private SubstancePolymer.MonomerSet.StartingMaterial parseSubstancePolymerMonomerSetStartingMaterial(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstancePolymer.MonomerSet.StartingMaterial.Builder builder = SubstancePolymer.MonomerSet.StartingMaterial.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44412,7 +47243,11 @@ private SubstancePolymer.MonomerSet.StartingMaterial parseSubstancePolymerMonome
                     builder.amount(parseSubstanceAmount("amount", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44429,6 +47264,7 @@ private SubstancePolymer.MonomerSet.StartingMaterial parseSubstancePolymerMonome
     private SubstancePolymer.Repeat parseSubstancePolymerRepeat(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstancePolymer.Repeat.Builder builder = SubstancePolymer.Repeat.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44467,7 +47303,11 @@ private SubstancePolymer.Repeat parseSubstancePolymerRepeat(java.lang.String ele
                     builder.repeatUnit(parseSubstancePolymerRepeatRepeatUnit("repeatUnit", reader, repeatUnitElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44484,6 +47324,7 @@ private SubstancePolymer.Repeat parseSubstancePolymerRepeat(java.lang.String ele
     private SubstancePolymer.Repeat.RepeatUnit parseSubstancePolymerRepeatRepeatUnit(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstancePolymer.Repeat.RepeatUnit.Builder builder = SubstancePolymer.Repeat.RepeatUnit.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44526,7 +47367,11 @@ private SubstancePolymer.Repeat.RepeatUnit parseSubstancePolymerRepeatRepeatUnit
                     builder.structuralRepresentation(parseSubstancePolymerRepeatRepeatUnitStructuralRepresentation("structuralRepresentation", reader, structuralRepresentationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44543,6 +47388,7 @@ private SubstancePolymer.Repeat.RepeatUnit parseSubstancePolymerRepeatRepeatUnit
     private SubstancePolymer.Repeat.RepeatUnit.DegreeOfPolymerisation parseSubstancePolymerRepeatRepeatUnitDegreeOfPolymerisation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstancePolymer.Repeat.RepeatUnit.DegreeOfPolymerisation.Builder builder = SubstancePolymer.Repeat.RepeatUnit.DegreeOfPolymerisation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44573,7 +47419,11 @@ private SubstancePolymer.Repeat.RepeatUnit.DegreeOfPolymerisation parseSubstance
                     builder.amount(parseSubstanceAmount("amount", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44590,6 +47440,7 @@ private SubstancePolymer.Repeat.RepeatUnit.DegreeOfPolymerisation parseSubstance
     private SubstancePolymer.Repeat.RepeatUnit.StructuralRepresentation parseSubstancePolymerRepeatRepeatUnitStructuralRepresentation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstancePolymer.Repeat.RepeatUnit.StructuralRepresentation.Builder builder = SubstancePolymer.Repeat.RepeatUnit.StructuralRepresentation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44624,7 +47475,11 @@ private SubstancePolymer.Repeat.RepeatUnit.StructuralRepresentation parseSubstan
                     builder.attachment(parseAttachment("attachment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44641,6 +47496,7 @@ private SubstancePolymer.Repeat.RepeatUnit.StructuralRepresentation parseSubstan
     private SubstanceProtein parseSubstanceProtein(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceProtein.Builder builder = SubstanceProtein.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, disulfideLinkageElementIndex = 0, subunitElementIndex = 0;
         while (reader.hasNext()) {
@@ -44699,7 +47555,11 @@ private SubstanceProtein parseSubstanceProtein(java.lang.String elementName, XML
                     builder.subunit(parseSubstanceProteinSubunit("subunit", reader, subunitElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44716,6 +47576,7 @@ private SubstanceProtein parseSubstanceProtein(java.lang.String elementName, XML
     private SubstanceProtein.Subunit parseSubstanceProteinSubunit(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceProtein.Subunit.Builder builder = SubstanceProtein.Subunit.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44770,7 +47631,11 @@ private SubstanceProtein.Subunit parseSubstanceProteinSubunit(java.lang.String e
                     builder.cTerminalModification(parseString("cTerminalModification", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44787,6 +47652,7 @@ private SubstanceProtein.Subunit parseSubstanceProteinSubunit(java.lang.String e
     private SubstanceReferenceInformation parseSubstanceReferenceInformation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceReferenceInformation.Builder builder = SubstanceReferenceInformation.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, geneElementIndex = 0, geneElementElementIndex = 0, classificationElementIndex = 0, targetElementIndex = 0;
         while (reader.hasNext()) {
@@ -44849,7 +47715,11 @@ private SubstanceReferenceInformation parseSubstanceReferenceInformation(java.la
                     builder.target(parseSubstanceReferenceInformationTarget("target", reader, targetElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44866,6 +47736,7 @@ private SubstanceReferenceInformation parseSubstanceReferenceInformation(java.la
     private SubstanceReferenceInformation.Classification parseSubstanceReferenceInformationClassification(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceReferenceInformation.Classification.Builder builder = SubstanceReferenceInformation.Classification.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44904,7 +47775,11 @@ private SubstanceReferenceInformation.Classification parseSubstanceReferenceInfo
                     builder.source(parseReference("source", reader, sourceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44921,6 +47796,7 @@ private SubstanceReferenceInformation.Classification parseSubstanceReferenceInfo
     private SubstanceReferenceInformation.Gene parseSubstanceReferenceInformationGene(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceReferenceInformation.Gene.Builder builder = SubstanceReferenceInformation.Gene.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -44955,7 +47831,11 @@ private SubstanceReferenceInformation.Gene parseSubstanceReferenceInformationGen
                     builder.source(parseReference("source", reader, sourceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -44972,6 +47852,7 @@ private SubstanceReferenceInformation.Gene parseSubstanceReferenceInformationGen
     private SubstanceReferenceInformation.GeneElement parseSubstanceReferenceInformationGeneElement(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceReferenceInformation.GeneElement.Builder builder = SubstanceReferenceInformation.GeneElement.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45006,7 +47887,11 @@ private SubstanceReferenceInformation.GeneElement parseSubstanceReferenceInforma
                     builder.source(parseReference("source", reader, sourceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45023,6 +47908,7 @@ private SubstanceReferenceInformation.GeneElement parseSubstanceReferenceInforma
     private SubstanceReferenceInformation.Target parseSubstanceReferenceInformationTarget(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceReferenceInformation.Target.Builder builder = SubstanceReferenceInformation.Target.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45085,7 +47971,11 @@ private SubstanceReferenceInformation.Target parseSubstanceReferenceInformationT
                     builder.source(parseReference("source", reader, sourceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45102,6 +47992,7 @@ private SubstanceReferenceInformation.Target parseSubstanceReferenceInformationT
     private SubstanceSourceMaterial parseSubstanceSourceMaterial(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSourceMaterial.Builder builder = SubstanceSourceMaterial.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, parentSubstanceIdElementIndex = 0, parentSubstanceNameElementIndex = 0, countryOfOriginElementIndex = 0, geographicalLocationElementIndex = 0, fractionDescriptionElementIndex = 0, partDescriptionElementIndex = 0;
         while (reader.hasNext()) {
@@ -45196,7 +48087,11 @@ private SubstanceSourceMaterial parseSubstanceSourceMaterial(java.lang.String el
                     builder.partDescription(parseSubstanceSourceMaterialPartDescription("partDescription", reader, partDescriptionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45213,6 +48108,7 @@ private SubstanceSourceMaterial parseSubstanceSourceMaterial(java.lang.String el
     private SubstanceSourceMaterial.FractionDescription parseSubstanceSourceMaterialFractionDescription(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSourceMaterial.FractionDescription.Builder builder = SubstanceSourceMaterial.FractionDescription.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45243,7 +48139,11 @@ private SubstanceSourceMaterial.FractionDescription parseSubstanceSourceMaterial
                     builder.materialType(parseCodeableConcept("materialType", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45260,6 +48160,7 @@ private SubstanceSourceMaterial.FractionDescription parseSubstanceSourceMaterial
     private SubstanceSourceMaterial.Organism parseSubstanceSourceMaterialOrganism(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSourceMaterial.Organism.Builder builder = SubstanceSourceMaterial.Organism.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45314,7 +48215,11 @@ private SubstanceSourceMaterial.Organism parseSubstanceSourceMaterialOrganism(ja
                     builder.organismGeneral(parseSubstanceSourceMaterialOrganismOrganismGeneral("organismGeneral", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45331,6 +48236,7 @@ private SubstanceSourceMaterial.Organism parseSubstanceSourceMaterialOrganism(ja
     private SubstanceSourceMaterial.Organism.Author parseSubstanceSourceMaterialOrganismAuthor(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSourceMaterial.Organism.Author.Builder builder = SubstanceSourceMaterial.Organism.Author.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45361,7 +48267,11 @@ private SubstanceSourceMaterial.Organism.Author parseSubstanceSourceMaterialOrga
                     builder.authorDescription(parseString("authorDescription", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45378,6 +48288,7 @@ private SubstanceSourceMaterial.Organism.Author parseSubstanceSourceMaterialOrga
     private SubstanceSourceMaterial.Organism.Hybrid parseSubstanceSourceMaterialOrganismHybrid(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSourceMaterial.Organism.Hybrid.Builder builder = SubstanceSourceMaterial.Organism.Hybrid.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45420,7 +48331,11 @@ private SubstanceSourceMaterial.Organism.Hybrid parseSubstanceSourceMaterialOrga
                     builder.hybridType(parseCodeableConcept("hybridType", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45437,6 +48352,7 @@ private SubstanceSourceMaterial.Organism.Hybrid parseSubstanceSourceMaterialOrga
     private SubstanceSourceMaterial.Organism.OrganismGeneral parseSubstanceSourceMaterialOrganismOrganismGeneral(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSourceMaterial.Organism.OrganismGeneral.Builder builder = SubstanceSourceMaterial.Organism.OrganismGeneral.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45475,7 +48391,11 @@ private SubstanceSourceMaterial.Organism.OrganismGeneral parseSubstanceSourceMat
                     builder.order(parseCodeableConcept("order", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45492,6 +48412,7 @@ private SubstanceSourceMaterial.Organism.OrganismGeneral parseSubstanceSourceMat
     private SubstanceSourceMaterial.PartDescription parseSubstanceSourceMaterialPartDescription(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSourceMaterial.PartDescription.Builder builder = SubstanceSourceMaterial.PartDescription.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45522,7 +48443,11 @@ private SubstanceSourceMaterial.PartDescription parseSubstanceSourceMaterialPart
                     builder.partLocation(parseCodeableConcept("partLocation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45539,6 +48464,7 @@ private SubstanceSourceMaterial.PartDescription parseSubstanceSourceMaterialPart
     private SubstanceSpecification parseSubstanceSpecification(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Builder builder = SubstanceSpecification.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, sourceElementIndex = 0, moietyElementIndex = 0, propertyElementIndex = 0, codeElementIndex = 0, nameElementIndex = 0, molecularWeightElementIndex = 0, relationshipElementIndex = 0;
         while (reader.hasNext()) {
@@ -45657,7 +48583,11 @@ private SubstanceSpecification parseSubstanceSpecification(java.lang.String elem
                     builder.sourceMaterial(parseReference("sourceMaterial", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45674,6 +48604,7 @@ private SubstanceSpecification parseSubstanceSpecification(java.lang.String elem
     private SubstanceSpecification.Code parseSubstanceSpecificationCode(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Code.Builder builder = SubstanceSpecification.Code.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45716,7 +48647,11 @@ private SubstanceSpecification.Code parseSubstanceSpecificationCode(java.lang.St
                     builder.source(parseReference("source", reader, sourceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45733,6 +48668,7 @@ private SubstanceSpecification.Code parseSubstanceSpecificationCode(java.lang.St
     private SubstanceSpecification.Moiety parseSubstanceSpecificationMoiety(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Moiety.Builder builder = SubstanceSpecification.Moiety.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45787,7 +48723,11 @@ private SubstanceSpecification.Moiety parseSubstanceSpecificationMoiety(java.lan
                     builder.amount(parseString("amountString", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45804,6 +48744,7 @@ private SubstanceSpecification.Moiety parseSubstanceSpecificationMoiety(java.lan
     private SubstanceSpecification.Name parseSubstanceSpecificationName(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Name.Builder builder = SubstanceSpecification.Name.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45870,7 +48811,11 @@ private SubstanceSpecification.Name parseSubstanceSpecificationName(java.lang.St
                     builder.source(parseReference("source", reader, sourceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45887,6 +48832,7 @@ private SubstanceSpecification.Name parseSubstanceSpecificationName(java.lang.St
     private SubstanceSpecification.Name.Official parseSubstanceSpecificationNameOfficial(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Name.Official.Builder builder = SubstanceSpecification.Name.Official.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45921,7 +48867,11 @@ private SubstanceSpecification.Name.Official parseSubstanceSpecificationNameOffi
                     builder.date(parseDateTime("date", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -45938,6 +48888,7 @@ private SubstanceSpecification.Name.Official parseSubstanceSpecificationNameOffi
     private SubstanceSpecification.Property parseSubstanceSpecificationProperty(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Property.Builder builder = SubstanceSpecification.Property.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -45988,7 +48939,11 @@ private SubstanceSpecification.Property parseSubstanceSpecificationProperty(java
                     builder.amount(parseString("amountString", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46005,6 +48960,7 @@ private SubstanceSpecification.Property parseSubstanceSpecificationProperty(java
     private SubstanceSpecification.Relationship parseSubstanceSpecificationRelationship(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Relationship.Builder builder = SubstanceSpecification.Relationship.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -46071,7 +49027,11 @@ private SubstanceSpecification.Relationship parseSubstanceSpecificationRelations
                     builder.source(parseReference("source", reader, sourceElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46088,6 +49048,7 @@ private SubstanceSpecification.Relationship parseSubstanceSpecificationRelations
     private SubstanceSpecification.Structure parseSubstanceSpecificationStructure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Structure.Builder builder = SubstanceSpecification.Structure.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -46142,7 +49103,11 @@ private SubstanceSpecification.Structure parseSubstanceSpecificationStructure(ja
                     builder.representation(parseSubstanceSpecificationStructureRepresentation("representation", reader, representationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46159,6 +49124,7 @@ private SubstanceSpecification.Structure parseSubstanceSpecificationStructure(ja
     private SubstanceSpecification.Structure.Isotope parseSubstanceSpecificationStructureIsotope(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Structure.Isotope.Builder builder = SubstanceSpecification.Structure.Isotope.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -46201,7 +49167,11 @@ private SubstanceSpecification.Structure.Isotope parseSubstanceSpecificationStru
                     builder.molecularWeight(parseSubstanceSpecificationStructureIsotopeMolecularWeight("molecularWeight", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46218,6 +49188,7 @@ private SubstanceSpecification.Structure.Isotope parseSubstanceSpecificationStru
     private SubstanceSpecification.Structure.Isotope.MolecularWeight parseSubstanceSpecificationStructureIsotopeMolecularWeight(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Structure.Isotope.MolecularWeight.Builder builder = SubstanceSpecification.Structure.Isotope.MolecularWeight.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -46252,7 +49223,11 @@ private SubstanceSpecification.Structure.Isotope.MolecularWeight parseSubstanceS
                     builder.amount(parseQuantity("amount", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46269,6 +49244,7 @@ private SubstanceSpecification.Structure.Isotope.MolecularWeight parseSubstanceS
     private SubstanceSpecification.Structure.Representation parseSubstanceSpecificationStructureRepresentation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SubstanceSpecification.Structure.Representation.Builder builder = SubstanceSpecification.Structure.Representation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -46303,7 +49279,11 @@ private SubstanceSpecification.Structure.Representation parseSubstanceSpecificat
                     builder.attachment(parseAttachment("attachment", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46320,6 +49300,7 @@ private SubstanceSpecification.Structure.Representation parseSubstanceSpecificat
     private SupplyDelivery parseSupplyDelivery(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SupplyDelivery.Builder builder = SupplyDelivery.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, basedOnElementIndex = 0, partOfElementIndex = 0, receiverElementIndex = 0;
         while (reader.hasNext()) {
@@ -46414,7 +49395,11 @@ private SupplyDelivery parseSupplyDelivery(java.lang.String elementName, XMLStre
                     builder.receiver(parseReference("receiver", reader, receiverElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46431,6 +49416,7 @@ private SupplyDelivery parseSupplyDelivery(java.lang.String elementName, XMLStre
     private SupplyDelivery.SuppliedItem parseSupplyDeliverySuppliedItem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SupplyDelivery.SuppliedItem.Builder builder = SupplyDelivery.SuppliedItem.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -46465,7 +49451,11 @@ private SupplyDelivery.SuppliedItem parseSupplyDeliverySuppliedItem(java.lang.St
                     builder.item(parseReference("itemReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46482,6 +49472,7 @@ private SupplyDelivery.SuppliedItem parseSupplyDeliverySuppliedItem(java.lang.St
     private SupplyRequest parseSupplyRequest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SupplyRequest.Builder builder = SupplyRequest.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, parameterElementIndex = 0, supplierElementIndex = 0, reasonCodeElementIndex = 0, reasonReferenceElementIndex = 0;
         while (reader.hasNext()) {
@@ -46596,7 +49587,11 @@ private SupplyRequest parseSupplyRequest(java.lang.String elementName, XMLStream
                     builder.deliverTo(parseReference("deliverTo", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46613,6 +49608,7 @@ private SupplyRequest parseSupplyRequest(java.lang.String elementName, XMLStream
     private SupplyRequest.Parameter parseSupplyRequestParameter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         SupplyRequest.Parameter.Builder builder = SupplyRequest.Parameter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -46655,7 +49651,11 @@ private SupplyRequest.Parameter parseSupplyRequestParameter(java.lang.String ele
                     builder.value(parseBoolean("valueBoolean", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46672,6 +49672,7 @@ private SupplyRequest.Parameter parseSupplyRequestParameter(java.lang.String ele
     private Task parseTask(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Task.Builder builder = Task.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, basedOnElementIndex = 0, partOfElementIndex = 0, performerTypeElementIndex = 0, insuranceElementIndex = 0, noteElementIndex = 0, relevantHistoryElementIndex = 0, inputElementIndex = 0, outputElementIndex = 0;
         while (reader.hasNext()) {
@@ -46838,7 +49839,11 @@ private Task parseTask(java.lang.String elementName, XMLStreamReader reader, int
                     builder.output(parseTaskOutput("output", reader, outputElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -46855,6 +49860,7 @@ private Task parseTask(java.lang.String elementName, XMLStreamReader reader, int
     private Task.Input parseTaskInput(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Task.Input.Builder builder = Task.Input.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47081,7 +50087,11 @@ private Task.Input parseTaskInput(java.lang.String elementName, XMLStreamReader
                     builder.value(parseMeta("valueMeta", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47098,6 +50108,7 @@ private Task.Input parseTaskInput(java.lang.String elementName, XMLStreamReader
     private Task.Output parseTaskOutput(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Task.Output.Builder builder = Task.Output.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47324,7 +50335,11 @@ private Task.Output parseTaskOutput(java.lang.String elementName, XMLStreamReade
                     builder.value(parseMeta("valueMeta", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47341,6 +50356,7 @@ private Task.Output parseTaskOutput(java.lang.String elementName, XMLStreamReade
     private Task.Restriction parseTaskRestriction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Task.Restriction.Builder builder = Task.Restriction.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47375,7 +50391,11 @@ private Task.Restriction parseTaskRestriction(java.lang.String elementName, XMLS
                     builder.recipient(parseReference("recipient", reader, recipientElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47392,6 +50412,7 @@ private Task.Restriction parseTaskRestriction(java.lang.String elementName, XMLS
     private TerminologyCapabilities parseTerminologyCapabilities(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.Builder builder = TerminologyCapabilities.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, codeSystemElementIndex = 0;
         while (reader.hasNext()) {
@@ -47530,7 +50551,11 @@ private TerminologyCapabilities parseTerminologyCapabilities(java.lang.String el
                     builder.closure(parseTerminologyCapabilitiesClosure("closure", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47547,6 +50572,7 @@ private TerminologyCapabilities parseTerminologyCapabilities(java.lang.String el
     private TerminologyCapabilities.Closure parseTerminologyCapabilitiesClosure(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.Closure.Builder builder = TerminologyCapabilities.Closure.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47573,7 +50599,11 @@ private TerminologyCapabilities.Closure parseTerminologyCapabilitiesClosure(java
                     builder.translation(parseBoolean("translation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47590,6 +50620,7 @@ private TerminologyCapabilities.Closure parseTerminologyCapabilitiesClosure(java
     private TerminologyCapabilities.CodeSystem parseTerminologyCapabilitiesCodeSystem(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.CodeSystem.Builder builder = TerminologyCapabilities.CodeSystem.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47624,7 +50655,11 @@ private TerminologyCapabilities.CodeSystem parseTerminologyCapabilitiesCodeSyste
                     builder.subsumption(parseBoolean("subsumption", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47641,6 +50676,7 @@ private TerminologyCapabilities.CodeSystem parseTerminologyCapabilitiesCodeSyste
     private TerminologyCapabilities.CodeSystem.Version parseTerminologyCapabilitiesCodeSystemVersion(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.CodeSystem.Version.Builder builder = TerminologyCapabilities.CodeSystem.Version.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47687,7 +50723,11 @@ private TerminologyCapabilities.CodeSystem.Version parseTerminologyCapabilitiesC
                     builder.property((Code) parseString(Code.builder(), "property", reader, propertyElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47704,6 +50744,7 @@ private TerminologyCapabilities.CodeSystem.Version parseTerminologyCapabilitiesC
     private TerminologyCapabilities.CodeSystem.Version.Filter parseTerminologyCapabilitiesCodeSystemVersionFilter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.CodeSystem.Version.Filter.Builder builder = TerminologyCapabilities.CodeSystem.Version.Filter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47734,7 +50775,11 @@ private TerminologyCapabilities.CodeSystem.Version.Filter parseTerminologyCapabi
                     builder.op((Code) parseString(Code.builder(), "op", reader, opElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47751,6 +50796,7 @@ private TerminologyCapabilities.CodeSystem.Version.Filter parseTerminologyCapabi
     private TerminologyCapabilities.Expansion parseTerminologyCapabilitiesExpansion(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.Expansion.Builder builder = TerminologyCapabilities.Expansion.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47793,7 +50839,11 @@ private TerminologyCapabilities.Expansion parseTerminologyCapabilitiesExpansion(
                     builder.textFilter((Markdown) parseString(Markdown.builder(), "textFilter", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47810,6 +50860,7 @@ private TerminologyCapabilities.Expansion parseTerminologyCapabilitiesExpansion(
     private TerminologyCapabilities.Expansion.Parameter parseTerminologyCapabilitiesExpansionParameter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.Expansion.Parameter.Builder builder = TerminologyCapabilities.Expansion.Parameter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47840,7 +50891,11 @@ private TerminologyCapabilities.Expansion.Parameter parseTerminologyCapabilities
                     builder.documentation(parseString("documentation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47857,6 +50912,7 @@ private TerminologyCapabilities.Expansion.Parameter parseTerminologyCapabilities
     private TerminologyCapabilities.Implementation parseTerminologyCapabilitiesImplementation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.Implementation.Builder builder = TerminologyCapabilities.Implementation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47887,7 +50943,11 @@ private TerminologyCapabilities.Implementation parseTerminologyCapabilitiesImple
                     builder.url((Url) parseUri(Url.builder(), "url", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47904,6 +50964,7 @@ private TerminologyCapabilities.Implementation parseTerminologyCapabilitiesImple
     private TerminologyCapabilities.Software parseTerminologyCapabilitiesSoftware(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.Software.Builder builder = TerminologyCapabilities.Software.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47934,7 +50995,11 @@ private TerminologyCapabilities.Software parseTerminologyCapabilitiesSoftware(ja
                     builder.version(parseString("version", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47951,6 +51016,7 @@ private TerminologyCapabilities.Software parseTerminologyCapabilitiesSoftware(ja
     private TerminologyCapabilities.Translation parseTerminologyCapabilitiesTranslation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.Translation.Builder builder = TerminologyCapabilities.Translation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -47977,7 +51043,11 @@ private TerminologyCapabilities.Translation parseTerminologyCapabilitiesTranslat
                     builder.needsMap(parseBoolean("needsMap", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -47994,6 +51064,7 @@ private TerminologyCapabilities.Translation parseTerminologyCapabilitiesTranslat
     private TerminologyCapabilities.ValidateCode parseTerminologyCapabilitiesValidateCode(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TerminologyCapabilities.ValidateCode.Builder builder = TerminologyCapabilities.ValidateCode.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48020,7 +51091,11 @@ private TerminologyCapabilities.ValidateCode parseTerminologyCapabilitiesValidat
                     builder.translations(parseBoolean("translations", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48037,6 +51112,7 @@ private TerminologyCapabilities.ValidateCode parseTerminologyCapabilitiesValidat
     private TestReport parseTestReport(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Builder builder = TestReport.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, participantElementIndex = 0, testElementIndex = 0;
         while (reader.hasNext()) {
@@ -48127,7 +51203,11 @@ private TestReport parseTestReport(java.lang.String elementName, XMLStreamReader
                     builder.teardown(parseTestReportTeardown("teardown", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48144,6 +51224,7 @@ private TestReport parseTestReport(java.lang.String elementName, XMLStreamReader
     private TestReport.Participant parseTestReportParticipant(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Participant.Builder builder = TestReport.Participant.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48178,7 +51259,11 @@ private TestReport.Participant parseTestReportParticipant(java.lang.String eleme
                     builder.display(parseString("display", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48195,6 +51280,7 @@ private TestReport.Participant parseTestReportParticipant(java.lang.String eleme
     private TestReport.Setup parseTestReportSetup(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Setup.Builder builder = TestReport.Setup.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48221,7 +51307,11 @@ private TestReport.Setup parseTestReportSetup(java.lang.String elementName, XMLS
                     builder.action(parseTestReportSetupAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48238,6 +51328,7 @@ private TestReport.Setup parseTestReportSetup(java.lang.String elementName, XMLS
     private TestReport.Setup.Action parseTestReportSetupAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Setup.Action.Builder builder = TestReport.Setup.Action.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48268,7 +51359,11 @@ private TestReport.Setup.Action parseTestReportSetupAction(java.lang.String elem
                     builder._assert(parseTestReportSetupActionAssert("assert", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48285,6 +51380,7 @@ private TestReport.Setup.Action parseTestReportSetupAction(java.lang.String elem
     private TestReport.Setup.Action.Assert parseTestReportSetupActionAssert(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Setup.Action.Assert.Builder builder = TestReport.Setup.Action.Assert.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48319,7 +51415,11 @@ private TestReport.Setup.Action.Assert parseTestReportSetupActionAssert(java.lan
                     builder.detail(parseString("detail", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48336,6 +51436,7 @@ private TestReport.Setup.Action.Assert parseTestReportSetupActionAssert(java.lan
     private TestReport.Setup.Action.Operation parseTestReportSetupActionOperation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Setup.Action.Operation.Builder builder = TestReport.Setup.Action.Operation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48370,7 +51471,11 @@ private TestReport.Setup.Action.Operation parseTestReportSetupActionOperation(ja
                     builder.detail(parseUri("detail", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48387,6 +51492,7 @@ private TestReport.Setup.Action.Operation parseTestReportSetupActionOperation(ja
     private TestReport.Teardown parseTestReportTeardown(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Teardown.Builder builder = TestReport.Teardown.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48413,7 +51519,11 @@ private TestReport.Teardown parseTestReportTeardown(java.lang.String elementName
                     builder.action(parseTestReportTeardownAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48430,6 +51540,7 @@ private TestReport.Teardown parseTestReportTeardown(java.lang.String elementName
     private TestReport.Teardown.Action parseTestReportTeardownAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Teardown.Action.Builder builder = TestReport.Teardown.Action.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48456,7 +51567,11 @@ private TestReport.Teardown.Action parseTestReportTeardownAction(java.lang.Strin
                     builder.operation(parseTestReportSetupActionOperation("operation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48473,6 +51588,7 @@ private TestReport.Teardown.Action parseTestReportTeardownAction(java.lang.Strin
     private TestReport.Test parseTestReportTest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Test.Builder builder = TestReport.Test.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48507,7 +51623,11 @@ private TestReport.Test parseTestReportTest(java.lang.String elementName, XMLStr
                     builder.action(parseTestReportTestAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48524,6 +51644,7 @@ private TestReport.Test parseTestReportTest(java.lang.String elementName, XMLStr
     private TestReport.Test.Action parseTestReportTestAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestReport.Test.Action.Builder builder = TestReport.Test.Action.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48554,7 +51675,11 @@ private TestReport.Test.Action parseTestReportTestAction(java.lang.String elemen
                     builder._assert(parseTestReportSetupActionAssert("assert", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48571,6 +51696,7 @@ private TestReport.Test.Action parseTestReportTestAction(java.lang.String elemen
     private TestScript parseTestScript(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Builder builder = TestScript.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0, originElementIndex = 0, destinationElementIndex = 0, fixtureElementIndex = 0, profileElementIndex = 0, variableElementIndex = 0, testElementIndex = 0;
         while (reader.hasNext()) {
@@ -48709,7 +51835,11 @@ private TestScript parseTestScript(java.lang.String elementName, XMLStreamReader
                     builder.teardown(parseTestScriptTeardown("teardown", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48726,6 +51856,7 @@ private TestScript parseTestScript(java.lang.String elementName, XMLStreamReader
     private TestScript.Destination parseTestScriptDestination(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Destination.Builder builder = TestScript.Destination.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48756,7 +51887,11 @@ private TestScript.Destination parseTestScriptDestination(java.lang.String eleme
                     builder.profile(parseCoding("profile", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48773,6 +51908,7 @@ private TestScript.Destination parseTestScriptDestination(java.lang.String eleme
     private TestScript.Fixture parseTestScriptFixture(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Fixture.Builder builder = TestScript.Fixture.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48807,7 +51943,11 @@ private TestScript.Fixture parseTestScriptFixture(java.lang.String elementName,
                     builder.resource(parseReference("resource", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48824,6 +51964,7 @@ private TestScript.Fixture parseTestScriptFixture(java.lang.String elementName,
     private TestScript.Metadata parseTestScriptMetadata(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Metadata.Builder builder = TestScript.Metadata.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48854,7 +51995,11 @@ private TestScript.Metadata parseTestScriptMetadata(java.lang.String elementName
                     builder.capability(parseTestScriptMetadataCapability("capability", reader, capabilityElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48871,6 +52016,7 @@ private TestScript.Metadata parseTestScriptMetadata(java.lang.String elementName
     private TestScript.Metadata.Capability parseTestScriptMetadataCapability(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Metadata.Capability.Builder builder = TestScript.Metadata.Capability.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48921,7 +52067,11 @@ private TestScript.Metadata.Capability parseTestScriptMetadataCapability(java.la
                     builder.capabilities((Canonical) parseUri(Canonical.builder(), "capabilities", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48938,6 +52088,7 @@ private TestScript.Metadata.Capability parseTestScriptMetadataCapability(java.la
     private TestScript.Metadata.Link parseTestScriptMetadataLink(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Metadata.Link.Builder builder = TestScript.Metadata.Link.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -48968,7 +52119,11 @@ private TestScript.Metadata.Link parseTestScriptMetadataLink(java.lang.String el
                     builder.description(parseString("description", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -48985,6 +52140,7 @@ private TestScript.Metadata.Link parseTestScriptMetadataLink(java.lang.String el
     private TestScript.Origin parseTestScriptOrigin(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Origin.Builder builder = TestScript.Origin.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49015,7 +52171,11 @@ private TestScript.Origin parseTestScriptOrigin(java.lang.String elementName, XM
                     builder.profile(parseCoding("profile", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49032,6 +52192,7 @@ private TestScript.Origin parseTestScriptOrigin(java.lang.String elementName, XM
     private TestScript.Setup parseTestScriptSetup(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Setup.Builder builder = TestScript.Setup.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49058,7 +52219,11 @@ private TestScript.Setup parseTestScriptSetup(java.lang.String elementName, XMLS
                     builder.action(parseTestScriptSetupAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49075,6 +52240,7 @@ private TestScript.Setup parseTestScriptSetup(java.lang.String elementName, XMLS
     private TestScript.Setup.Action parseTestScriptSetupAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Setup.Action.Builder builder = TestScript.Setup.Action.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49105,7 +52271,11 @@ private TestScript.Setup.Action parseTestScriptSetupAction(java.lang.String elem
                     builder._assert(parseTestScriptSetupActionAssert("assert", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49122,6 +52292,7 @@ private TestScript.Setup.Action parseTestScriptSetupAction(java.lang.String elem
     private TestScript.Setup.Action.Assert parseTestScriptSetupActionAssert(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Setup.Action.Assert.Builder builder = TestScript.Setup.Action.Assert.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49232,7 +52403,11 @@ private TestScript.Setup.Action.Assert parseTestScriptSetupActionAssert(java.lan
                     builder.warningOnly(parseBoolean("warningOnly", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49249,6 +52424,7 @@ private TestScript.Setup.Action.Assert parseTestScriptSetupActionAssert(java.lan
     private TestScript.Setup.Action.Operation parseTestScriptSetupActionOperation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Setup.Action.Operation.Builder builder = TestScript.Setup.Action.Operation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49339,7 +52515,11 @@ private TestScript.Setup.Action.Operation parseTestScriptSetupActionOperation(ja
                     builder.url(parseString("url", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49356,6 +52536,7 @@ private TestScript.Setup.Action.Operation parseTestScriptSetupActionOperation(ja
     private TestScript.Setup.Action.Operation.RequestHeader parseTestScriptSetupActionOperationRequestHeader(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Setup.Action.Operation.RequestHeader.Builder builder = TestScript.Setup.Action.Operation.RequestHeader.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49386,7 +52567,11 @@ private TestScript.Setup.Action.Operation.RequestHeader parseTestScriptSetupActi
                     builder.value(parseString("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49403,6 +52588,7 @@ private TestScript.Setup.Action.Operation.RequestHeader parseTestScriptSetupActi
     private TestScript.Teardown parseTestScriptTeardown(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Teardown.Builder builder = TestScript.Teardown.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49429,7 +52615,11 @@ private TestScript.Teardown parseTestScriptTeardown(java.lang.String elementName
                     builder.action(parseTestScriptTeardownAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49446,6 +52636,7 @@ private TestScript.Teardown parseTestScriptTeardown(java.lang.String elementName
     private TestScript.Teardown.Action parseTestScriptTeardownAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Teardown.Action.Builder builder = TestScript.Teardown.Action.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49472,7 +52663,11 @@ private TestScript.Teardown.Action parseTestScriptTeardownAction(java.lang.Strin
                     builder.operation(parseTestScriptSetupActionOperation("operation", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49489,6 +52684,7 @@ private TestScript.Teardown.Action parseTestScriptTeardownAction(java.lang.Strin
     private TestScript.Test parseTestScriptTest(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Test.Builder builder = TestScript.Test.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49523,7 +52719,11 @@ private TestScript.Test parseTestScriptTest(java.lang.String elementName, XMLStr
                     builder.action(parseTestScriptTestAction("action", reader, actionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49540,6 +52740,7 @@ private TestScript.Test parseTestScriptTest(java.lang.String elementName, XMLStr
     private TestScript.Test.Action parseTestScriptTestAction(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Test.Action.Builder builder = TestScript.Test.Action.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49570,7 +52771,11 @@ private TestScript.Test.Action parseTestScriptTestAction(java.lang.String elemen
                     builder._assert(parseTestScriptSetupActionAssert("assert", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49587,6 +52792,7 @@ private TestScript.Test.Action parseTestScriptTestAction(java.lang.String elemen
     private TestScript.Variable parseTestScriptVariable(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TestScript.Variable.Builder builder = TestScript.Variable.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49641,7 +52847,11 @@ private TestScript.Variable parseTestScriptVariable(java.lang.String elementName
                     builder.sourceId((Id) parseString(Id.builder(), "sourceId", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49658,6 +52868,7 @@ private TestScript.Variable parseTestScriptVariable(java.lang.String elementName
     private Time parseTime(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Time.Builder builder = Time.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49680,7 +52891,11 @@ private Time parseTime(java.lang.String elementName, XMLStreamReader reader, int
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49697,6 +52912,7 @@ private Time parseTime(java.lang.String elementName, XMLStreamReader reader, int
     private Timing parseTiming(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Timing.Builder builder = Timing.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49731,7 +52947,11 @@ private Timing parseTiming(java.lang.String elementName, XMLStreamReader reader,
                     builder.code(parseCodeableConcept("code", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49748,6 +52968,7 @@ private Timing parseTiming(java.lang.String elementName, XMLStreamReader reader,
     private Timing.Repeat parseTimingRepeat(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Timing.Repeat.Builder builder = Timing.Repeat.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49838,7 +53059,11 @@ private Timing.Repeat parseTimingRepeat(java.lang.String elementName, XMLStreamR
                     builder.offset((UnsignedInt) parseInteger(UnsignedInt.builder(), "offset", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49855,6 +53080,7 @@ private Timing.Repeat parseTimingRepeat(java.lang.String elementName, XMLStreamR
     private TriggerDefinition parseTriggerDefinition(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         TriggerDefinition.Builder builder = TriggerDefinition.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49905,7 +53131,11 @@ private TriggerDefinition parseTriggerDefinition(java.lang.String elementName, X
                     builder.condition(parseExpression("condition", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49921,6 +53151,7 @@ private TriggerDefinition parseTriggerDefinition(java.lang.String elementName, X
 
     private Uri parseUri(Uri.Builder builder, java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -49943,7 +53174,11 @@ private Uri parseUri(Uri.Builder builder, java.lang.String elementName, XMLStrea
                     builder.extension(parseExtension("extension", reader, extensionElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -49964,6 +53199,7 @@ private Uri parseUri(java.lang.String elementName, XMLStreamReader reader, int e
     private UsageContext parseUsageContext(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         UsageContext.Builder builder = UsageContext.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50002,7 +53238,11 @@ private UsageContext parseUsageContext(java.lang.String elementName, XMLStreamRe
                     builder.value(parseReference("valueReference", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50019,6 +53259,7 @@ private UsageContext parseUsageContext(java.lang.String elementName, XMLStreamRe
     private ValueSet parseValueSet(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ValueSet.Builder builder = ValueSet.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, contactElementIndex = 0, useContextElementIndex = 0, jurisdictionElementIndex = 0;
         while (reader.hasNext()) {
@@ -50133,7 +53374,11 @@ private ValueSet parseValueSet(java.lang.String elementName, XMLStreamReader rea
                     builder.expansion(parseValueSetExpansion("expansion", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50150,6 +53395,7 @@ private ValueSet parseValueSet(java.lang.String elementName, XMLStreamReader rea
     private ValueSet.Compose parseValueSetCompose(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ValueSet.Compose.Builder builder = ValueSet.Compose.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50188,7 +53434,11 @@ private ValueSet.Compose parseValueSetCompose(java.lang.String elementName, XMLS
                     builder.exclude(parseValueSetComposeInclude("exclude", reader, excludeElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50205,6 +53455,7 @@ private ValueSet.Compose parseValueSetCompose(java.lang.String elementName, XMLS
     private ValueSet.Compose.Include parseValueSetComposeInclude(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ValueSet.Compose.Include.Builder builder = ValueSet.Compose.Include.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50247,7 +53498,11 @@ private ValueSet.Compose.Include parseValueSetComposeInclude(java.lang.String el
                     builder.valueSet((Canonical) parseUri(Canonical.builder(), "valueSet", reader, valueSetElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50264,6 +53519,7 @@ private ValueSet.Compose.Include parseValueSetComposeInclude(java.lang.String el
     private ValueSet.Compose.Include.Concept parseValueSetComposeIncludeConcept(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ValueSet.Compose.Include.Concept.Builder builder = ValueSet.Compose.Include.Concept.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50298,7 +53554,11 @@ private ValueSet.Compose.Include.Concept parseValueSetComposeIncludeConcept(java
                     builder.designation(parseValueSetComposeIncludeConceptDesignation("designation", reader, designationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50315,6 +53575,7 @@ private ValueSet.Compose.Include.Concept parseValueSetComposeIncludeConcept(java
     private ValueSet.Compose.Include.Concept.Designation parseValueSetComposeIncludeConceptDesignation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ValueSet.Compose.Include.Concept.Designation.Builder builder = ValueSet.Compose.Include.Concept.Designation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50349,7 +53610,11 @@ private ValueSet.Compose.Include.Concept.Designation parseValueSetComposeInclude
                     builder.value(parseString("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50366,6 +53631,7 @@ private ValueSet.Compose.Include.Concept.Designation parseValueSetComposeInclude
     private ValueSet.Compose.Include.Filter parseValueSetComposeIncludeFilter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ValueSet.Compose.Include.Filter.Builder builder = ValueSet.Compose.Include.Filter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50400,7 +53666,11 @@ private ValueSet.Compose.Include.Filter parseValueSetComposeIncludeFilter(java.l
                     builder.value(parseString("value", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50417,6 +53687,7 @@ private ValueSet.Compose.Include.Filter parseValueSetComposeIncludeFilter(java.l
     private ValueSet.Expansion parseValueSetExpansion(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ValueSet.Expansion.Builder builder = ValueSet.Expansion.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50463,7 +53734,11 @@ private ValueSet.Expansion parseValueSetExpansion(java.lang.String elementName,
                     builder.contains(parseValueSetExpansionContains("contains", reader, containsElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50480,6 +53755,7 @@ private ValueSet.Expansion parseValueSetExpansion(java.lang.String elementName,
     private ValueSet.Expansion.Contains parseValueSetExpansionContains(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ValueSet.Expansion.Contains.Builder builder = ValueSet.Expansion.Contains.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50534,7 +53810,11 @@ private ValueSet.Expansion.Contains parseValueSetExpansionContains(java.lang.Str
                     builder.contains(parseValueSetExpansionContains("contains", reader, containsElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50551,6 +53831,7 @@ private ValueSet.Expansion.Contains parseValueSetExpansionContains(java.lang.Str
     private ValueSet.Expansion.Parameter parseValueSetExpansionParameter(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         ValueSet.Expansion.Parameter.Builder builder = ValueSet.Expansion.Parameter.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50605,7 +53886,11 @@ private ValueSet.Expansion.Parameter parseValueSetExpansionParameter(java.lang.S
                     builder.value(parseDateTime("valueDateTime", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50622,6 +53907,7 @@ private ValueSet.Expansion.Parameter parseValueSetExpansionParameter(java.lang.S
     private VerificationResult parseVerificationResult(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         VerificationResult.Builder builder = VerificationResult.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, targetElementIndex = 0, targetLocationElementIndex = 0, validationProcessElementIndex = 0, primarySourceElementIndex = 0, validatorElementIndex = 0;
         while (reader.hasNext()) {
@@ -50720,7 +54006,11 @@ private VerificationResult parseVerificationResult(java.lang.String elementName,
                     builder.validator(parseVerificationResultValidator("validator", reader, validatorElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50737,6 +54027,7 @@ private VerificationResult parseVerificationResult(java.lang.String elementName,
     private VerificationResult.Attestation parseVerificationResultAttestation(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         VerificationResult.Attestation.Builder builder = VerificationResult.Attestation.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50791,7 +54082,11 @@ private VerificationResult.Attestation parseVerificationResultAttestation(java.l
                     builder.sourceSignature(parseSignature("sourceSignature", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50808,6 +54103,7 @@ private VerificationResult.Attestation parseVerificationResultAttestation(java.l
     private VerificationResult.PrimarySource parseVerificationResultPrimarySource(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         VerificationResult.PrimarySource.Builder builder = VerificationResult.PrimarySource.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50858,7 +54154,11 @@ private VerificationResult.PrimarySource parseVerificationResultPrimarySource(ja
                     builder.pushTypeAvailable(parseCodeableConcept("pushTypeAvailable", reader, pushTypeAvailableElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50875,6 +54175,7 @@ private VerificationResult.PrimarySource parseVerificationResultPrimarySource(ja
     private VerificationResult.Validator parseVerificationResultValidator(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         VerificationResult.Validator.Builder builder = VerificationResult.Validator.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -50909,7 +54210,11 @@ private VerificationResult.Validator parseVerificationResultValidator(java.lang.
                     builder.attestationSignature(parseSignature("attestationSignature", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -50926,6 +54231,7 @@ private VerificationResult.Validator parseVerificationResultValidator(java.lang.
     private VisionPrescription parseVisionPrescription(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         VisionPrescription.Builder builder = VisionPrescription.builder();
+        builder.setValidating(validating);
         int position = -1;
         int containedElementIndex = 0, extensionElementIndex = 0, modifierExtensionElementIndex = 0, identifierElementIndex = 0, lensSpecificationElementIndex = 0;
         while (reader.hasNext()) {
@@ -51000,7 +54306,11 @@ private VisionPrescription parseVisionPrescription(java.lang.String elementName,
                     builder.lensSpecification(parseVisionPrescriptionLensSpecification("lensSpecification", reader, lensSpecificationElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -51017,6 +54327,7 @@ private VisionPrescription parseVisionPrescription(java.lang.String elementName,
     private VisionPrescription.LensSpecification parseVisionPrescriptionLensSpecification(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         VisionPrescription.LensSpecification.Builder builder = VisionPrescription.LensSpecification.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -51095,7 +54406,11 @@ private VisionPrescription.LensSpecification parseVisionPrescriptionLensSpecific
                     builder.note(parseAnnotation("note", reader, noteElementIndex++));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -51112,6 +54427,7 @@ private VisionPrescription.LensSpecification parseVisionPrescriptionLensSpecific
     private VisionPrescription.LensSpecification.Prism parseVisionPrescriptionLensSpecificationPrism(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         VisionPrescription.LensSpecification.Prism.Builder builder = VisionPrescription.LensSpecification.Prism.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
@@ -51142,7 +54458,11 @@ private VisionPrescription.LensSpecification.Prism parseVisionPrescriptionLensSp
                     builder.base((VisionBase) parseString(VisionBase.builder(), "base", reader, -1));
                     break;
                 default:
-                    throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    if (!ignoringUnrecognizedElements) {
+                        throw new IllegalArgumentException("Unrecognized element: '" + localName + "'");
+                    }
+                    reader.nextTag();
+                    break;
                 }
                 break;
             case XMLStreamReader.END_ELEMENT:
@@ -51159,6 +54479,7 @@ private VisionPrescription.LensSpecification.Prism parseVisionPrescriptionLensSp
     private Xhtml parseXhtml(java.lang.String elementName, XMLStreamReader reader, int elementIndex) throws XMLStreamException {
         stackPush(elementName, elementIndex);
         Xhtml.Builder builder = Xhtml.builder();
+        builder.setValidating(validating);
         java.lang.String id = reader.getAttributeValue(null, "id");
         if (id != null) {
             builder.id(id);
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/patch/FHIRJsonPatch.java b/fhir-model/src/main/java/com/ibm/fhir/model/patch/FHIRJsonPatch.java
index 3ee1ea87d7e..10b03e10522 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/patch/FHIRJsonPatch.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/patch/FHIRJsonPatch.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -8,11 +8,11 @@
 
 import java.util.Objects;
 
-import javax.json.JsonArray;
-import javax.json.JsonException;
-import javax.json.JsonObject;
-import javax.json.JsonPatch;
-import javax.json.spi.JsonProvider;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonException;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonPatch;
+import jakarta.json.spi.JsonProvider;
 
 import com.ibm.fhir.model.format.Format;
 import com.ibm.fhir.model.generator.exception.FHIRGeneratorException;
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/patch/FHIRPatch.java b/fhir-model/src/main/java/com/ibm/fhir/model/patch/FHIRPatch.java
index c9683da440d..a683183d318 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/patch/FHIRPatch.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/patch/FHIRPatch.java
@@ -1,13 +1,13 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
 
 package com.ibm.fhir.model.patch;
 
-import javax.json.JsonArray;
-import javax.json.JsonPatch;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonPatch;
 
 import com.ibm.fhir.model.patch.exception.FHIRPatchException;
 import com.ibm.fhir.model.resource.Resource;
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Account.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Account.java
index 832fc223929..3f401518c88 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Account.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Account.java
@@ -89,20 +89,17 @@ public class Account extends DomainResource {
 
     private Account(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         type = builder.type;
         name = builder.name;
-        subject = Collections.unmodifiableList(ValidationSupport.checkList(builder.subject, "subject", Reference.class));
+        subject = Collections.unmodifiableList(builder.subject);
         servicePeriod = builder.servicePeriod;
-        coverage = Collections.unmodifiableList(ValidationSupport.checkList(builder.coverage, "coverage", Coverage.class));
+        coverage = Collections.unmodifiableList(builder.coverage);
         owner = builder.owner;
         description = builder.description;
-        guarantor = Collections.unmodifiableList(ValidationSupport.checkList(builder.guarantor, "guarantor", Guarantor.class));
+        guarantor = Collections.unmodifiableList(builder.guarantor);
         partOf = builder.partOf;
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Device", "Practitioner", "PractitionerRole", "Location", "HealthcareService", "Organization");
-        ValidationSupport.checkReferenceType(owner, "owner", "Organization");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "Account");
     }
 
     /**
@@ -839,7 +836,23 @@ public Builder partOf(Reference partOf) {
          */
         @Override
         public Account build() {
-            return new Account(this);
+            Account account = new Account(this);
+            if (validating) {
+                validate(account);
+            }
+            return account;
+        }
+
+        protected void validate(Account account) {
+            super.validate(account);
+            ValidationSupport.checkList(account.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(account.status, "status");
+            ValidationSupport.checkList(account.subject, "subject", Reference.class);
+            ValidationSupport.checkList(account.coverage, "coverage", Coverage.class);
+            ValidationSupport.checkList(account.guarantor, "guarantor", Guarantor.class);
+            ValidationSupport.checkReferenceType(account.subject, "subject", "Patient", "Device", "Practitioner", "PractitionerRole", "Location", "HealthcareService", "Organization");
+            ValidationSupport.checkReferenceType(account.owner, "owner", "Organization");
+            ValidationSupport.checkReferenceType(account.partOf, "partOf", "Account");
         }
 
         protected Builder from(Account account) {
@@ -873,10 +886,8 @@ public static class Coverage extends BackboneElement {
 
         private Coverage(Builder builder) {
             super(builder);
-            coverage = ValidationSupport.requireNonNull(builder.coverage, "coverage");
+            coverage = builder.coverage;
             priority = builder.priority;
-            ValidationSupport.checkReferenceType(coverage, "coverage", "Coverage");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1130,7 +1141,18 @@ public Builder priority(PositiveInt priority) {
              */
             @Override
             public Coverage build() {
-                return new Coverage(this);
+                Coverage coverage = new Coverage(this);
+                if (validating) {
+                    validate(coverage);
+                }
+                return coverage;
+            }
+
+            protected void validate(Coverage coverage) {
+                super.validate(coverage);
+                ValidationSupport.requireNonNull(coverage.coverage, "coverage");
+                ValidationSupport.checkReferenceType(coverage.coverage, "coverage", "Coverage");
+                ValidationSupport.requireValueOrChildren(coverage);
             }
 
             protected Builder from(Coverage coverage) {
@@ -1154,11 +1176,9 @@ public static class Guarantor extends BackboneElement {
 
         private Guarantor(Builder builder) {
             super(builder);
-            party = ValidationSupport.requireNonNull(builder.party, "party");
+            party = builder.party;
             onHold = builder.onHold;
             period = builder.period;
-            ValidationSupport.checkReferenceType(party, "party", "Patient", "RelatedPerson", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1437,7 +1457,18 @@ public Builder period(Period period) {
              */
             @Override
             public Guarantor build() {
-                return new Guarantor(this);
+                Guarantor guarantor = new Guarantor(this);
+                if (validating) {
+                    validate(guarantor);
+                }
+                return guarantor;
+            }
+
+            protected void validate(Guarantor guarantor) {
+                super.validate(guarantor);
+                ValidationSupport.requireNonNull(guarantor.party, "party");
+                ValidationSupport.checkReferenceType(guarantor.party, "party", "Patient", "RelatedPerson", "Organization");
+                ValidationSupport.requireValueOrChildren(guarantor);
             }
 
             protected Builder from(Guarantor guarantor) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ActivityDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ActivityDefinition.java
index 61bc9b06216..9573e0d945f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ActivityDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ActivityDefinition.java
@@ -230,57 +230,51 @@ public class ActivityDefinition extends DomainResource {
     private ActivityDefinition(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
         subtitle = builder.subtitle;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
-        subject = ValidationSupport.choiceElement(builder.subject, "subject", CodeableConcept.class, Reference.class);
+        subject = builder.subject;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         usage = builder.usage;
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
-        library = Collections.unmodifiableList(ValidationSupport.checkList(builder.library, "library", Canonical.class));
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
+        library = Collections.unmodifiableList(builder.library);
         kind = builder.kind;
         profile = builder.profile;
         code = builder.code;
         intent = builder.intent;
         priority = builder.priority;
         doNotPerform = builder.doNotPerform;
-        timing = ValidationSupport.choiceElement(builder.timing, "timing", Timing.class, DateTime.class, Age.class, Period.class, Range.class, Duration.class);
+        timing = builder.timing;
         location = builder.location;
-        participant = Collections.unmodifiableList(ValidationSupport.checkList(builder.participant, "participant", Participant.class));
-        product = ValidationSupport.choiceElement(builder.product, "product", Reference.class, CodeableConcept.class);
+        participant = Collections.unmodifiableList(builder.participant);
+        product = builder.product;
         quantity = builder.quantity;
-        dosage = Collections.unmodifiableList(ValidationSupport.checkList(builder.dosage, "dosage", Dosage.class));
-        bodySite = Collections.unmodifiableList(ValidationSupport.checkList(builder.bodySite, "bodySite", CodeableConcept.class));
-        specimenRequirement = Collections.unmodifiableList(ValidationSupport.checkList(builder.specimenRequirement, "specimenRequirement", Reference.class));
-        observationRequirement = Collections.unmodifiableList(ValidationSupport.checkList(builder.observationRequirement, "observationRequirement", Reference.class));
-        observationResultRequirement = Collections.unmodifiableList(ValidationSupport.checkList(builder.observationResultRequirement, "observationResultRequirement", Reference.class));
+        dosage = Collections.unmodifiableList(builder.dosage);
+        bodySite = Collections.unmodifiableList(builder.bodySite);
+        specimenRequirement = Collections.unmodifiableList(builder.specimenRequirement);
+        observationRequirement = Collections.unmodifiableList(builder.observationRequirement);
+        observationResultRequirement = Collections.unmodifiableList(builder.observationResultRequirement);
         transform = builder.transform;
-        dynamicValue = Collections.unmodifiableList(ValidationSupport.checkList(builder.dynamicValue, "dynamicValue", DynamicValue.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Group");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(product, "product", "Medication", "Substance");
-        ValidationSupport.checkReferenceType(specimenRequirement, "specimenRequirement", "SpecimenDefinition");
-        ValidationSupport.checkReferenceType(observationRequirement, "observationRequirement", "ObservationDefinition");
-        ValidationSupport.checkReferenceType(observationResultRequirement, "observationResultRequirement", "ObservationDefinition");
+        dynamicValue = Collections.unmodifiableList(builder.dynamicValue);
     }
 
     /**
@@ -2399,7 +2393,43 @@ public Builder dynamicValue(Collection<DynamicValue> dynamicValue) {
          */
         @Override
         public ActivityDefinition build() {
-            return new ActivityDefinition(this);
+            ActivityDefinition activityDefinition = new ActivityDefinition(this);
+            if (validating) {
+                validate(activityDefinition);
+            }
+            return activityDefinition;
+        }
+
+        protected void validate(ActivityDefinition activityDefinition) {
+            super.validate(activityDefinition);
+            ValidationSupport.checkList(activityDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(activityDefinition.status, "status");
+            ValidationSupport.choiceElement(activityDefinition.subject, "subject", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(activityDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(activityDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(activityDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(activityDefinition.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(activityDefinition.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(activityDefinition.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(activityDefinition.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(activityDefinition.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(activityDefinition.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.checkList(activityDefinition.library, "library", Canonical.class);
+            ValidationSupport.choiceElement(activityDefinition.timing, "timing", Timing.class, DateTime.class, Age.class, Period.class, Range.class, Duration.class);
+            ValidationSupport.checkList(activityDefinition.participant, "participant", Participant.class);
+            ValidationSupport.choiceElement(activityDefinition.product, "product", Reference.class, CodeableConcept.class);
+            ValidationSupport.checkList(activityDefinition.dosage, "dosage", Dosage.class);
+            ValidationSupport.checkList(activityDefinition.bodySite, "bodySite", CodeableConcept.class);
+            ValidationSupport.checkList(activityDefinition.specimenRequirement, "specimenRequirement", Reference.class);
+            ValidationSupport.checkList(activityDefinition.observationRequirement, "observationRequirement", Reference.class);
+            ValidationSupport.checkList(activityDefinition.observationResultRequirement, "observationResultRequirement", Reference.class);
+            ValidationSupport.checkList(activityDefinition.dynamicValue, "dynamicValue", DynamicValue.class);
+            ValidationSupport.checkReferenceType(activityDefinition.subject, "subject", "Group");
+            ValidationSupport.checkReferenceType(activityDefinition.location, "location", "Location");
+            ValidationSupport.checkReferenceType(activityDefinition.product, "product", "Medication", "Substance");
+            ValidationSupport.checkReferenceType(activityDefinition.specimenRequirement, "specimenRequirement", "SpecimenDefinition");
+            ValidationSupport.checkReferenceType(activityDefinition.observationRequirement, "observationRequirement", "ObservationDefinition");
+            ValidationSupport.checkReferenceType(activityDefinition.observationResultRequirement, "observationResultRequirement", "ObservationDefinition");
         }
 
         protected Builder from(ActivityDefinition activityDefinition) {
@@ -2476,9 +2506,8 @@ public static class Participant extends BackboneElement {
 
         private Participant(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            type = builder.type;
             role = builder.role;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2721,7 +2750,17 @@ public Builder role(CodeableConcept role) {
              */
             @Override
             public Participant build() {
-                return new Participant(this);
+                Participant participant = new Participant(this);
+                if (validating) {
+                    validate(participant);
+                }
+                return participant;
+            }
+
+            protected void validate(Participant participant) {
+                super.validate(participant);
+                ValidationSupport.requireNonNull(participant.type, "type");
+                ValidationSupport.requireValueOrChildren(participant);
             }
 
             protected Builder from(Participant participant) {
@@ -2746,9 +2785,8 @@ public static class DynamicValue extends BackboneElement {
 
         private DynamicValue(Builder builder) {
             super(builder);
-            path = ValidationSupport.requireNonNull(builder.path, "path");
-            expression = ValidationSupport.requireNonNull(builder.expression, "expression");
-            ValidationSupport.requireValueOrChildren(this);
+            path = builder.path;
+            expression = builder.expression;
         }
 
         /**
@@ -3002,7 +3040,18 @@ public Builder expression(Expression expression) {
              */
             @Override
             public DynamicValue build() {
-                return new DynamicValue(this);
+                DynamicValue dynamicValue = new DynamicValue(this);
+                if (validating) {
+                    validate(dynamicValue);
+                }
+                return dynamicValue;
+            }
+
+            protected void validate(DynamicValue dynamicValue) {
+                super.validate(dynamicValue);
+                ValidationSupport.requireNonNull(dynamicValue.path, "path");
+                ValidationSupport.requireNonNull(dynamicValue.expression, "expression");
+                ValidationSupport.requireValueOrChildren(dynamicValue);
             }
 
             protected Builder from(DynamicValue dynamicValue) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/AdverseEvent.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/AdverseEvent.java
index 91b66c7f5de..0cd3a429cb8 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/AdverseEvent.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/AdverseEvent.java
@@ -149,36 +149,25 @@ public class AdverseEvent extends DomainResource {
     private AdverseEvent(Builder builder) {
         super(builder);
         identifier = builder.identifier;
-        actuality = ValidationSupport.requireNonNull(builder.actuality, "actuality");
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        actuality = builder.actuality;
+        category = Collections.unmodifiableList(builder.category);
         event = builder.event;
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        subject = builder.subject;
         encounter = builder.encounter;
         date = builder.date;
         detected = builder.detected;
         recordedDate = builder.recordedDate;
-        resultingCondition = Collections.unmodifiableList(ValidationSupport.checkList(builder.resultingCondition, "resultingCondition", Reference.class));
+        resultingCondition = Collections.unmodifiableList(builder.resultingCondition);
         location = builder.location;
         seriousness = builder.seriousness;
         severity = builder.severity;
         outcome = builder.outcome;
         recorder = builder.recorder;
-        contributor = Collections.unmodifiableList(ValidationSupport.checkList(builder.contributor, "contributor", Reference.class));
-        suspectEntity = Collections.unmodifiableList(ValidationSupport.checkList(builder.suspectEntity, "suspectEntity", SuspectEntity.class));
-        subjectMedicalHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.subjectMedicalHistory, "subjectMedicalHistory", Reference.class));
-        referenceDocument = Collections.unmodifiableList(ValidationSupport.checkList(builder.referenceDocument, "referenceDocument", Reference.class));
-        study = Collections.unmodifiableList(ValidationSupport.checkList(builder.study, "study", Reference.class));
-        ValidationSupport.checkValueSetBinding(severity, "severity", "http://hl7.org/fhir/ValueSet/adverse-event-severity", "http://terminology.hl7.org/CodeSystem/adverse-event-severity", "mild", "moderate", "severe");
-        ValidationSupport.checkValueSetBinding(outcome, "outcome", "http://hl7.org/fhir/ValueSet/adverse-event-outcome", "http://terminology.hl7.org/CodeSystem/adverse-event-outcome", "resolved", "recovering", "ongoing", "resolvedWithSequelae", "fatal", "unknown");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group", "Practitioner", "RelatedPerson");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(resultingCondition, "resultingCondition", "Condition");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(recorder, "recorder", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
-        ValidationSupport.checkReferenceType(contributor, "contributor", "Practitioner", "PractitionerRole", "Device");
-        ValidationSupport.checkReferenceType(subjectMedicalHistory, "subjectMedicalHistory", "Condition", "Observation", "AllergyIntolerance", "FamilyMemberHistory", "Immunization", "Procedure", "Media", "DocumentReference");
-        ValidationSupport.checkReferenceType(referenceDocument, "referenceDocument", "DocumentReference");
-        ValidationSupport.checkReferenceType(study, "study", "ResearchStudy");
+        contributor = Collections.unmodifiableList(builder.contributor);
+        suspectEntity = Collections.unmodifiableList(builder.suspectEntity);
+        subjectMedicalHistory = Collections.unmodifiableList(builder.subjectMedicalHistory);
+        referenceDocument = Collections.unmodifiableList(builder.referenceDocument);
+        study = Collections.unmodifiableList(builder.study);
     }
 
     /**
@@ -1312,7 +1301,35 @@ public Builder study(Collection<Reference> study) {
          */
         @Override
         public AdverseEvent build() {
-            return new AdverseEvent(this);
+            AdverseEvent adverseEvent = new AdverseEvent(this);
+            if (validating) {
+                validate(adverseEvent);
+            }
+            return adverseEvent;
+        }
+
+        protected void validate(AdverseEvent adverseEvent) {
+            super.validate(adverseEvent);
+            ValidationSupport.requireNonNull(adverseEvent.actuality, "actuality");
+            ValidationSupport.checkList(adverseEvent.category, "category", CodeableConcept.class);
+            ValidationSupport.requireNonNull(adverseEvent.subject, "subject");
+            ValidationSupport.checkList(adverseEvent.resultingCondition, "resultingCondition", Reference.class);
+            ValidationSupport.checkList(adverseEvent.contributor, "contributor", Reference.class);
+            ValidationSupport.checkList(adverseEvent.suspectEntity, "suspectEntity", SuspectEntity.class);
+            ValidationSupport.checkList(adverseEvent.subjectMedicalHistory, "subjectMedicalHistory", Reference.class);
+            ValidationSupport.checkList(adverseEvent.referenceDocument, "referenceDocument", Reference.class);
+            ValidationSupport.checkList(adverseEvent.study, "study", Reference.class);
+            ValidationSupport.checkValueSetBinding(adverseEvent.severity, "severity", "http://hl7.org/fhir/ValueSet/adverse-event-severity", "http://terminology.hl7.org/CodeSystem/adverse-event-severity", "mild", "moderate", "severe");
+            ValidationSupport.checkValueSetBinding(adverseEvent.outcome, "outcome", "http://hl7.org/fhir/ValueSet/adverse-event-outcome", "http://terminology.hl7.org/CodeSystem/adverse-event-outcome", "resolved", "recovering", "ongoing", "resolvedWithSequelae", "fatal", "unknown");
+            ValidationSupport.checkReferenceType(adverseEvent.subject, "subject", "Patient", "Group", "Practitioner", "RelatedPerson");
+            ValidationSupport.checkReferenceType(adverseEvent.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(adverseEvent.resultingCondition, "resultingCondition", "Condition");
+            ValidationSupport.checkReferenceType(adverseEvent.location, "location", "Location");
+            ValidationSupport.checkReferenceType(adverseEvent.recorder, "recorder", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
+            ValidationSupport.checkReferenceType(adverseEvent.contributor, "contributor", "Practitioner", "PractitionerRole", "Device");
+            ValidationSupport.checkReferenceType(adverseEvent.subjectMedicalHistory, "subjectMedicalHistory", "Condition", "Observation", "AllergyIntolerance", "FamilyMemberHistory", "Immunization", "Procedure", "Media", "DocumentReference");
+            ValidationSupport.checkReferenceType(adverseEvent.referenceDocument, "referenceDocument", "DocumentReference");
+            ValidationSupport.checkReferenceType(adverseEvent.study, "study", "ResearchStudy");
         }
 
         protected Builder from(AdverseEvent adverseEvent) {
@@ -1354,10 +1371,8 @@ public static class SuspectEntity extends BackboneElement {
 
         private SuspectEntity(Builder builder) {
             super(builder);
-            instance = ValidationSupport.requireNonNull(builder.instance, "instance");
-            causality = Collections.unmodifiableList(ValidationSupport.checkList(builder.causality, "causality", Causality.class));
-            ValidationSupport.checkReferenceType(instance, "instance", "Immunization", "Procedure", "Substance", "Medication", "MedicationAdministration", "MedicationStatement", "Device");
-            ValidationSupport.requireValueOrChildren(this);
+            instance = builder.instance;
+            causality = Collections.unmodifiableList(builder.causality);
         }
 
         /**
@@ -1633,7 +1648,19 @@ public Builder causality(Collection<Causality> causality) {
              */
             @Override
             public SuspectEntity build() {
-                return new SuspectEntity(this);
+                SuspectEntity suspectEntity = new SuspectEntity(this);
+                if (validating) {
+                    validate(suspectEntity);
+                }
+                return suspectEntity;
+            }
+
+            protected void validate(SuspectEntity suspectEntity) {
+                super.validate(suspectEntity);
+                ValidationSupport.requireNonNull(suspectEntity.instance, "instance");
+                ValidationSupport.checkList(suspectEntity.causality, "causality", Causality.class);
+                ValidationSupport.checkReferenceType(suspectEntity.instance, "instance", "Immunization", "Procedure", "Substance", "Medication", "MedicationAdministration", "MedicationStatement", "Device");
+                ValidationSupport.requireValueOrChildren(suspectEntity);
             }
 
             protected Builder from(SuspectEntity suspectEntity) {
@@ -1676,8 +1703,6 @@ private Causality(Builder builder) {
                 productRelatedness = builder.productRelatedness;
                 author = builder.author;
                 method = builder.method;
-                ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole");
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1977,7 +2002,17 @@ public Builder method(CodeableConcept method) {
                  */
                 @Override
                 public Causality build() {
-                    return new Causality(this);
+                    Causality causality = new Causality(this);
+                    if (validating) {
+                        validate(causality);
+                    }
+                    return causality;
+                }
+
+                protected void validate(Causality causality) {
+                    super.validate(causality);
+                    ValidationSupport.checkReferenceType(causality.author, "author", "Practitioner", "PractitionerRole");
+                    ValidationSupport.requireValueOrChildren(causality);
                 }
 
                 protected Builder from(Causality causality) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/AllergyIntolerance.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/AllergyIntolerance.java
index 04f371831d1..600cec1b05e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/AllergyIntolerance.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/AllergyIntolerance.java
@@ -142,28 +142,22 @@ public class AllergyIntolerance extends DomainResource {
 
     private AllergyIntolerance(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         clinicalStatus = builder.clinicalStatus;
         verificationStatus = builder.verificationStatus;
         type = builder.type;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", AllergyIntoleranceCategory.class));
+        category = Collections.unmodifiableList(builder.category);
         criticality = builder.criticality;
         code = builder.code;
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
+        patient = builder.patient;
         encounter = builder.encounter;
-        onset = ValidationSupport.choiceElement(builder.onset, "onset", DateTime.class, Age.class, Period.class, Range.class, String.class);
+        onset = builder.onset;
         recordedDate = builder.recordedDate;
         recorder = builder.recorder;
         asserter = builder.asserter;
         lastOccurrence = builder.lastOccurrence;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        reaction = Collections.unmodifiableList(ValidationSupport.checkList(builder.reaction, "reaction", Reaction.class));
-        ValidationSupport.checkValueSetBinding(clinicalStatus, "clinicalStatus", "http://hl7.org/fhir/ValueSet/allergyintolerance-clinical", "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical", "active", "inactive", "resolved");
-        ValidationSupport.checkValueSetBinding(verificationStatus, "verificationStatus", "http://hl7.org/fhir/ValueSet/allergyintolerance-verification", "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification", "unconfirmed", "confirmed", "refuted", "entered-in-error");
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(recorder, "recorder", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson");
-        ValidationSupport.checkReferenceType(asserter, "asserter", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole");
+        note = Collections.unmodifiableList(builder.note);
+        reaction = Collections.unmodifiableList(builder.reaction);
     }
 
     /**
@@ -1062,7 +1056,27 @@ public Builder reaction(Collection<Reaction> reaction) {
          */
         @Override
         public AllergyIntolerance build() {
-            return new AllergyIntolerance(this);
+            AllergyIntolerance allergyIntolerance = new AllergyIntolerance(this);
+            if (validating) {
+                validate(allergyIntolerance);
+            }
+            return allergyIntolerance;
+        }
+
+        protected void validate(AllergyIntolerance allergyIntolerance) {
+            super.validate(allergyIntolerance);
+            ValidationSupport.checkList(allergyIntolerance.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(allergyIntolerance.category, "category", AllergyIntoleranceCategory.class);
+            ValidationSupport.requireNonNull(allergyIntolerance.patient, "patient");
+            ValidationSupport.choiceElement(allergyIntolerance.onset, "onset", DateTime.class, Age.class, Period.class, Range.class, String.class);
+            ValidationSupport.checkList(allergyIntolerance.note, "note", Annotation.class);
+            ValidationSupport.checkList(allergyIntolerance.reaction, "reaction", Reaction.class);
+            ValidationSupport.checkValueSetBinding(allergyIntolerance.clinicalStatus, "clinicalStatus", "http://hl7.org/fhir/ValueSet/allergyintolerance-clinical", "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical", "active", "inactive", "resolved");
+            ValidationSupport.checkValueSetBinding(allergyIntolerance.verificationStatus, "verificationStatus", "http://hl7.org/fhir/ValueSet/allergyintolerance-verification", "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification", "unconfirmed", "confirmed", "refuted", "entered-in-error");
+            ValidationSupport.checkReferenceType(allergyIntolerance.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(allergyIntolerance.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(allergyIntolerance.recorder, "recorder", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson");
+            ValidationSupport.checkReferenceType(allergyIntolerance.asserter, "asserter", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole");
         }
 
         protected Builder from(AllergyIntolerance allergyIntolerance) {
@@ -1127,13 +1141,12 @@ public static class Reaction extends BackboneElement {
         private Reaction(Builder builder) {
             super(builder);
             substance = builder.substance;
-            manifestation = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.manifestation, "manifestation", CodeableConcept.class));
+            manifestation = Collections.unmodifiableList(builder.manifestation);
             description = builder.description;
             onset = builder.onset;
             severity = builder.severity;
             exposureRoute = builder.exposureRoute;
-            note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-            ValidationSupport.requireValueOrChildren(this);
+            note = Collections.unmodifiableList(builder.note);
         }
 
         /**
@@ -1577,7 +1590,18 @@ public Builder note(Collection<Annotation> note) {
              */
             @Override
             public Reaction build() {
-                return new Reaction(this);
+                Reaction reaction = new Reaction(this);
+                if (validating) {
+                    validate(reaction);
+                }
+                return reaction;
+            }
+
+            protected void validate(Reaction reaction) {
+                super.validate(reaction);
+                ValidationSupport.checkNonEmptyList(reaction.manifestation, "manifestation", CodeableConcept.class);
+                ValidationSupport.checkList(reaction.note, "note", Annotation.class);
+                ValidationSupport.requireValueOrChildren(reaction);
             }
 
             protected Builder from(Reaction reaction) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Appointment.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Appointment.java
index 19c78cc29a1..003580fad65 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Appointment.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Appointment.java
@@ -192,31 +192,28 @@ public class Appointment extends DomainResource {
 
     private Appointment(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         cancelationReason = builder.cancelationReason;
-        serviceCategory = Collections.unmodifiableList(ValidationSupport.checkList(builder.serviceCategory, "serviceCategory", CodeableConcept.class));
-        serviceType = Collections.unmodifiableList(ValidationSupport.checkList(builder.serviceType, "serviceType", CodeableConcept.class));
-        specialty = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialty, "specialty", CodeableConcept.class));
+        serviceCategory = Collections.unmodifiableList(builder.serviceCategory);
+        serviceType = Collections.unmodifiableList(builder.serviceType);
+        specialty = Collections.unmodifiableList(builder.specialty);
         appointmentType = builder.appointmentType;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
         priority = builder.priority;
         description = builder.description;
-        supportingInformation = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInformation, "supportingInformation", Reference.class));
+        supportingInformation = Collections.unmodifiableList(builder.supportingInformation);
         start = builder.start;
         end = builder.end;
         minutesDuration = builder.minutesDuration;
-        slot = Collections.unmodifiableList(ValidationSupport.checkList(builder.slot, "slot", Reference.class));
+        slot = Collections.unmodifiableList(builder.slot);
         created = builder.created;
         comment = builder.comment;
         patientInstruction = builder.patientInstruction;
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        participant = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.participant, "participant", Participant.class));
-        requestedPeriod = Collections.unmodifiableList(ValidationSupport.checkList(builder.requestedPeriod, "requestedPeriod", Period.class));
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Procedure", "Observation", "ImmunizationRecommendation");
-        ValidationSupport.checkReferenceType(slot, "slot", "Slot");
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "ServiceRequest");
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        participant = Collections.unmodifiableList(builder.participant);
+        requestedPeriod = Collections.unmodifiableList(builder.requestedPeriod);
     }
 
     /**
@@ -1454,7 +1451,30 @@ public Builder requestedPeriod(Collection<Period> requestedPeriod) {
          */
         @Override
         public Appointment build() {
-            return new Appointment(this);
+            Appointment appointment = new Appointment(this);
+            if (validating) {
+                validate(appointment);
+            }
+            return appointment;
+        }
+
+        protected void validate(Appointment appointment) {
+            super.validate(appointment);
+            ValidationSupport.checkList(appointment.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(appointment.status, "status");
+            ValidationSupport.checkList(appointment.serviceCategory, "serviceCategory", CodeableConcept.class);
+            ValidationSupport.checkList(appointment.serviceType, "serviceType", CodeableConcept.class);
+            ValidationSupport.checkList(appointment.specialty, "specialty", CodeableConcept.class);
+            ValidationSupport.checkList(appointment.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(appointment.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(appointment.supportingInformation, "supportingInformation", Reference.class);
+            ValidationSupport.checkList(appointment.slot, "slot", Reference.class);
+            ValidationSupport.checkList(appointment.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkNonEmptyList(appointment.participant, "participant", Participant.class);
+            ValidationSupport.checkList(appointment.requestedPeriod, "requestedPeriod", Period.class);
+            ValidationSupport.checkReferenceType(appointment.reasonReference, "reasonReference", "Condition", "Procedure", "Observation", "ImmunizationRecommendation");
+            ValidationSupport.checkReferenceType(appointment.slot, "slot", "Slot");
+            ValidationSupport.checkReferenceType(appointment.basedOn, "basedOn", "ServiceRequest");
         }
 
         protected Builder from(Appointment appointment) {
@@ -1521,13 +1541,11 @@ public static class Participant extends BackboneElement {
 
         private Participant(Builder builder) {
             super(builder);
-            type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+            type = Collections.unmodifiableList(builder.type);
             actor = builder.actor;
             required = builder.required;
-            status = ValidationSupport.requireNonNull(builder.status, "status");
+            status = builder.status;
             period = builder.period;
-            ValidationSupport.checkReferenceType(actor, "actor", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Device", "HealthcareService", "Location");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1890,7 +1908,19 @@ public Builder period(Period period) {
              */
             @Override
             public Participant build() {
-                return new Participant(this);
+                Participant participant = new Participant(this);
+                if (validating) {
+                    validate(participant);
+                }
+                return participant;
+            }
+
+            protected void validate(Participant participant) {
+                super.validate(participant);
+                ValidationSupport.checkList(participant.type, "type", CodeableConcept.class);
+                ValidationSupport.requireNonNull(participant.status, "status");
+                ValidationSupport.checkReferenceType(participant.actor, "actor", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Device", "HealthcareService", "Location");
+                ValidationSupport.requireValueOrChildren(participant);
             }
 
             protected Builder from(Participant participant) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/AppointmentResponse.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/AppointmentResponse.java
index cd9b9bbfa7a..3929013bf00 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/AppointmentResponse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/AppointmentResponse.java
@@ -94,16 +94,14 @@ public class AppointmentResponse extends DomainResource {
 
     private AppointmentResponse(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        appointment = ValidationSupport.requireNonNull(builder.appointment, "appointment");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        appointment = builder.appointment;
         start = builder.start;
         end = builder.end;
-        participantType = Collections.unmodifiableList(ValidationSupport.checkList(builder.participantType, "participantType", CodeableConcept.class));
+        participantType = Collections.unmodifiableList(builder.participantType);
         actor = builder.actor;
-        participantStatus = ValidationSupport.requireNonNull(builder.participantStatus, "participantStatus");
+        participantStatus = builder.participantStatus;
         comment = builder.comment;
-        ValidationSupport.checkReferenceType(appointment, "appointment", "Appointment");
-        ValidationSupport.checkReferenceType(actor, "actor", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Device", "HealthcareService", "Location");
     }
 
     /**
@@ -698,7 +696,21 @@ public Builder comment(String comment) {
          */
         @Override
         public AppointmentResponse build() {
-            return new AppointmentResponse(this);
+            AppointmentResponse appointmentResponse = new AppointmentResponse(this);
+            if (validating) {
+                validate(appointmentResponse);
+            }
+            return appointmentResponse;
+        }
+
+        protected void validate(AppointmentResponse appointmentResponse) {
+            super.validate(appointmentResponse);
+            ValidationSupport.checkList(appointmentResponse.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(appointmentResponse.appointment, "appointment");
+            ValidationSupport.checkList(appointmentResponse.participantType, "participantType", CodeableConcept.class);
+            ValidationSupport.requireNonNull(appointmentResponse.participantStatus, "participantStatus");
+            ValidationSupport.checkReferenceType(appointmentResponse.appointment, "appointment", "Appointment");
+            ValidationSupport.checkReferenceType(appointmentResponse.actor, "actor", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Device", "HealthcareService", "Location");
         }
 
         protected Builder from(AppointmentResponse appointmentResponse) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/AuditEvent.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/AuditEvent.java
index efd3da35961..a8301b50c6a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/AuditEvent.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/AuditEvent.java
@@ -206,17 +206,17 @@ public class AuditEvent extends DomainResource {
 
     private AuditEvent(Builder builder) {
         super(builder);
-        type = ValidationSupport.requireNonNull(builder.type, "type");
-        subtype = Collections.unmodifiableList(ValidationSupport.checkList(builder.subtype, "subtype", Coding.class));
+        type = builder.type;
+        subtype = Collections.unmodifiableList(builder.subtype);
         action = builder.action;
         period = builder.period;
-        recorded = ValidationSupport.requireNonNull(builder.recorded, "recorded");
+        recorded = builder.recorded;
         outcome = builder.outcome;
         outcomeDesc = builder.outcomeDesc;
-        purposeOfEvent = Collections.unmodifiableList(ValidationSupport.checkList(builder.purposeOfEvent, "purposeOfEvent", CodeableConcept.class));
-        agent = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.agent, "agent", Agent.class));
-        source = ValidationSupport.requireNonNull(builder.source, "source");
-        entity = Collections.unmodifiableList(ValidationSupport.checkList(builder.entity, "entity", Entity.class));
+        purposeOfEvent = Collections.unmodifiableList(builder.purposeOfEvent);
+        agent = Collections.unmodifiableList(builder.agent);
+        source = builder.source;
+        entity = Collections.unmodifiableList(builder.entity);
     }
 
     /**
@@ -923,7 +923,22 @@ public Builder entity(Collection<Entity> entity) {
          */
         @Override
         public AuditEvent build() {
-            return new AuditEvent(this);
+            AuditEvent auditEvent = new AuditEvent(this);
+            if (validating) {
+                validate(auditEvent);
+            }
+            return auditEvent;
+        }
+
+        protected void validate(AuditEvent auditEvent) {
+            super.validate(auditEvent);
+            ValidationSupport.requireNonNull(auditEvent.type, "type");
+            ValidationSupport.checkList(auditEvent.subtype, "subtype", Coding.class);
+            ValidationSupport.requireNonNull(auditEvent.recorded, "recorded");
+            ValidationSupport.checkList(auditEvent.purposeOfEvent, "purposeOfEvent", CodeableConcept.class);
+            ValidationSupport.checkNonEmptyList(auditEvent.agent, "agent", Agent.class);
+            ValidationSupport.requireNonNull(auditEvent.source, "source");
+            ValidationSupport.checkList(auditEvent.entity, "entity", Entity.class);
         }
 
         protected Builder from(AuditEvent auditEvent) {
@@ -991,19 +1006,16 @@ public static class Agent extends BackboneElement {
         private Agent(Builder builder) {
             super(builder);
             type = builder.type;
-            role = Collections.unmodifiableList(ValidationSupport.checkList(builder.role, "role", CodeableConcept.class));
+            role = Collections.unmodifiableList(builder.role);
             who = builder.who;
             altId = builder.altId;
             name = builder.name;
-            requestor = ValidationSupport.requireNonNull(builder.requestor, "requestor");
+            requestor = builder.requestor;
             location = builder.location;
-            policy = Collections.unmodifiableList(ValidationSupport.checkList(builder.policy, "policy", Uri.class));
+            policy = Collections.unmodifiableList(builder.policy);
             media = builder.media;
             network = builder.network;
-            purposeOfUse = Collections.unmodifiableList(ValidationSupport.checkList(builder.purposeOfUse, "purposeOfUse", CodeableConcept.class));
-            ValidationSupport.checkReferenceType(who, "who", "PractitionerRole", "Practitioner", "Organization", "Device", "Patient", "RelatedPerson");
-            ValidationSupport.checkReferenceType(location, "location", "Location");
-            ValidationSupport.requireValueOrChildren(this);
+            purposeOfUse = Collections.unmodifiableList(builder.purposeOfUse);
         }
 
         /**
@@ -1593,7 +1605,22 @@ public Builder purposeOfUse(Collection<CodeableConcept> purposeOfUse) {
              */
             @Override
             public Agent build() {
-                return new Agent(this);
+                Agent agent = new Agent(this);
+                if (validating) {
+                    validate(agent);
+                }
+                return agent;
+            }
+
+            protected void validate(Agent agent) {
+                super.validate(agent);
+                ValidationSupport.checkList(agent.role, "role", CodeableConcept.class);
+                ValidationSupport.requireNonNull(agent.requestor, "requestor");
+                ValidationSupport.checkList(agent.policy, "policy", Uri.class);
+                ValidationSupport.checkList(agent.purposeOfUse, "purposeOfUse", CodeableConcept.class);
+                ValidationSupport.checkReferenceType(agent.who, "who", "PractitionerRole", "Practitioner", "Organization", "Device", "Patient", "RelatedPerson");
+                ValidationSupport.checkReferenceType(agent.location, "location", "Location");
+                ValidationSupport.requireValueOrChildren(agent);
             }
 
             protected Builder from(Agent agent) {
@@ -1630,7 +1657,6 @@ private Network(Builder builder) {
                 super(builder);
                 address = builder.address;
                 type = builder.type;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1866,7 +1892,16 @@ public Builder type(AuditEventAgentNetworkType type) {
                  */
                 @Override
                 public Network build() {
-                    return new Network(this);
+                    Network network = new Network(this);
+                    if (validating) {
+                        validate(network);
+                    }
+                    return network;
+                }
+
+                protected void validate(Network network) {
+                    super.validate(network);
+                    ValidationSupport.requireValueOrChildren(network);
                 }
 
                 protected Builder from(Network network) {
@@ -1899,10 +1934,8 @@ public static class Source extends BackboneElement {
         private Source(Builder builder) {
             super(builder);
             site = builder.site;
-            observer = ValidationSupport.requireNonNull(builder.observer, "observer");
-            type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", Coding.class));
-            ValidationSupport.checkReferenceType(observer, "observer", "PractitionerRole", "Practitioner", "Organization", "Device", "Patient", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
+            observer = builder.observer;
+            type = Collections.unmodifiableList(builder.type);
         }
 
         /**
@@ -2206,7 +2239,19 @@ public Builder type(Collection<Coding> type) {
              */
             @Override
             public Source build() {
-                return new Source(this);
+                Source source = new Source(this);
+                if (validating) {
+                    validate(source);
+                }
+                return source;
+            }
+
+            protected void validate(Source source) {
+                super.validate(source);
+                ValidationSupport.requireNonNull(source.observer, "observer");
+                ValidationSupport.checkList(source.type, "type", Coding.class);
+                ValidationSupport.checkReferenceType(source.observer, "observer", "PractitionerRole", "Practitioner", "Organization", "Device", "Patient", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(source);
             }
 
             protected Builder from(Source source) {
@@ -2266,12 +2311,11 @@ private Entity(Builder builder) {
             type = builder.type;
             role = builder.role;
             lifecycle = builder.lifecycle;
-            securityLabel = Collections.unmodifiableList(ValidationSupport.checkList(builder.securityLabel, "securityLabel", Coding.class));
+            securityLabel = Collections.unmodifiableList(builder.securityLabel);
             name = builder.name;
             description = builder.description;
             query = builder.query;
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Detail.class));
-            ValidationSupport.requireValueOrChildren(this);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -2750,7 +2794,18 @@ public Builder detail(Collection<Detail> detail) {
              */
             @Override
             public Entity build() {
-                return new Entity(this);
+                Entity entity = new Entity(this);
+                if (validating) {
+                    validate(entity);
+                }
+                return entity;
+            }
+
+            protected void validate(Entity entity) {
+                super.validate(entity);
+                ValidationSupport.checkList(entity.securityLabel, "securityLabel", Coding.class);
+                ValidationSupport.checkList(entity.detail, "detail", Detail.class);
+                ValidationSupport.requireValueOrChildren(entity);
             }
 
             protected Builder from(Entity entity) {
@@ -2780,9 +2835,8 @@ public static class Detail extends BackboneElement {
 
             private Detail(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
-                value = ValidationSupport.requireChoiceElement(builder.value, "value", String.class, Base64Binary.class);
-                ValidationSupport.requireValueOrChildren(this);
+                type = builder.type;
+                value = builder.value;
             }
 
             /**
@@ -3034,7 +3088,18 @@ public Builder value(Element value) {
                  */
                 @Override
                 public Detail build() {
-                    return new Detail(this);
+                    Detail detail = new Detail(this);
+                    if (validating) {
+                        validate(detail);
+                    }
+                    return detail;
+                }
+
+                protected void validate(Detail detail) {
+                    super.validate(detail);
+                    ValidationSupport.requireNonNull(detail.type, "type");
+                    ValidationSupport.requireChoiceElement(detail.value, "value", String.class, Base64Binary.class);
+                    ValidationSupport.requireValueOrChildren(detail);
                 }
 
                 protected Builder from(Detail detail) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Basic.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Basic.java
index 28d69844354..015496c5d09 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Basic.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Basic.java
@@ -66,12 +66,11 @@ public class Basic extends DomainResource {
 
     private Basic(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        code = ValidationSupport.requireNonNull(builder.code, "code");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        code = builder.code;
         subject = builder.subject;
         created = builder.created;
         author = builder.author;
-        ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson", "Organization");
     }
 
     /**
@@ -540,7 +539,18 @@ public Builder author(Reference author) {
          */
         @Override
         public Basic build() {
-            return new Basic(this);
+            Basic basic = new Basic(this);
+            if (validating) {
+                validate(basic);
+            }
+            return basic;
+        }
+
+        protected void validate(Basic basic) {
+            super.validate(basic);
+            ValidationSupport.checkList(basic.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(basic.code, "code");
+            ValidationSupport.checkReferenceType(basic.author, "author", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson", "Organization");
         }
 
         protected Builder from(Basic basic) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Binary.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Binary.java
index 58729184ed8..2f9c83c1c68 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Binary.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Binary.java
@@ -51,7 +51,7 @@ public class Binary extends Resource {
 
     private Binary(Builder builder) {
         super(builder);
-        contentType = ValidationSupport.requireNonNull(builder.contentType, "contentType");
+        contentType = builder.contentType;
         securityContext = builder.securityContext;
         data = builder.data;
     }
@@ -296,7 +296,16 @@ public Builder data(Base64Binary data) {
          */
         @Override
         public Binary build() {
-            return new Binary(this);
+            Binary binary = new Binary(this);
+            if (validating) {
+                validate(binary);
+            }
+            return binary;
+        }
+
+        protected void validate(Binary binary) {
+            super.validate(binary);
+            ValidationSupport.requireNonNull(binary.contentType, "contentType");
         }
 
         protected Builder from(Binary binary) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/BiologicallyDerivedProduct.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/BiologicallyDerivedProduct.java
index 25d82ebe21c..4413de00c43 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/BiologicallyDerivedProduct.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/BiologicallyDerivedProduct.java
@@ -87,19 +87,17 @@ public class BiologicallyDerivedProduct extends DomainResource {
 
     private BiologicallyDerivedProduct(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         productCategory = builder.productCategory;
         productCode = builder.productCode;
         status = builder.status;
-        request = Collections.unmodifiableList(ValidationSupport.checkList(builder.request, "request", Reference.class));
+        request = Collections.unmodifiableList(builder.request);
         quantity = builder.quantity;
-        parent = Collections.unmodifiableList(ValidationSupport.checkList(builder.parent, "parent", Reference.class));
+        parent = Collections.unmodifiableList(builder.parent);
         collection = builder.collection;
-        processing = Collections.unmodifiableList(ValidationSupport.checkList(builder.processing, "processing", Processing.class));
+        processing = Collections.unmodifiableList(builder.processing);
         manipulation = builder.manipulation;
-        storage = Collections.unmodifiableList(ValidationSupport.checkList(builder.storage, "storage", Storage.class));
-        ValidationSupport.checkReferenceType(request, "request", "ServiceRequest");
-        ValidationSupport.checkReferenceType(parent, "parent", "BiologicallyDerivedProduct");
+        storage = Collections.unmodifiableList(builder.storage);
     }
 
     /**
@@ -837,7 +835,22 @@ public Builder storage(java.util.Collection<Storage> storage) {
          */
         @Override
         public BiologicallyDerivedProduct build() {
-            return new BiologicallyDerivedProduct(this);
+            BiologicallyDerivedProduct biologicallyDerivedProduct = new BiologicallyDerivedProduct(this);
+            if (validating) {
+                validate(biologicallyDerivedProduct);
+            }
+            return biologicallyDerivedProduct;
+        }
+
+        protected void validate(BiologicallyDerivedProduct biologicallyDerivedProduct) {
+            super.validate(biologicallyDerivedProduct);
+            ValidationSupport.checkList(biologicallyDerivedProduct.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(biologicallyDerivedProduct.request, "request", Reference.class);
+            ValidationSupport.checkList(biologicallyDerivedProduct.parent, "parent", Reference.class);
+            ValidationSupport.checkList(biologicallyDerivedProduct.processing, "processing", Processing.class);
+            ValidationSupport.checkList(biologicallyDerivedProduct.storage, "storage", Storage.class);
+            ValidationSupport.checkReferenceType(biologicallyDerivedProduct.request, "request", "ServiceRequest");
+            ValidationSupport.checkReferenceType(biologicallyDerivedProduct.parent, "parent", "BiologicallyDerivedProduct");
         }
 
         protected Builder from(BiologicallyDerivedProduct biologicallyDerivedProduct) {
@@ -872,10 +885,7 @@ private Collection(Builder builder) {
             super(builder);
             collector = builder.collector;
             source = builder.source;
-            collected = ValidationSupport.choiceElement(builder.collected, "collected", DateTime.class, Period.class);
-            ValidationSupport.checkReferenceType(collector, "collector", "Practitioner", "PractitionerRole");
-            ValidationSupport.checkReferenceType(source, "source", "Patient", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
+            collected = builder.collected;
         }
 
         /**
@@ -1160,7 +1170,19 @@ public Builder collected(Element collected) {
              */
             @Override
             public Collection build() {
-                return new Collection(this);
+                Collection collection = new Collection(this);
+                if (validating) {
+                    validate(collection);
+                }
+                return collection;
+            }
+
+            protected void validate(Collection collection) {
+                super.validate(collection);
+                ValidationSupport.choiceElement(collection.collected, "collected", DateTime.class, Period.class);
+                ValidationSupport.checkReferenceType(collection.collector, "collector", "Practitioner", "PractitionerRole");
+                ValidationSupport.checkReferenceType(collection.source, "source", "Patient", "Organization");
+                ValidationSupport.requireValueOrChildren(collection);
             }
 
             protected Builder from(Collection collection) {
@@ -1196,9 +1218,7 @@ private Processing(Builder builder) {
             description = builder.description;
             procedure = builder.procedure;
             additive = builder.additive;
-            time = ValidationSupport.choiceElement(builder.time, "time", DateTime.class, Period.class);
-            ValidationSupport.checkReferenceType(additive, "additive", "Substance");
-            ValidationSupport.requireValueOrChildren(this);
+            time = builder.time;
         }
 
         /**
@@ -1503,7 +1523,18 @@ public Builder time(Element time) {
              */
             @Override
             public Processing build() {
-                return new Processing(this);
+                Processing processing = new Processing(this);
+                if (validating) {
+                    validate(processing);
+                }
+                return processing;
+            }
+
+            protected void validate(Processing processing) {
+                super.validate(processing);
+                ValidationSupport.choiceElement(processing.time, "time", DateTime.class, Period.class);
+                ValidationSupport.checkReferenceType(processing.additive, "additive", "Substance");
+                ValidationSupport.requireValueOrChildren(processing);
             }
 
             protected Builder from(Processing processing) {
@@ -1529,8 +1560,7 @@ public static class Manipulation extends BackboneElement {
         private Manipulation(Builder builder) {
             super(builder);
             description = builder.description;
-            time = ValidationSupport.choiceElement(builder.time, "time", DateTime.class, Period.class);
-            ValidationSupport.requireValueOrChildren(this);
+            time = builder.time;
         }
 
         /**
@@ -1772,7 +1802,17 @@ public Builder time(Element time) {
              */
             @Override
             public Manipulation build() {
-                return new Manipulation(this);
+                Manipulation manipulation = new Manipulation(this);
+                if (validating) {
+                    validate(manipulation);
+                }
+                return manipulation;
+            }
+
+            protected void validate(Manipulation manipulation) {
+                super.validate(manipulation);
+                ValidationSupport.choiceElement(manipulation.time, "time", DateTime.class, Period.class);
+                ValidationSupport.requireValueOrChildren(manipulation);
             }
 
             protected Builder from(Manipulation manipulation) {
@@ -1805,7 +1845,6 @@ private Storage(Builder builder) {
             temperature = builder.temperature;
             scale = builder.scale;
             duration = builder.duration;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2099,7 +2138,16 @@ public Builder duration(Period duration) {
              */
             @Override
             public Storage build() {
-                return new Storage(this);
+                Storage storage = new Storage(this);
+                if (validating) {
+                    validate(storage);
+                }
+                return storage;
+            }
+
+            protected void validate(Storage storage) {
+                super.validate(storage);
+                ValidationSupport.requireValueOrChildren(storage);
             }
 
             protected Builder from(Storage storage) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/BodyStructure.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/BodyStructure.java
index 4dc2014d39f..35ddc88e8c6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/BodyStructure.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/BodyStructure.java
@@ -84,15 +84,14 @@ public class BodyStructure extends DomainResource {
 
     private BodyStructure(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
         morphology = builder.morphology;
         location = builder.location;
-        locationQualifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.locationQualifier, "locationQualifier", CodeableConcept.class));
+        locationQualifier = Collections.unmodifiableList(builder.locationQualifier);
         description = builder.description;
-        image = Collections.unmodifiableList(ValidationSupport.checkList(builder.image, "image", Attachment.class));
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
+        image = Collections.unmodifiableList(builder.image);
+        patient = builder.patient;
     }
 
     /**
@@ -689,7 +688,20 @@ public Builder patient(Reference patient) {
          */
         @Override
         public BodyStructure build() {
-            return new BodyStructure(this);
+            BodyStructure bodyStructure = new BodyStructure(this);
+            if (validating) {
+                validate(bodyStructure);
+            }
+            return bodyStructure;
+        }
+
+        protected void validate(BodyStructure bodyStructure) {
+            super.validate(bodyStructure);
+            ValidationSupport.checkList(bodyStructure.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(bodyStructure.locationQualifier, "locationQualifier", CodeableConcept.class);
+            ValidationSupport.checkList(bodyStructure.image, "image", Attachment.class);
+            ValidationSupport.requireNonNull(bodyStructure.patient, "patient");
+            ValidationSupport.checkReferenceType(bodyStructure.patient, "patient", "Patient");
         }
 
         protected Builder from(BodyStructure bodyStructure) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Bundle.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Bundle.java
index 43e7cce5be2..00df2c465f0 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Bundle.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Bundle.java
@@ -151,11 +151,11 @@ public class Bundle extends Resource {
     private Bundle(Builder builder) {
         super(builder);
         identifier = builder.identifier;
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        type = builder.type;
         timestamp = builder.timestamp;
         total = builder.total;
-        link = Collections.unmodifiableList(ValidationSupport.checkList(builder.link, "link", Link.class));
-        entry = Collections.unmodifiableList(ValidationSupport.checkList(builder.entry, "entry", Entry.class));
+        link = Collections.unmodifiableList(builder.link);
+        entry = Collections.unmodifiableList(builder.entry);
         signature = builder.signature;
     }
 
@@ -552,7 +552,18 @@ public Builder signature(Signature signature) {
          */
         @Override
         public Bundle build() {
-            return new Bundle(this);
+            Bundle bundle = new Bundle(this);
+            if (validating) {
+                validate(bundle);
+            }
+            return bundle;
+        }
+
+        protected void validate(Bundle bundle) {
+            super.validate(bundle);
+            ValidationSupport.requireNonNull(bundle.type, "type");
+            ValidationSupport.checkList(bundle.link, "link", Link.class);
+            ValidationSupport.checkList(bundle.entry, "entry", Entry.class);
         }
 
         protected Builder from(Bundle bundle) {
@@ -581,9 +592,8 @@ public static class Link extends BackboneElement {
 
         private Link(Builder builder) {
             super(builder);
-            relation = ValidationSupport.requireNonNull(builder.relation, "relation");
-            url = ValidationSupport.requireNonNull(builder.url, "url");
-            ValidationSupport.requireValueOrChildren(this);
+            relation = builder.relation;
+            url = builder.url;
         }
 
         /**
@@ -833,7 +843,18 @@ public Builder url(Uri url) {
              */
             @Override
             public Link build() {
-                return new Link(this);
+                Link link = new Link(this);
+                if (validating) {
+                    validate(link);
+                }
+                return link;
+            }
+
+            protected void validate(Link link) {
+                super.validate(link);
+                ValidationSupport.requireNonNull(link.relation, "relation");
+                ValidationSupport.requireNonNull(link.url, "url");
+                ValidationSupport.requireValueOrChildren(link);
             }
 
             protected Builder from(Link link) {
@@ -865,13 +886,12 @@ public static class Entry extends BackboneElement {
 
         private Entry(Builder builder) {
             super(builder);
-            link = Collections.unmodifiableList(ValidationSupport.checkList(builder.link, "link", Bundle.Link.class));
+            link = Collections.unmodifiableList(builder.link);
             fullUrl = builder.fullUrl;
             resource = builder.resource;
             search = builder.search;
             request = builder.request;
             response = builder.response;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1257,7 +1277,17 @@ public Builder response(Response response) {
              */
             @Override
             public Entry build() {
-                return new Entry(this);
+                Entry entry = new Entry(this);
+                if (validating) {
+                    validate(entry);
+                }
+                return entry;
+            }
+
+            protected void validate(Entry entry) {
+                super.validate(entry);
+                ValidationSupport.checkList(entry.link, "link", Bundle.Link.class);
+                ValidationSupport.requireValueOrChildren(entry);
             }
 
             protected Builder from(Entry entry) {
@@ -1291,7 +1321,6 @@ private Search(Builder builder) {
                 super(builder);
                 mode = builder.mode;
                 score = builder.score;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1529,7 +1558,16 @@ public Builder score(Decimal score) {
                  */
                 @Override
                 public Search build() {
-                    return new Search(this);
+                    Search search = new Search(this);
+                    if (validating) {
+                        validate(search);
+                    }
+                    return search;
+                }
+
+                protected void validate(Search search) {
+                    super.validate(search);
+                    ValidationSupport.requireValueOrChildren(search);
                 }
 
                 protected Builder from(Search search) {
@@ -1569,13 +1607,12 @@ public static class Request extends BackboneElement {
 
             private Request(Builder builder) {
                 super(builder);
-                method = ValidationSupport.requireNonNull(builder.method, "method");
-                url = ValidationSupport.requireNonNull(builder.url, "url");
+                method = builder.method;
+                url = builder.url;
                 ifNoneMatch = builder.ifNoneMatch;
                 ifModifiedSince = builder.ifModifiedSince;
                 ifMatch = builder.ifMatch;
                 ifNoneExist = builder.ifNoneExist;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1949,7 +1986,18 @@ public Builder ifNoneExist(String ifNoneExist) {
                  */
                 @Override
                 public Request build() {
-                    return new Request(this);
+                    Request request = new Request(this);
+                    if (validating) {
+                        validate(request);
+                    }
+                    return request;
+                }
+
+                protected void validate(Request request) {
+                    super.validate(request);
+                    ValidationSupport.requireNonNull(request.method, "method");
+                    ValidationSupport.requireNonNull(request.url, "url");
+                    ValidationSupport.requireValueOrChildren(request);
                 }
 
                 protected Builder from(Request request) {
@@ -1984,12 +2032,11 @@ public static class Response extends BackboneElement {
 
             private Response(Builder builder) {
                 super(builder);
-                status = ValidationSupport.requireNonNull(builder.status, "status");
+                status = builder.status;
                 location = builder.location;
                 etag = builder.etag;
                 lastModified = builder.lastModified;
                 outcome = builder.outcome;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2323,7 +2370,17 @@ public Builder outcome(Resource outcome) {
                  */
                 @Override
                 public Response build() {
-                    return new Response(this);
+                    Response response = new Response(this);
+                    if (validating) {
+                        validate(response);
+                    }
+                    return response;
+                }
+
+                protected void validate(Response response) {
+                    super.validate(response);
+                    ValidationSupport.requireNonNull(response.status, "status");
+                    ValidationSupport.requireValueOrChildren(response);
                 }
 
                 protected Builder from(Response response) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CapabilityStatement.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CapabilityStatement.java
index f2e483450bc..06d96b80e33 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CapabilityStatement.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CapabilityStatement.java
@@ -261,28 +261,28 @@ private CapabilityStatement(Builder builder) {
         version = builder.version;
         name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
-        date = ValidationSupport.requireNonNull(builder.date, "date");
+        date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         copyright = builder.copyright;
-        kind = ValidationSupport.requireNonNull(builder.kind, "kind");
-        instantiates = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiates, "instantiates", Canonical.class));
-        imports = Collections.unmodifiableList(ValidationSupport.checkList(builder.imports, "imports", Canonical.class));
+        kind = builder.kind;
+        instantiates = Collections.unmodifiableList(builder.instantiates);
+        imports = Collections.unmodifiableList(builder.imports);
         software = builder.software;
         implementation = builder.implementation;
-        fhirVersion = ValidationSupport.requireNonNull(builder.fhirVersion, "fhirVersion");
-        format = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.format, "format", Code.class));
-        patchFormat = Collections.unmodifiableList(ValidationSupport.checkList(builder.patchFormat, "patchFormat", Code.class));
-        implementationGuide = Collections.unmodifiableList(ValidationSupport.checkList(builder.implementationGuide, "implementationGuide", Canonical.class));
-        rest = Collections.unmodifiableList(ValidationSupport.checkList(builder.rest, "rest", Rest.class));
-        messaging = Collections.unmodifiableList(ValidationSupport.checkList(builder.messaging, "messaging", Messaging.class));
-        document = Collections.unmodifiableList(ValidationSupport.checkList(builder.document, "document", Document.class));
+        fhirVersion = builder.fhirVersion;
+        format = Collections.unmodifiableList(builder.format);
+        patchFormat = Collections.unmodifiableList(builder.patchFormat);
+        implementationGuide = Collections.unmodifiableList(builder.implementationGuide);
+        rest = Collections.unmodifiableList(builder.rest);
+        messaging = Collections.unmodifiableList(builder.messaging);
+        document = Collections.unmodifiableList(builder.document);
     }
 
     /**
@@ -1619,7 +1619,30 @@ public Builder document(Collection<Document> document) {
          */
         @Override
         public CapabilityStatement build() {
-            return new CapabilityStatement(this);
+            CapabilityStatement capabilityStatement = new CapabilityStatement(this);
+            if (validating) {
+                validate(capabilityStatement);
+            }
+            return capabilityStatement;
+        }
+
+        protected void validate(CapabilityStatement capabilityStatement) {
+            super.validate(capabilityStatement);
+            ValidationSupport.requireNonNull(capabilityStatement.status, "status");
+            ValidationSupport.requireNonNull(capabilityStatement.date, "date");
+            ValidationSupport.checkList(capabilityStatement.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(capabilityStatement.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(capabilityStatement.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.requireNonNull(capabilityStatement.kind, "kind");
+            ValidationSupport.checkList(capabilityStatement.instantiates, "instantiates", Canonical.class);
+            ValidationSupport.checkList(capabilityStatement.imports, "imports", Canonical.class);
+            ValidationSupport.requireNonNull(capabilityStatement.fhirVersion, "fhirVersion");
+            ValidationSupport.checkNonEmptyList(capabilityStatement.format, "format", Code.class);
+            ValidationSupport.checkList(capabilityStatement.patchFormat, "patchFormat", Code.class);
+            ValidationSupport.checkList(capabilityStatement.implementationGuide, "implementationGuide", Canonical.class);
+            ValidationSupport.checkList(capabilityStatement.rest, "rest", Rest.class);
+            ValidationSupport.checkList(capabilityStatement.messaging, "messaging", Messaging.class);
+            ValidationSupport.checkList(capabilityStatement.document, "document", Document.class);
         }
 
         protected Builder from(CapabilityStatement capabilityStatement) {
@@ -1669,10 +1692,9 @@ public static class Software extends BackboneElement {
 
         private Software(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
+            name = builder.name;
             version = builder.version;
             releaseDate = builder.releaseDate;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1944,7 +1966,17 @@ public Builder releaseDate(DateTime releaseDate) {
              */
             @Override
             public Software build() {
-                return new Software(this);
+                Software software = new Software(this);
+                if (validating) {
+                    validate(software);
+                }
+                return software;
+            }
+
+            protected void validate(Software software) {
+                super.validate(software);
+                ValidationSupport.requireNonNull(software.name, "name");
+                ValidationSupport.requireValueOrChildren(software);
             }
 
             protected Builder from(Software software) {
@@ -1973,11 +2005,9 @@ public static class Implementation extends BackboneElement {
 
         private Implementation(Builder builder) {
             super(builder);
-            description = ValidationSupport.requireNonNull(builder.description, "description");
+            description = builder.description;
             url = builder.url;
             custodian = builder.custodian;
-            ValidationSupport.checkReferenceType(custodian, "custodian", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2258,7 +2288,18 @@ public Builder custodian(Reference custodian) {
              */
             @Override
             public Implementation build() {
-                return new Implementation(this);
+                Implementation implementation = new Implementation(this);
+                if (validating) {
+                    validate(implementation);
+                }
+                return implementation;
+            }
+
+            protected void validate(Implementation implementation) {
+                super.validate(implementation);
+                ValidationSupport.requireNonNull(implementation.description, "description");
+                ValidationSupport.checkReferenceType(implementation.custodian, "custodian", "Organization");
+                ValidationSupport.requireValueOrChildren(implementation);
             }
 
             protected Builder from(Implementation implementation) {
@@ -2297,15 +2338,14 @@ public static class Rest extends BackboneElement {
 
         private Rest(Builder builder) {
             super(builder);
-            mode = ValidationSupport.requireNonNull(builder.mode, "mode");
+            mode = builder.mode;
             documentation = builder.documentation;
             security = builder.security;
-            resource = Collections.unmodifiableList(ValidationSupport.checkList(builder.resource, "resource", Resource.class));
-            interaction = Collections.unmodifiableList(ValidationSupport.checkList(builder.interaction, "interaction", Interaction.class));
-            searchParam = Collections.unmodifiableList(ValidationSupport.checkList(builder.searchParam, "searchParam", CapabilityStatement.Rest.Resource.SearchParam.class));
-            operation = Collections.unmodifiableList(ValidationSupport.checkList(builder.operation, "operation", CapabilityStatement.Rest.Resource.Operation.class));
-            compartment = Collections.unmodifiableList(ValidationSupport.checkList(builder.compartment, "compartment", Canonical.class));
-            ValidationSupport.requireValueOrChildren(this);
+            resource = Collections.unmodifiableList(builder.resource);
+            interaction = Collections.unmodifiableList(builder.interaction);
+            searchParam = Collections.unmodifiableList(builder.searchParam);
+            operation = Collections.unmodifiableList(builder.operation);
+            compartment = Collections.unmodifiableList(builder.compartment);
         }
 
         /**
@@ -2828,7 +2868,22 @@ public Builder compartment(Collection<Canonical> compartment) {
              */
             @Override
             public Rest build() {
-                return new Rest(this);
+                Rest rest = new Rest(this);
+                if (validating) {
+                    validate(rest);
+                }
+                return rest;
+            }
+
+            protected void validate(Rest rest) {
+                super.validate(rest);
+                ValidationSupport.requireNonNull(rest.mode, "mode");
+                ValidationSupport.checkList(rest.resource, "resource", Resource.class);
+                ValidationSupport.checkList(rest.interaction, "interaction", Interaction.class);
+                ValidationSupport.checkList(rest.searchParam, "searchParam", CapabilityStatement.Rest.Resource.SearchParam.class);
+                ValidationSupport.checkList(rest.operation, "operation", CapabilityStatement.Rest.Resource.Operation.class);
+                ValidationSupport.checkList(rest.compartment, "compartment", Canonical.class);
+                ValidationSupport.requireValueOrChildren(rest);
             }
 
             protected Builder from(Rest rest) {
@@ -2864,9 +2919,8 @@ public static class Security extends BackboneElement {
             private Security(Builder builder) {
                 super(builder);
                 cors = builder.cors;
-                service = Collections.unmodifiableList(ValidationSupport.checkList(builder.service, "service", CodeableConcept.class));
+                service = Collections.unmodifiableList(builder.service);
                 description = builder.description;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -3151,7 +3205,17 @@ public Builder description(Markdown description) {
                  */
                 @Override
                 public Security build() {
-                    return new Security(this);
+                    Security security = new Security(this);
+                    if (validating) {
+                        validate(security);
+                    }
+                    return security;
+                }
+
+                protected void validate(Security security) {
+                    super.validate(security);
+                    ValidationSupport.checkList(security.service, "service", CodeableConcept.class);
+                    ValidationSupport.requireValueOrChildren(security);
                 }
 
                 protected Builder from(Security security) {
@@ -3223,11 +3287,11 @@ public static class Resource extends BackboneElement {
 
             private Resource(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
+                type = builder.type;
                 profile = builder.profile;
-                supportedProfile = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportedProfile, "supportedProfile", Canonical.class));
+                supportedProfile = Collections.unmodifiableList(builder.supportedProfile);
                 documentation = builder.documentation;
-                interaction = Collections.unmodifiableList(ValidationSupport.checkList(builder.interaction, "interaction", Interaction.class));
+                interaction = Collections.unmodifiableList(builder.interaction);
                 versioning = builder.versioning;
                 readHistory = builder.readHistory;
                 updateCreate = builder.updateCreate;
@@ -3235,12 +3299,11 @@ private Resource(Builder builder) {
                 conditionalRead = builder.conditionalRead;
                 conditionalUpdate = builder.conditionalUpdate;
                 conditionalDelete = builder.conditionalDelete;
-                referencePolicy = Collections.unmodifiableList(ValidationSupport.checkList(builder.referencePolicy, "referencePolicy", ReferenceHandlingPolicy.class));
-                searchInclude = Collections.unmodifiableList(ValidationSupport.checkList(builder.searchInclude, "searchInclude", String.class));
-                searchRevInclude = Collections.unmodifiableList(ValidationSupport.checkList(builder.searchRevInclude, "searchRevInclude", String.class));
-                searchParam = Collections.unmodifiableList(ValidationSupport.checkList(builder.searchParam, "searchParam", SearchParam.class));
-                operation = Collections.unmodifiableList(ValidationSupport.checkList(builder.operation, "operation", Operation.class));
-                ValidationSupport.requireValueOrChildren(this);
+                referencePolicy = Collections.unmodifiableList(builder.referencePolicy);
+                searchInclude = Collections.unmodifiableList(builder.searchInclude);
+                searchRevInclude = Collections.unmodifiableList(builder.searchRevInclude);
+                searchParam = Collections.unmodifiableList(builder.searchParam);
+                operation = Collections.unmodifiableList(builder.operation);
             }
 
             /**
@@ -4090,7 +4153,24 @@ public Builder operation(Collection<Operation> operation) {
                  */
                 @Override
                 public Resource build() {
-                    return new Resource(this);
+                    Resource resource = new Resource(this);
+                    if (validating) {
+                        validate(resource);
+                    }
+                    return resource;
+                }
+
+                protected void validate(Resource resource) {
+                    super.validate(resource);
+                    ValidationSupport.requireNonNull(resource.type, "type");
+                    ValidationSupport.checkList(resource.supportedProfile, "supportedProfile", Canonical.class);
+                    ValidationSupport.checkList(resource.interaction, "interaction", Interaction.class);
+                    ValidationSupport.checkList(resource.referencePolicy, "referencePolicy", ReferenceHandlingPolicy.class);
+                    ValidationSupport.checkList(resource.searchInclude, "searchInclude", String.class);
+                    ValidationSupport.checkList(resource.searchRevInclude, "searchRevInclude", String.class);
+                    ValidationSupport.checkList(resource.searchParam, "searchParam", SearchParam.class);
+                    ValidationSupport.checkList(resource.operation, "operation", Operation.class);
+                    ValidationSupport.requireValueOrChildren(resource);
                 }
 
                 protected Builder from(Resource resource) {
@@ -4132,9 +4212,8 @@ public static class Interaction extends BackboneElement {
 
                 private Interaction(Builder builder) {
                     super(builder);
-                    code = ValidationSupport.requireNonNull(builder.code, "code");
+                    code = builder.code;
                     documentation = builder.documentation;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -4379,7 +4458,17 @@ public Builder documentation(Markdown documentation) {
                      */
                     @Override
                     public Interaction build() {
-                        return new Interaction(this);
+                        Interaction interaction = new Interaction(this);
+                        if (validating) {
+                            validate(interaction);
+                        }
+                        return interaction;
+                    }
+
+                    protected void validate(Interaction interaction) {
+                        super.validate(interaction);
+                        ValidationSupport.requireNonNull(interaction.code, "code");
+                        ValidationSupport.requireValueOrChildren(interaction);
                     }
 
                     protected Builder from(Interaction interaction) {
@@ -4411,11 +4500,10 @@ public static class SearchParam extends BackboneElement {
 
                 private SearchParam(Builder builder) {
                     super(builder);
-                    name = ValidationSupport.requireNonNull(builder.name, "name");
+                    name = builder.name;
                     definition = builder.definition;
-                    type = ValidationSupport.requireNonNull(builder.type, "type");
+                    type = builder.type;
                     documentation = builder.documentation;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -4727,7 +4815,18 @@ public Builder documentation(Markdown documentation) {
                      */
                     @Override
                     public SearchParam build() {
-                        return new SearchParam(this);
+                        SearchParam searchParam = new SearchParam(this);
+                        if (validating) {
+                            validate(searchParam);
+                        }
+                        return searchParam;
+                    }
+
+                    protected void validate(SearchParam searchParam) {
+                        super.validate(searchParam);
+                        ValidationSupport.requireNonNull(searchParam.name, "name");
+                        ValidationSupport.requireNonNull(searchParam.type, "type");
+                        ValidationSupport.requireValueOrChildren(searchParam);
                     }
 
                     protected Builder from(SearchParam searchParam) {
@@ -4756,10 +4855,9 @@ public static class Operation extends BackboneElement {
 
                 private Operation(Builder builder) {
                     super(builder);
-                    name = ValidationSupport.requireNonNull(builder.name, "name");
-                    definition = ValidationSupport.requireNonNull(builder.definition, "definition");
+                    name = builder.name;
+                    definition = builder.definition;
                     documentation = builder.documentation;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -5046,7 +5144,18 @@ public Builder documentation(Markdown documentation) {
                      */
                     @Override
                     public Operation build() {
-                        return new Operation(this);
+                        Operation operation = new Operation(this);
+                        if (validating) {
+                            validate(operation);
+                        }
+                        return operation;
+                    }
+
+                    protected void validate(Operation operation) {
+                        super.validate(operation);
+                        ValidationSupport.requireNonNull(operation.name, "name");
+                        ValidationSupport.requireNonNull(operation.definition, "definition");
+                        ValidationSupport.requireValueOrChildren(operation);
                     }
 
                     protected Builder from(Operation operation) {
@@ -5076,9 +5185,8 @@ public static class Interaction extends BackboneElement {
 
             private Interaction(Builder builder) {
                 super(builder);
-                code = ValidationSupport.requireNonNull(builder.code, "code");
+                code = builder.code;
                 documentation = builder.documentation;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -5323,7 +5431,17 @@ public Builder documentation(Markdown documentation) {
                  */
                 @Override
                 public Interaction build() {
-                    return new Interaction(this);
+                    Interaction interaction = new Interaction(this);
+                    if (validating) {
+                        validate(interaction);
+                    }
+                    return interaction;
+                }
+
+                protected void validate(Interaction interaction) {
+                    super.validate(interaction);
+                    ValidationSupport.requireNonNull(interaction.code, "code");
+                    ValidationSupport.requireValueOrChildren(interaction);
                 }
 
                 protected Builder from(Interaction interaction) {
@@ -5348,11 +5466,10 @@ public static class Messaging extends BackboneElement {
 
         private Messaging(Builder builder) {
             super(builder);
-            endpoint = Collections.unmodifiableList(ValidationSupport.checkList(builder.endpoint, "endpoint", Endpoint.class));
+            endpoint = Collections.unmodifiableList(builder.endpoint);
             reliableCache = builder.reliableCache;
             documentation = builder.documentation;
-            supportedMessage = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportedMessage, "supportedMessage", SupportedMessage.class));
-            ValidationSupport.requireValueOrChildren(this);
+            supportedMessage = Collections.unmodifiableList(builder.supportedMessage);
         }
 
         /**
@@ -5690,7 +5807,18 @@ public Builder supportedMessage(Collection<SupportedMessage> supportedMessage) {
              */
             @Override
             public Messaging build() {
-                return new Messaging(this);
+                Messaging messaging = new Messaging(this);
+                if (validating) {
+                    validate(messaging);
+                }
+                return messaging;
+            }
+
+            protected void validate(Messaging messaging) {
+                super.validate(messaging);
+                ValidationSupport.checkList(messaging.endpoint, "endpoint", Endpoint.class);
+                ValidationSupport.checkList(messaging.supportedMessage, "supportedMessage", SupportedMessage.class);
+                ValidationSupport.requireValueOrChildren(messaging);
             }
 
             protected Builder from(Messaging messaging) {
@@ -5720,9 +5848,8 @@ public static class Endpoint extends BackboneElement {
 
             private Endpoint(Builder builder) {
                 super(builder);
-                protocol = ValidationSupport.requireNonNull(builder.protocol, "protocol");
-                address = ValidationSupport.requireNonNull(builder.address, "address");
-                ValidationSupport.requireValueOrChildren(this);
+                protocol = builder.protocol;
+                address = builder.address;
             }
 
             /**
@@ -5970,7 +6097,18 @@ public Builder address(Url address) {
                  */
                 @Override
                 public Endpoint build() {
-                    return new Endpoint(this);
+                    Endpoint endpoint = new Endpoint(this);
+                    if (validating) {
+                        validate(endpoint);
+                    }
+                    return endpoint;
+                }
+
+                protected void validate(Endpoint endpoint) {
+                    super.validate(endpoint);
+                    ValidationSupport.requireNonNull(endpoint.protocol, "protocol");
+                    ValidationSupport.requireNonNull(endpoint.address, "address");
+                    ValidationSupport.requireValueOrChildren(endpoint);
                 }
 
                 protected Builder from(Endpoint endpoint) {
@@ -6001,9 +6139,8 @@ public static class SupportedMessage extends BackboneElement {
 
             private SupportedMessage(Builder builder) {
                 super(builder);
-                mode = ValidationSupport.requireNonNull(builder.mode, "mode");
-                definition = ValidationSupport.requireNonNull(builder.definition, "definition");
-                ValidationSupport.requireValueOrChildren(this);
+                mode = builder.mode;
+                definition = builder.definition;
             }
 
             /**
@@ -6249,7 +6386,18 @@ public Builder definition(Canonical definition) {
                  */
                 @Override
                 public SupportedMessage build() {
-                    return new SupportedMessage(this);
+                    SupportedMessage supportedMessage = new SupportedMessage(this);
+                    if (validating) {
+                        validate(supportedMessage);
+                    }
+                    return supportedMessage;
+                }
+
+                protected void validate(SupportedMessage supportedMessage) {
+                    super.validate(supportedMessage);
+                    ValidationSupport.requireNonNull(supportedMessage.mode, "mode");
+                    ValidationSupport.requireNonNull(supportedMessage.definition, "definition");
+                    ValidationSupport.requireValueOrChildren(supportedMessage);
                 }
 
                 protected Builder from(SupportedMessage supportedMessage) {
@@ -6282,10 +6430,9 @@ public static class Document extends BackboneElement {
 
         private Document(Builder builder) {
             super(builder);
-            mode = ValidationSupport.requireNonNull(builder.mode, "mode");
+            mode = builder.mode;
             documentation = builder.documentation;
-            profile = ValidationSupport.requireNonNull(builder.profile, "profile");
-            ValidationSupport.requireValueOrChildren(this);
+            profile = builder.profile;
         }
 
         /**
@@ -6562,7 +6709,18 @@ public Builder profile(Canonical profile) {
              */
             @Override
             public Document build() {
-                return new Document(this);
+                Document document = new Document(this);
+                if (validating) {
+                    validate(document);
+                }
+                return document;
+            }
+
+            protected void validate(Document document) {
+                super.validate(document);
+                ValidationSupport.requireNonNull(document.mode, "mode");
+                ValidationSupport.requireNonNull(document.profile, "profile");
+                ValidationSupport.requireValueOrChildren(document);
             }
 
             protected Builder from(Document document) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CarePlan.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CarePlan.java
index dc3ed73284f..b491bcc4a2e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CarePlan.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CarePlan.java
@@ -141,39 +141,29 @@ public class CarePlan extends DomainResource {
 
     private CarePlan(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-        instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        replaces = Collections.unmodifiableList(ValidationSupport.checkList(builder.replaces, "replaces", Reference.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        intent = ValidationSupport.requireNonNull(builder.intent, "intent");
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+        instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        replaces = Collections.unmodifiableList(builder.replaces);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        status = builder.status;
+        intent = builder.intent;
+        category = Collections.unmodifiableList(builder.category);
         title = builder.title;
         description = builder.description;
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        subject = builder.subject;
         encounter = builder.encounter;
         period = builder.period;
         created = builder.created;
         author = builder.author;
-        contributor = Collections.unmodifiableList(ValidationSupport.checkList(builder.contributor, "contributor", Reference.class));
-        careTeam = Collections.unmodifiableList(ValidationSupport.checkList(builder.careTeam, "careTeam", Reference.class));
-        addresses = Collections.unmodifiableList(ValidationSupport.checkList(builder.addresses, "addresses", Reference.class));
-        supportingInfo = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInfo, "supportingInfo", Reference.class));
-        goal = Collections.unmodifiableList(ValidationSupport.checkList(builder.goal, "goal", Reference.class));
-        activity = Collections.unmodifiableList(ValidationSupport.checkList(builder.activity, "activity", Activity.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "CarePlan");
-        ValidationSupport.checkReferenceType(replaces, "replaces", "CarePlan");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "CarePlan");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(author, "author", "Patient", "Practitioner", "PractitionerRole", "Device", "RelatedPerson", "Organization", "CareTeam");
-        ValidationSupport.checkReferenceType(contributor, "contributor", "Patient", "Practitioner", "PractitionerRole", "Device", "RelatedPerson", "Organization", "CareTeam");
-        ValidationSupport.checkReferenceType(careTeam, "careTeam", "CareTeam");
-        ValidationSupport.checkReferenceType(addresses, "addresses", "Condition");
-        ValidationSupport.checkReferenceType(goal, "goal", "Goal");
+        contributor = Collections.unmodifiableList(builder.contributor);
+        careTeam = Collections.unmodifiableList(builder.careTeam);
+        addresses = Collections.unmodifiableList(builder.addresses);
+        supportingInfo = Collections.unmodifiableList(builder.supportingInfo);
+        goal = Collections.unmodifiableList(builder.goal);
+        activity = Collections.unmodifiableList(builder.activity);
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -1545,7 +1535,42 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public CarePlan build() {
-            return new CarePlan(this);
+            CarePlan carePlan = new CarePlan(this);
+            if (validating) {
+                validate(carePlan);
+            }
+            return carePlan;
+        }
+
+        protected void validate(CarePlan carePlan) {
+            super.validate(carePlan);
+            ValidationSupport.checkList(carePlan.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(carePlan.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+            ValidationSupport.checkList(carePlan.instantiatesUri, "instantiatesUri", Uri.class);
+            ValidationSupport.checkList(carePlan.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(carePlan.replaces, "replaces", Reference.class);
+            ValidationSupport.checkList(carePlan.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(carePlan.status, "status");
+            ValidationSupport.requireNonNull(carePlan.intent, "intent");
+            ValidationSupport.checkList(carePlan.category, "category", CodeableConcept.class);
+            ValidationSupport.requireNonNull(carePlan.subject, "subject");
+            ValidationSupport.checkList(carePlan.contributor, "contributor", Reference.class);
+            ValidationSupport.checkList(carePlan.careTeam, "careTeam", Reference.class);
+            ValidationSupport.checkList(carePlan.addresses, "addresses", Reference.class);
+            ValidationSupport.checkList(carePlan.supportingInfo, "supportingInfo", Reference.class);
+            ValidationSupport.checkList(carePlan.goal, "goal", Reference.class);
+            ValidationSupport.checkList(carePlan.activity, "activity", Activity.class);
+            ValidationSupport.checkList(carePlan.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(carePlan.basedOn, "basedOn", "CarePlan");
+            ValidationSupport.checkReferenceType(carePlan.replaces, "replaces", "CarePlan");
+            ValidationSupport.checkReferenceType(carePlan.partOf, "partOf", "CarePlan");
+            ValidationSupport.checkReferenceType(carePlan.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(carePlan.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(carePlan.author, "author", "Patient", "Practitioner", "PractitionerRole", "Device", "RelatedPerson", "Organization", "CareTeam");
+            ValidationSupport.checkReferenceType(carePlan.contributor, "contributor", "Patient", "Practitioner", "PractitionerRole", "Device", "RelatedPerson", "Organization", "CareTeam");
+            ValidationSupport.checkReferenceType(carePlan.careTeam, "careTeam", "CareTeam");
+            ValidationSupport.checkReferenceType(carePlan.addresses, "addresses", "Condition");
+            ValidationSupport.checkReferenceType(carePlan.goal, "goal", "Goal");
         }
 
         protected Builder from(CarePlan carePlan) {
@@ -1597,13 +1622,11 @@ public static class Activity extends BackboneElement {
 
         private Activity(Builder builder) {
             super(builder);
-            outcomeCodeableConcept = Collections.unmodifiableList(ValidationSupport.checkList(builder.outcomeCodeableConcept, "outcomeCodeableConcept", CodeableConcept.class));
-            outcomeReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.outcomeReference, "outcomeReference", Reference.class));
-            progress = Collections.unmodifiableList(ValidationSupport.checkList(builder.progress, "progress", Annotation.class));
+            outcomeCodeableConcept = Collections.unmodifiableList(builder.outcomeCodeableConcept);
+            outcomeReference = Collections.unmodifiableList(builder.outcomeReference);
+            progress = Collections.unmodifiableList(builder.progress);
             reference = builder.reference;
             detail = builder.detail;
-            ValidationSupport.checkReferenceType(reference, "reference", "Appointment", "CommunicationRequest", "DeviceRequest", "MedicationRequest", "NutritionOrder", "Task", "ServiceRequest", "VisionPrescription", "RequestGroup");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2010,7 +2033,20 @@ public Builder detail(Detail detail) {
              */
             @Override
             public Activity build() {
-                return new Activity(this);
+                Activity activity = new Activity(this);
+                if (validating) {
+                    validate(activity);
+                }
+                return activity;
+            }
+
+            protected void validate(Activity activity) {
+                super.validate(activity);
+                ValidationSupport.checkList(activity.outcomeCodeableConcept, "outcomeCodeableConcept", CodeableConcept.class);
+                ValidationSupport.checkList(activity.outcomeReference, "outcomeReference", Reference.class);
+                ValidationSupport.checkList(activity.progress, "progress", Annotation.class);
+                ValidationSupport.checkReferenceType(activity.reference, "reference", "Appointment", "CommunicationRequest", "DeviceRequest", "MedicationRequest", "NutritionOrder", "Task", "ServiceRequest", "VisionPrescription", "RequestGroup");
+                ValidationSupport.requireValueOrChildren(activity);
             }
 
             protected Builder from(Activity activity) {
@@ -2088,28 +2124,22 @@ public static class Detail extends BackboneElement {
             private Detail(Builder builder) {
                 super(builder);
                 kind = builder.kind;
-                instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-                instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
+                instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+                instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
                 code = builder.code;
-                reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-                reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-                goal = Collections.unmodifiableList(ValidationSupport.checkList(builder.goal, "goal", Reference.class));
-                status = ValidationSupport.requireNonNull(builder.status, "status");
+                reasonCode = Collections.unmodifiableList(builder.reasonCode);
+                reasonReference = Collections.unmodifiableList(builder.reasonReference);
+                goal = Collections.unmodifiableList(builder.goal);
+                status = builder.status;
                 statusReason = builder.statusReason;
                 doNotPerform = builder.doNotPerform;
-                scheduled = ValidationSupport.choiceElement(builder.scheduled, "scheduled", Timing.class, Period.class, String.class);
+                scheduled = builder.scheduled;
                 location = builder.location;
-                performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Reference.class));
-                product = ValidationSupport.choiceElement(builder.product, "product", CodeableConcept.class, Reference.class);
+                performer = Collections.unmodifiableList(builder.performer);
+                product = builder.product;
                 dailyAmount = builder.dailyAmount;
                 quantity = builder.quantity;
                 description = builder.description;
-                ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
-                ValidationSupport.checkReferenceType(goal, "goal", "Goal");
-                ValidationSupport.checkReferenceType(location, "location", "Location");
-                ValidationSupport.checkReferenceType(performer, "performer", "Practitioner", "PractitionerRole", "Organization", "RelatedPerson", "Patient", "CareTeam", "HealthcareService", "Device");
-                ValidationSupport.checkReferenceType(product, "product", "Medication", "Substance");
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -3004,7 +3034,30 @@ public Builder description(String description) {
                  */
                 @Override
                 public Detail build() {
-                    return new Detail(this);
+                    Detail detail = new Detail(this);
+                    if (validating) {
+                        validate(detail);
+                    }
+                    return detail;
+                }
+
+                protected void validate(Detail detail) {
+                    super.validate(detail);
+                    ValidationSupport.checkList(detail.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+                    ValidationSupport.checkList(detail.instantiatesUri, "instantiatesUri", Uri.class);
+                    ValidationSupport.checkList(detail.reasonCode, "reasonCode", CodeableConcept.class);
+                    ValidationSupport.checkList(detail.reasonReference, "reasonReference", Reference.class);
+                    ValidationSupport.checkList(detail.goal, "goal", Reference.class);
+                    ValidationSupport.requireNonNull(detail.status, "status");
+                    ValidationSupport.choiceElement(detail.scheduled, "scheduled", Timing.class, Period.class, String.class);
+                    ValidationSupport.checkList(detail.performer, "performer", Reference.class);
+                    ValidationSupport.choiceElement(detail.product, "product", CodeableConcept.class, Reference.class);
+                    ValidationSupport.checkReferenceType(detail.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
+                    ValidationSupport.checkReferenceType(detail.goal, "goal", "Goal");
+                    ValidationSupport.checkReferenceType(detail.location, "location", "Location");
+                    ValidationSupport.checkReferenceType(detail.performer, "performer", "Practitioner", "PractitionerRole", "Organization", "RelatedPerson", "Patient", "CareTeam", "HealthcareService", "Device");
+                    ValidationSupport.checkReferenceType(detail.product, "product", "Medication", "Substance");
+                    ValidationSupport.requireValueOrChildren(detail);
                 }
 
                 protected Builder from(Detail detail) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CareTeam.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CareTeam.java
index 16d339f9a14..9e09c20387c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CareTeam.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CareTeam.java
@@ -103,23 +103,19 @@ public class CareTeam extends DomainResource {
 
     private CareTeam(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         status = builder.status;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        category = Collections.unmodifiableList(builder.category);
         name = builder.name;
         subject = builder.subject;
         encounter = builder.encounter;
         period = builder.period;
-        participant = Collections.unmodifiableList(ValidationSupport.checkList(builder.participant, "participant", Participant.class));
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        managingOrganization = Collections.unmodifiableList(ValidationSupport.checkList(builder.managingOrganization, "managingOrganization", Reference.class));
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition");
-        ValidationSupport.checkReferenceType(managingOrganization, "managingOrganization", "Organization");
+        participant = Collections.unmodifiableList(builder.participant);
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        managingOrganization = Collections.unmodifiableList(builder.managingOrganization);
+        telecom = Collections.unmodifiableList(builder.telecom);
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -981,7 +977,27 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public CareTeam build() {
-            return new CareTeam(this);
+            CareTeam careTeam = new CareTeam(this);
+            if (validating) {
+                validate(careTeam);
+            }
+            return careTeam;
+        }
+
+        protected void validate(CareTeam careTeam) {
+            super.validate(careTeam);
+            ValidationSupport.checkList(careTeam.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(careTeam.category, "category", CodeableConcept.class);
+            ValidationSupport.checkList(careTeam.participant, "participant", Participant.class);
+            ValidationSupport.checkList(careTeam.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(careTeam.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(careTeam.managingOrganization, "managingOrganization", Reference.class);
+            ValidationSupport.checkList(careTeam.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.checkList(careTeam.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(careTeam.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(careTeam.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(careTeam.reasonReference, "reasonReference", "Condition");
+            ValidationSupport.checkReferenceType(careTeam.managingOrganization, "managingOrganization", "Organization");
         }
 
         protected Builder from(CareTeam careTeam) {
@@ -1025,13 +1041,10 @@ public static class Participant extends BackboneElement {
 
         private Participant(Builder builder) {
             super(builder);
-            role = Collections.unmodifiableList(ValidationSupport.checkList(builder.role, "role", CodeableConcept.class));
+            role = Collections.unmodifiableList(builder.role);
             member = builder.member;
             onBehalfOf = builder.onBehalfOf;
             period = builder.period;
-            ValidationSupport.checkReferenceType(member, "member", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Organization", "CareTeam");
-            ValidationSupport.checkReferenceType(onBehalfOf, "onBehalfOf", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1363,7 +1376,19 @@ public Builder period(Period period) {
              */
             @Override
             public Participant build() {
-                return new Participant(this);
+                Participant participant = new Participant(this);
+                if (validating) {
+                    validate(participant);
+                }
+                return participant;
+            }
+
+            protected void validate(Participant participant) {
+                super.validate(participant);
+                ValidationSupport.checkList(participant.role, "role", CodeableConcept.class);
+                ValidationSupport.checkReferenceType(participant.member, "member", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Organization", "CareTeam");
+                ValidationSupport.checkReferenceType(participant.onBehalfOf, "onBehalfOf", "Organization");
+                ValidationSupport.requireValueOrChildren(participant);
             }
 
             protected Builder from(Participant participant) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CatalogEntry.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CatalogEntry.java
index 43310682407..3c72f3a66b3 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CatalogEntry.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CatalogEntry.java
@@ -77,20 +77,19 @@ public class CatalogEntry extends DomainResource {
 
     private CatalogEntry(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         type = builder.type;
-        orderable = ValidationSupport.requireNonNull(builder.orderable, "orderable");
-        referencedItem = ValidationSupport.requireNonNull(builder.referencedItem, "referencedItem");
-        additionalIdentifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.additionalIdentifier, "additionalIdentifier", Identifier.class));
-        classification = Collections.unmodifiableList(ValidationSupport.checkList(builder.classification, "classification", CodeableConcept.class));
+        orderable = builder.orderable;
+        referencedItem = builder.referencedItem;
+        additionalIdentifier = Collections.unmodifiableList(builder.additionalIdentifier);
+        classification = Collections.unmodifiableList(builder.classification);
         status = builder.status;
         validityPeriod = builder.validityPeriod;
         validTo = builder.validTo;
         lastUpdated = builder.lastUpdated;
-        additionalCharacteristic = Collections.unmodifiableList(ValidationSupport.checkList(builder.additionalCharacteristic, "additionalCharacteristic", CodeableConcept.class));
-        additionalClassification = Collections.unmodifiableList(ValidationSupport.checkList(builder.additionalClassification, "additionalClassification", CodeableConcept.class));
-        relatedEntry = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedEntry, "relatedEntry", RelatedEntry.class));
-        ValidationSupport.checkReferenceType(referencedItem, "referencedItem", "Medication", "Device", "Organization", "Practitioner", "PractitionerRole", "HealthcareService", "ActivityDefinition", "PlanDefinition", "SpecimenDefinition", "ObservationDefinition", "Binary");
+        additionalCharacteristic = Collections.unmodifiableList(builder.additionalCharacteristic);
+        additionalClassification = Collections.unmodifiableList(builder.additionalClassification);
+        relatedEntry = Collections.unmodifiableList(builder.relatedEntry);
     }
 
     /**
@@ -904,7 +903,24 @@ public Builder relatedEntry(Collection<RelatedEntry> relatedEntry) {
          */
         @Override
         public CatalogEntry build() {
-            return new CatalogEntry(this);
+            CatalogEntry catalogEntry = new CatalogEntry(this);
+            if (validating) {
+                validate(catalogEntry);
+            }
+            return catalogEntry;
+        }
+
+        protected void validate(CatalogEntry catalogEntry) {
+            super.validate(catalogEntry);
+            ValidationSupport.checkList(catalogEntry.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(catalogEntry.orderable, "orderable");
+            ValidationSupport.requireNonNull(catalogEntry.referencedItem, "referencedItem");
+            ValidationSupport.checkList(catalogEntry.additionalIdentifier, "additionalIdentifier", Identifier.class);
+            ValidationSupport.checkList(catalogEntry.classification, "classification", CodeableConcept.class);
+            ValidationSupport.checkList(catalogEntry.additionalCharacteristic, "additionalCharacteristic", CodeableConcept.class);
+            ValidationSupport.checkList(catalogEntry.additionalClassification, "additionalClassification", CodeableConcept.class);
+            ValidationSupport.checkList(catalogEntry.relatedEntry, "relatedEntry", RelatedEntry.class);
+            ValidationSupport.checkReferenceType(catalogEntry.referencedItem, "referencedItem", "Medication", "Device", "Organization", "Practitioner", "PractitionerRole", "HealthcareService", "ActivityDefinition", "PlanDefinition", "SpecimenDefinition", "ObservationDefinition", "Binary");
         }
 
         protected Builder from(CatalogEntry catalogEntry) {
@@ -944,10 +960,8 @@ public static class RelatedEntry extends BackboneElement {
 
         private RelatedEntry(Builder builder) {
             super(builder);
-            relationtype = ValidationSupport.requireNonNull(builder.relationtype, "relationtype");
-            item = ValidationSupport.requireNonNull(builder.item, "item");
-            ValidationSupport.checkReferenceType(item, "item", "CatalogEntry");
-            ValidationSupport.requireValueOrChildren(this);
+            relationtype = builder.relationtype;
+            item = builder.item;
         }
 
         /**
@@ -1198,7 +1212,19 @@ public Builder item(Reference item) {
              */
             @Override
             public RelatedEntry build() {
-                return new RelatedEntry(this);
+                RelatedEntry relatedEntry = new RelatedEntry(this);
+                if (validating) {
+                    validate(relatedEntry);
+                }
+                return relatedEntry;
+            }
+
+            protected void validate(RelatedEntry relatedEntry) {
+                super.validate(relatedEntry);
+                ValidationSupport.requireNonNull(relatedEntry.relationtype, "relationtype");
+                ValidationSupport.requireNonNull(relatedEntry.item, "item");
+                ValidationSupport.checkReferenceType(relatedEntry.item, "item", "CatalogEntry");
+                ValidationSupport.requireValueOrChildren(relatedEntry);
             }
 
             protected Builder from(RelatedEntry relatedEntry) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ChargeItem.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ChargeItem.java
index 618e9ec5f64..53940e45f23 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ChargeItem.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ChargeItem.java
@@ -144,42 +144,32 @@ public class ChargeItem extends DomainResource {
 
     private ChargeItem(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        definitionUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.definitionUri, "definitionUri", Uri.class));
-        definitionCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.definitionCanonical, "definitionCanonical", Canonical.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        code = ValidationSupport.requireNonNull(builder.code, "code");
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        definitionUri = Collections.unmodifiableList(builder.definitionUri);
+        definitionCanonical = Collections.unmodifiableList(builder.definitionCanonical);
+        status = builder.status;
+        partOf = Collections.unmodifiableList(builder.partOf);
+        code = builder.code;
+        subject = builder.subject;
         context = builder.context;
-        occurrence = ValidationSupport.choiceElement(builder.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
-        performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Performer.class));
+        occurrence = builder.occurrence;
+        performer = Collections.unmodifiableList(builder.performer);
         performingOrganization = builder.performingOrganization;
         requestingOrganization = builder.requestingOrganization;
         costCenter = builder.costCenter;
         quantity = builder.quantity;
-        bodysite = Collections.unmodifiableList(ValidationSupport.checkList(builder.bodysite, "bodysite", CodeableConcept.class));
+        bodysite = Collections.unmodifiableList(builder.bodysite);
         factorOverride = builder.factorOverride;
         priceOverride = builder.priceOverride;
         overrideReason = builder.overrideReason;
         enterer = builder.enterer;
         enteredDate = builder.enteredDate;
-        reason = Collections.unmodifiableList(ValidationSupport.checkList(builder.reason, "reason", CodeableConcept.class));
-        service = Collections.unmodifiableList(ValidationSupport.checkList(builder.service, "service", Reference.class));
-        product = ValidationSupport.choiceElement(builder.product, "product", Reference.class, CodeableConcept.class);
-        account = Collections.unmodifiableList(ValidationSupport.checkList(builder.account, "account", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        supportingInformation = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInformation, "supportingInformation", Reference.class));
-        ValidationSupport.checkReferenceType(partOf, "partOf", "ChargeItem");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(context, "context", "Encounter", "EpisodeOfCare");
-        ValidationSupport.checkReferenceType(performingOrganization, "performingOrganization", "Organization");
-        ValidationSupport.checkReferenceType(requestingOrganization, "requestingOrganization", "Organization");
-        ValidationSupport.checkReferenceType(costCenter, "costCenter", "Organization");
-        ValidationSupport.checkReferenceType(enterer, "enterer", "Practitioner", "PractitionerRole", "Organization", "Patient", "Device", "RelatedPerson");
-        ValidationSupport.checkReferenceType(service, "service", "DiagnosticReport", "ImagingStudy", "Immunization", "MedicationAdministration", "MedicationDispense", "Observation", "Procedure", "SupplyDelivery");
-        ValidationSupport.checkReferenceType(product, "product", "Device", "Medication", "Substance");
-        ValidationSupport.checkReferenceType(account, "account", "Account");
+        reason = Collections.unmodifiableList(builder.reason);
+        service = Collections.unmodifiableList(builder.service);
+        product = builder.product;
+        account = Collections.unmodifiableList(builder.account);
+        note = Collections.unmodifiableList(builder.note);
+        supportingInformation = Collections.unmodifiableList(builder.supportingInformation);
     }
 
     /**
@@ -1557,7 +1547,41 @@ public Builder supportingInformation(Collection<Reference> supportingInformation
          */
         @Override
         public ChargeItem build() {
-            return new ChargeItem(this);
+            ChargeItem chargeItem = new ChargeItem(this);
+            if (validating) {
+                validate(chargeItem);
+            }
+            return chargeItem;
+        }
+
+        protected void validate(ChargeItem chargeItem) {
+            super.validate(chargeItem);
+            ValidationSupport.checkList(chargeItem.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(chargeItem.definitionUri, "definitionUri", Uri.class);
+            ValidationSupport.checkList(chargeItem.definitionCanonical, "definitionCanonical", Canonical.class);
+            ValidationSupport.requireNonNull(chargeItem.status, "status");
+            ValidationSupport.checkList(chargeItem.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(chargeItem.code, "code");
+            ValidationSupport.requireNonNull(chargeItem.subject, "subject");
+            ValidationSupport.choiceElement(chargeItem.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
+            ValidationSupport.checkList(chargeItem.performer, "performer", Performer.class);
+            ValidationSupport.checkList(chargeItem.bodysite, "bodysite", CodeableConcept.class);
+            ValidationSupport.checkList(chargeItem.reason, "reason", CodeableConcept.class);
+            ValidationSupport.checkList(chargeItem.service, "service", Reference.class);
+            ValidationSupport.choiceElement(chargeItem.product, "product", Reference.class, CodeableConcept.class);
+            ValidationSupport.checkList(chargeItem.account, "account", Reference.class);
+            ValidationSupport.checkList(chargeItem.note, "note", Annotation.class);
+            ValidationSupport.checkList(chargeItem.supportingInformation, "supportingInformation", Reference.class);
+            ValidationSupport.checkReferenceType(chargeItem.partOf, "partOf", "ChargeItem");
+            ValidationSupport.checkReferenceType(chargeItem.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(chargeItem.context, "context", "Encounter", "EpisodeOfCare");
+            ValidationSupport.checkReferenceType(chargeItem.performingOrganization, "performingOrganization", "Organization");
+            ValidationSupport.checkReferenceType(chargeItem.requestingOrganization, "requestingOrganization", "Organization");
+            ValidationSupport.checkReferenceType(chargeItem.costCenter, "costCenter", "Organization");
+            ValidationSupport.checkReferenceType(chargeItem.enterer, "enterer", "Practitioner", "PractitionerRole", "Organization", "Patient", "Device", "RelatedPerson");
+            ValidationSupport.checkReferenceType(chargeItem.service, "service", "DiagnosticReport", "ImagingStudy", "Immunization", "MedicationAdministration", "MedicationDispense", "Observation", "Procedure", "SupplyDelivery");
+            ValidationSupport.checkReferenceType(chargeItem.product, "product", "Device", "Medication", "Substance");
+            ValidationSupport.checkReferenceType(chargeItem.account, "account", "Account");
         }
 
         protected Builder from(ChargeItem chargeItem) {
@@ -1610,9 +1634,7 @@ public static class Performer extends BackboneElement {
         private Performer(Builder builder) {
             super(builder);
             function = builder.function;
-            actor = ValidationSupport.requireNonNull(builder.actor, "actor");
-            ValidationSupport.checkReferenceType(actor, "actor", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "Patient", "Device", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
+            actor = builder.actor;
         }
 
         /**
@@ -1866,7 +1888,18 @@ public Builder actor(Reference actor) {
              */
             @Override
             public Performer build() {
-                return new Performer(this);
+                Performer performer = new Performer(this);
+                if (validating) {
+                    validate(performer);
+                }
+                return performer;
+            }
+
+            protected void validate(Performer performer) {
+                super.validate(performer);
+                ValidationSupport.requireNonNull(performer.actor, "actor");
+                ValidationSupport.checkReferenceType(performer.actor, "actor", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "Patient", "Device", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(performer);
             }
 
             protected Builder from(Performer performer) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ChargeItemDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ChargeItemDefinition.java
index f0479c32281..41fb3765af9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ChargeItemDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ChargeItemDefinition.java
@@ -139,30 +139,29 @@ public class ChargeItemDefinition extends DomainResource {
 
     private ChargeItemDefinition(Builder builder) {
         super(builder);
-        url = ValidationSupport.requireNonNull(builder.url, "url");
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        url = builder.url;
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         title = builder.title;
-        derivedFromUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.derivedFromUri, "derivedFromUri", Uri.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Canonical.class));
-        replaces = Collections.unmodifiableList(ValidationSupport.checkList(builder.replaces, "replaces", Canonical.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        derivedFromUri = Collections.unmodifiableList(builder.derivedFromUri);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        replaces = Collections.unmodifiableList(builder.replaces);
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
         code = builder.code;
-        instance = Collections.unmodifiableList(ValidationSupport.checkList(builder.instance, "instance", Reference.class));
-        applicability = Collections.unmodifiableList(ValidationSupport.checkList(builder.applicability, "applicability", Applicability.class));
-        propertyGroup = Collections.unmodifiableList(ValidationSupport.checkList(builder.propertyGroup, "propertyGroup", PropertyGroup.class));
-        ValidationSupport.checkReferenceType(instance, "instance", "Medication", "Substance", "Device");
+        instance = Collections.unmodifiableList(builder.instance);
+        applicability = Collections.unmodifiableList(builder.applicability);
+        propertyGroup = Collections.unmodifiableList(builder.propertyGroup);
     }
 
     /**
@@ -1391,7 +1390,28 @@ public Builder propertyGroup(Collection<PropertyGroup> propertyGroup) {
          */
         @Override
         public ChargeItemDefinition build() {
-            return new ChargeItemDefinition(this);
+            ChargeItemDefinition chargeItemDefinition = new ChargeItemDefinition(this);
+            if (validating) {
+                validate(chargeItemDefinition);
+            }
+            return chargeItemDefinition;
+        }
+
+        protected void validate(ChargeItemDefinition chargeItemDefinition) {
+            super.validate(chargeItemDefinition);
+            ValidationSupport.requireNonNull(chargeItemDefinition.url, "url");
+            ValidationSupport.checkList(chargeItemDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(chargeItemDefinition.derivedFromUri, "derivedFromUri", Uri.class);
+            ValidationSupport.checkList(chargeItemDefinition.partOf, "partOf", Canonical.class);
+            ValidationSupport.checkList(chargeItemDefinition.replaces, "replaces", Canonical.class);
+            ValidationSupport.requireNonNull(chargeItemDefinition.status, "status");
+            ValidationSupport.checkList(chargeItemDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(chargeItemDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(chargeItemDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(chargeItemDefinition.instance, "instance", Reference.class);
+            ValidationSupport.checkList(chargeItemDefinition.applicability, "applicability", Applicability.class);
+            ValidationSupport.checkList(chargeItemDefinition.propertyGroup, "propertyGroup", PropertyGroup.class);
+            ValidationSupport.checkReferenceType(chargeItemDefinition.instance, "instance", "Medication", "Substance", "Device");
         }
 
         protected Builder from(ChargeItemDefinition chargeItemDefinition) {
@@ -1436,7 +1456,6 @@ private Applicability(Builder builder) {
             description = builder.description;
             language = builder.language;
             expression = builder.expression;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1707,7 +1726,16 @@ public Builder expression(String expression) {
              */
             @Override
             public Applicability build() {
-                return new Applicability(this);
+                Applicability applicability = new Applicability(this);
+                if (validating) {
+                    validate(applicability);
+                }
+                return applicability;
+            }
+
+            protected void validate(Applicability applicability) {
+                super.validate(applicability);
+                ValidationSupport.requireValueOrChildren(applicability);
             }
 
             protected Builder from(Applicability applicability) {
@@ -1730,9 +1758,8 @@ public static class PropertyGroup extends BackboneElement {
 
         private PropertyGroup(Builder builder) {
             super(builder);
-            applicability = Collections.unmodifiableList(ValidationSupport.checkList(builder.applicability, "applicability", ChargeItemDefinition.Applicability.class));
-            priceComponent = Collections.unmodifiableList(ValidationSupport.checkList(builder.priceComponent, "priceComponent", PriceComponent.class));
-            ValidationSupport.requireValueOrChildren(this);
+            applicability = Collections.unmodifiableList(builder.applicability);
+            priceComponent = Collections.unmodifiableList(builder.priceComponent);
         }
 
         /**
@@ -2017,7 +2044,18 @@ public Builder priceComponent(Collection<PriceComponent> priceComponent) {
              */
             @Override
             public PropertyGroup build() {
-                return new PropertyGroup(this);
+                PropertyGroup propertyGroup = new PropertyGroup(this);
+                if (validating) {
+                    validate(propertyGroup);
+                }
+                return propertyGroup;
+            }
+
+            protected void validate(PropertyGroup propertyGroup) {
+                super.validate(propertyGroup);
+                ValidationSupport.checkList(propertyGroup.applicability, "applicability", ChargeItemDefinition.Applicability.class);
+                ValidationSupport.checkList(propertyGroup.priceComponent, "priceComponent", PriceComponent.class);
+                ValidationSupport.requireValueOrChildren(propertyGroup);
             }
 
             protected Builder from(PropertyGroup propertyGroup) {
@@ -2049,11 +2087,10 @@ public static class PriceComponent extends BackboneElement {
 
             private PriceComponent(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
+                type = builder.type;
                 code = builder.code;
                 factor = builder.factor;
                 amount = builder.amount;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2356,7 +2393,17 @@ public Builder amount(Money amount) {
                  */
                 @Override
                 public PriceComponent build() {
-                    return new PriceComponent(this);
+                    PriceComponent priceComponent = new PriceComponent(this);
+                    if (validating) {
+                        validate(priceComponent);
+                    }
+                    return priceComponent;
+                }
+
+                protected void validate(PriceComponent priceComponent) {
+                    super.validate(priceComponent);
+                    ValidationSupport.requireNonNull(priceComponent.type, "type");
+                    ValidationSupport.requireValueOrChildren(priceComponent);
                 }
 
                 protected Builder from(PriceComponent priceComponent) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Claim.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Claim.java
index 5b3fa4709fe..6f0b14cbca1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Claim.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Claim.java
@@ -170,41 +170,33 @@ public class Claim extends DomainResource {
 
     private Claim(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        type = builder.type;
         subType = builder.subType;
-        use = ValidationSupport.requireNonNull(builder.use, "use");
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
+        use = builder.use;
+        patient = builder.patient;
         billablePeriod = builder.billablePeriod;
-        created = ValidationSupport.requireNonNull(builder.created, "created");
+        created = builder.created;
         enterer = builder.enterer;
         insurer = builder.insurer;
-        provider = ValidationSupport.requireNonNull(builder.provider, "provider");
-        priority = ValidationSupport.requireNonNull(builder.priority, "priority");
+        provider = builder.provider;
+        priority = builder.priority;
         fundsReserve = builder.fundsReserve;
-        related = Collections.unmodifiableList(ValidationSupport.checkList(builder.related, "related", Related.class));
+        related = Collections.unmodifiableList(builder.related);
         prescription = builder.prescription;
         originalPrescription = builder.originalPrescription;
         payee = builder.payee;
         referral = builder.referral;
         facility = builder.facility;
-        careTeam = Collections.unmodifiableList(ValidationSupport.checkList(builder.careTeam, "careTeam", CareTeam.class));
-        supportingInfo = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInfo, "supportingInfo", SupportingInfo.class));
-        diagnosis = Collections.unmodifiableList(ValidationSupport.checkList(builder.diagnosis, "diagnosis", Diagnosis.class));
-        procedure = Collections.unmodifiableList(ValidationSupport.checkList(builder.procedure, "procedure", Procedure.class));
-        insurance = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.insurance, "insurance", Insurance.class));
+        careTeam = Collections.unmodifiableList(builder.careTeam);
+        supportingInfo = Collections.unmodifiableList(builder.supportingInfo);
+        diagnosis = Collections.unmodifiableList(builder.diagnosis);
+        procedure = Collections.unmodifiableList(builder.procedure);
+        insurance = Collections.unmodifiableList(builder.insurance);
         accident = builder.accident;
-        item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", Item.class));
+        item = Collections.unmodifiableList(builder.item);
         total = builder.total;
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(enterer, "enterer", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(insurer, "insurer", "Organization");
-        ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(prescription, "prescription", "DeviceRequest", "MedicationRequest", "VisionPrescription");
-        ValidationSupport.checkReferenceType(originalPrescription, "originalPrescription", "DeviceRequest", "MedicationRequest", "VisionPrescription");
-        ValidationSupport.checkReferenceType(referral, "referral", "ServiceRequest");
-        ValidationSupport.checkReferenceType(facility, "facility", "Location");
     }
 
     /**
@@ -1531,7 +1523,38 @@ public Builder total(Money total) {
          */
         @Override
         public Claim build() {
-            return new Claim(this);
+            Claim claim = new Claim(this);
+            if (validating) {
+                validate(claim);
+            }
+            return claim;
+        }
+
+        protected void validate(Claim claim) {
+            super.validate(claim);
+            ValidationSupport.checkList(claim.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(claim.status, "status");
+            ValidationSupport.requireNonNull(claim.type, "type");
+            ValidationSupport.requireNonNull(claim.use, "use");
+            ValidationSupport.requireNonNull(claim.patient, "patient");
+            ValidationSupport.requireNonNull(claim.created, "created");
+            ValidationSupport.requireNonNull(claim.provider, "provider");
+            ValidationSupport.requireNonNull(claim.priority, "priority");
+            ValidationSupport.checkList(claim.related, "related", Related.class);
+            ValidationSupport.checkList(claim.careTeam, "careTeam", CareTeam.class);
+            ValidationSupport.checkList(claim.supportingInfo, "supportingInfo", SupportingInfo.class);
+            ValidationSupport.checkList(claim.diagnosis, "diagnosis", Diagnosis.class);
+            ValidationSupport.checkList(claim.procedure, "procedure", Procedure.class);
+            ValidationSupport.checkNonEmptyList(claim.insurance, "insurance", Insurance.class);
+            ValidationSupport.checkList(claim.item, "item", Item.class);
+            ValidationSupport.checkReferenceType(claim.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(claim.enterer, "enterer", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(claim.insurer, "insurer", "Organization");
+            ValidationSupport.checkReferenceType(claim.provider, "provider", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(claim.prescription, "prescription", "DeviceRequest", "MedicationRequest", "VisionPrescription");
+            ValidationSupport.checkReferenceType(claim.originalPrescription, "originalPrescription", "DeviceRequest", "MedicationRequest", "VisionPrescription");
+            ValidationSupport.checkReferenceType(claim.referral, "referral", "ServiceRequest");
+            ValidationSupport.checkReferenceType(claim.facility, "facility", "Location");
         }
 
         protected Builder from(Claim claim) {
@@ -1588,8 +1611,6 @@ private Related(Builder builder) {
             claim = builder.claim;
             relationship = builder.relationship;
             reference = builder.reference;
-            ValidationSupport.checkReferenceType(claim, "claim", "Claim");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1859,7 +1880,17 @@ public Builder reference(Identifier reference) {
              */
             @Override
             public Related build() {
-                return new Related(this);
+                Related related = new Related(this);
+                if (validating) {
+                    validate(related);
+                }
+                return related;
+            }
+
+            protected void validate(Related related) {
+                super.validate(related);
+                ValidationSupport.checkReferenceType(related.claim, "claim", "Claim");
+                ValidationSupport.requireValueOrChildren(related);
             }
 
             protected Builder from(Related related) {
@@ -1889,10 +1920,8 @@ public static class Payee extends BackboneElement {
 
         private Payee(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            type = builder.type;
             party = builder.party;
-            ValidationSupport.checkReferenceType(party, "party", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2144,7 +2173,18 @@ public Builder party(Reference party) {
              */
             @Override
             public Payee build() {
-                return new Payee(this);
+                Payee payee = new Payee(this);
+                if (validating) {
+                    validate(payee);
+                }
+                return payee;
+            }
+
+            protected void validate(Payee payee) {
+                super.validate(payee);
+                ValidationSupport.requireNonNull(payee.type, "type");
+                ValidationSupport.checkReferenceType(payee.party, "party", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(payee);
             }
 
             protected Builder from(Payee payee) {
@@ -2183,13 +2223,11 @@ public static class CareTeam extends BackboneElement {
 
         private CareTeam(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            provider = ValidationSupport.requireNonNull(builder.provider, "provider");
+            sequence = builder.sequence;
+            provider = builder.provider;
             responsible = builder.responsible;
             role = builder.role;
             qualification = builder.qualification;
-            ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2529,7 +2567,19 @@ public Builder qualification(CodeableConcept qualification) {
              */
             @Override
             public CareTeam build() {
-                return new CareTeam(this);
+                CareTeam careTeam = new CareTeam(this);
+                if (validating) {
+                    validate(careTeam);
+                }
+                return careTeam;
+            }
+
+            protected void validate(CareTeam careTeam) {
+                super.validate(careTeam);
+                ValidationSupport.requireNonNull(careTeam.sequence, "sequence");
+                ValidationSupport.requireNonNull(careTeam.provider, "provider");
+                ValidationSupport.checkReferenceType(careTeam.provider, "provider", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.requireValueOrChildren(careTeam);
             }
 
             protected Builder from(CareTeam careTeam) {
@@ -2580,13 +2630,12 @@ public static class SupportingInfo extends BackboneElement {
 
         private SupportingInfo(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            category = ValidationSupport.requireNonNull(builder.category, "category");
+            sequence = builder.sequence;
+            category = builder.category;
             code = builder.code;
-            timing = ValidationSupport.choiceElement(builder.timing, "timing", Date.class, Period.class);
-            value = ValidationSupport.choiceElement(builder.value, "value", Boolean.class, String.class, Quantity.class, Attachment.class, Reference.class);
+            timing = builder.timing;
+            value = builder.value;
             reason = builder.reason;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2967,7 +3016,20 @@ public Builder reason(CodeableConcept reason) {
              */
             @Override
             public SupportingInfo build() {
-                return new SupportingInfo(this);
+                SupportingInfo supportingInfo = new SupportingInfo(this);
+                if (validating) {
+                    validate(supportingInfo);
+                }
+                return supportingInfo;
+            }
+
+            protected void validate(SupportingInfo supportingInfo) {
+                super.validate(supportingInfo);
+                ValidationSupport.requireNonNull(supportingInfo.sequence, "sequence");
+                ValidationSupport.requireNonNull(supportingInfo.category, "category");
+                ValidationSupport.choiceElement(supportingInfo.timing, "timing", Date.class, Period.class);
+                ValidationSupport.choiceElement(supportingInfo.value, "value", Boolean.class, String.class, Quantity.class, Attachment.class, Reference.class);
+                ValidationSupport.requireValueOrChildren(supportingInfo);
             }
 
             protected Builder from(SupportingInfo supportingInfo) {
@@ -3023,13 +3085,11 @@ public static class Diagnosis extends BackboneElement {
 
         private Diagnosis(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            diagnosis = ValidationSupport.requireChoiceElement(builder.diagnosis, "diagnosis", CodeableConcept.class, Reference.class);
-            type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+            sequence = builder.sequence;
+            diagnosis = builder.diagnosis;
+            type = Collections.unmodifiableList(builder.type);
             onAdmission = builder.onAdmission;
             packageCode = builder.packageCode;
-            ValidationSupport.checkReferenceType(diagnosis, "diagnosis", "Condition");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3395,7 +3455,20 @@ public Builder packageCode(CodeableConcept packageCode) {
              */
             @Override
             public Diagnosis build() {
-                return new Diagnosis(this);
+                Diagnosis diagnosis = new Diagnosis(this);
+                if (validating) {
+                    validate(diagnosis);
+                }
+                return diagnosis;
+            }
+
+            protected void validate(Diagnosis diagnosis) {
+                super.validate(diagnosis);
+                ValidationSupport.requireNonNull(diagnosis.sequence, "sequence");
+                ValidationSupport.requireChoiceElement(diagnosis.diagnosis, "diagnosis", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkList(diagnosis.type, "type", CodeableConcept.class);
+                ValidationSupport.checkReferenceType(diagnosis.diagnosis, "diagnosis", "Condition");
+                ValidationSupport.requireValueOrChildren(diagnosis);
             }
 
             protected Builder from(Diagnosis diagnosis) {
@@ -3439,14 +3512,11 @@ public static class Procedure extends BackboneElement {
 
         private Procedure(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+            sequence = builder.sequence;
+            type = Collections.unmodifiableList(builder.type);
             date = builder.date;
-            procedure = ValidationSupport.requireChoiceElement(builder.procedure, "procedure", CodeableConcept.class, Reference.class);
-            udi = Collections.unmodifiableList(ValidationSupport.checkList(builder.udi, "udi", Reference.class));
-            ValidationSupport.checkReferenceType(procedure, "procedure", "Procedure");
-            ValidationSupport.checkReferenceType(udi, "udi", "Device");
-            ValidationSupport.requireValueOrChildren(this);
+            procedure = builder.procedure;
+            udi = Collections.unmodifiableList(builder.udi);
         }
 
         /**
@@ -3840,7 +3910,22 @@ public Builder udi(Collection<Reference> udi) {
              */
             @Override
             public Procedure build() {
-                return new Procedure(this);
+                Procedure procedure = new Procedure(this);
+                if (validating) {
+                    validate(procedure);
+                }
+                return procedure;
+            }
+
+            protected void validate(Procedure procedure) {
+                super.validate(procedure);
+                ValidationSupport.requireNonNull(procedure.sequence, "sequence");
+                ValidationSupport.checkList(procedure.type, "type", CodeableConcept.class);
+                ValidationSupport.requireChoiceElement(procedure.procedure, "procedure", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkList(procedure.udi, "udi", Reference.class);
+                ValidationSupport.checkReferenceType(procedure.procedure, "procedure", "Procedure");
+                ValidationSupport.checkReferenceType(procedure.udi, "udi", "Device");
+                ValidationSupport.requireValueOrChildren(procedure);
             }
 
             protected Builder from(Procedure procedure) {
@@ -3877,16 +3962,13 @@ public static class Insurance extends BackboneElement {
 
         private Insurance(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            focal = ValidationSupport.requireNonNull(builder.focal, "focal");
+            sequence = builder.sequence;
+            focal = builder.focal;
             identifier = builder.identifier;
-            coverage = ValidationSupport.requireNonNull(builder.coverage, "coverage");
+            coverage = builder.coverage;
             businessArrangement = builder.businessArrangement;
-            preAuthRef = Collections.unmodifiableList(ValidationSupport.checkList(builder.preAuthRef, "preAuthRef", String.class));
+            preAuthRef = Collections.unmodifiableList(builder.preAuthRef);
             claimResponse = builder.claimResponse;
-            ValidationSupport.checkReferenceType(coverage, "coverage", "Coverage");
-            ValidationSupport.checkReferenceType(claimResponse, "claimResponse", "ClaimResponse");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -4317,7 +4399,22 @@ public Builder claimResponse(Reference claimResponse) {
              */
             @Override
             public Insurance build() {
-                return new Insurance(this);
+                Insurance insurance = new Insurance(this);
+                if (validating) {
+                    validate(insurance);
+                }
+                return insurance;
+            }
+
+            protected void validate(Insurance insurance) {
+                super.validate(insurance);
+                ValidationSupport.requireNonNull(insurance.sequence, "sequence");
+                ValidationSupport.requireNonNull(insurance.focal, "focal");
+                ValidationSupport.requireNonNull(insurance.coverage, "coverage");
+                ValidationSupport.checkList(insurance.preAuthRef, "preAuthRef", String.class);
+                ValidationSupport.checkReferenceType(insurance.coverage, "coverage", "Coverage");
+                ValidationSupport.checkReferenceType(insurance.claimResponse, "claimResponse", "ClaimResponse");
+                ValidationSupport.requireValueOrChildren(insurance);
             }
 
             protected Builder from(Insurance insurance) {
@@ -4353,11 +4450,9 @@ public static class Accident extends BackboneElement {
 
         private Accident(Builder builder) {
             super(builder);
-            date = ValidationSupport.requireNonNull(builder.date, "date");
+            date = builder.date;
             type = builder.type;
-            location = ValidationSupport.choiceElement(builder.location, "location", Address.class, Reference.class);
-            ValidationSupport.checkReferenceType(location, "location", "Location");
-            ValidationSupport.requireValueOrChildren(this);
+            location = builder.location;
         }
 
         /**
@@ -4642,7 +4737,19 @@ public Builder location(Element location) {
              */
             @Override
             public Accident build() {
-                return new Accident(this);
+                Accident accident = new Accident(this);
+                if (validating) {
+                    validate(accident);
+                }
+                return accident;
+            }
+
+            protected void validate(Accident accident) {
+                super.validate(accident);
+                ValidationSupport.requireNonNull(accident.date, "date");
+                ValidationSupport.choiceElement(accident.location, "location", Address.class, Reference.class);
+                ValidationSupport.checkReferenceType(accident.location, "location", "Location");
+                ValidationSupport.requireValueOrChildren(accident);
             }
 
             protected Builder from(Accident accident) {
@@ -4739,31 +4846,27 @@ public static class Item extends BackboneElement {
 
         private Item(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            careTeamSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.careTeamSequence, "careTeamSequence", PositiveInt.class));
-            diagnosisSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.diagnosisSequence, "diagnosisSequence", PositiveInt.class));
-            procedureSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.procedureSequence, "procedureSequence", PositiveInt.class));
-            informationSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.informationSequence, "informationSequence", PositiveInt.class));
+            sequence = builder.sequence;
+            careTeamSequence = Collections.unmodifiableList(builder.careTeamSequence);
+            diagnosisSequence = Collections.unmodifiableList(builder.diagnosisSequence);
+            procedureSequence = Collections.unmodifiableList(builder.procedureSequence);
+            informationSequence = Collections.unmodifiableList(builder.informationSequence);
             revenue = builder.revenue;
             category = builder.category;
-            productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-            modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
-            programCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.programCode, "programCode", CodeableConcept.class));
-            serviced = ValidationSupport.choiceElement(builder.serviced, "serviced", Date.class, Period.class);
-            location = ValidationSupport.choiceElement(builder.location, "location", CodeableConcept.class, Address.class, Reference.class);
+            productOrService = builder.productOrService;
+            modifier = Collections.unmodifiableList(builder.modifier);
+            programCode = Collections.unmodifiableList(builder.programCode);
+            serviced = builder.serviced;
+            location = builder.location;
             quantity = builder.quantity;
             unitPrice = builder.unitPrice;
             factor = builder.factor;
             net = builder.net;
-            udi = Collections.unmodifiableList(ValidationSupport.checkList(builder.udi, "udi", Reference.class));
+            udi = Collections.unmodifiableList(builder.udi);
             bodySite = builder.bodySite;
-            subSite = Collections.unmodifiableList(ValidationSupport.checkList(builder.subSite, "subSite", CodeableConcept.class));
-            encounter = Collections.unmodifiableList(ValidationSupport.checkList(builder.encounter, "encounter", Reference.class));
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Detail.class));
-            ValidationSupport.checkReferenceType(location, "location", "Location");
-            ValidationSupport.checkReferenceType(udi, "udi", "Device");
-            ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-            ValidationSupport.requireValueOrChildren(this);
+            subSite = Collections.unmodifiableList(builder.subSite);
+            encounter = Collections.unmodifiableList(builder.encounter);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -5804,7 +5907,33 @@ public Builder detail(Collection<Detail> detail) {
              */
             @Override
             public Item build() {
-                return new Item(this);
+                Item item = new Item(this);
+                if (validating) {
+                    validate(item);
+                }
+                return item;
+            }
+
+            protected void validate(Item item) {
+                super.validate(item);
+                ValidationSupport.requireNonNull(item.sequence, "sequence");
+                ValidationSupport.checkList(item.careTeamSequence, "careTeamSequence", PositiveInt.class);
+                ValidationSupport.checkList(item.diagnosisSequence, "diagnosisSequence", PositiveInt.class);
+                ValidationSupport.checkList(item.procedureSequence, "procedureSequence", PositiveInt.class);
+                ValidationSupport.checkList(item.informationSequence, "informationSequence", PositiveInt.class);
+                ValidationSupport.requireNonNull(item.productOrService, "productOrService");
+                ValidationSupport.checkList(item.modifier, "modifier", CodeableConcept.class);
+                ValidationSupport.checkList(item.programCode, "programCode", CodeableConcept.class);
+                ValidationSupport.choiceElement(item.serviced, "serviced", Date.class, Period.class);
+                ValidationSupport.choiceElement(item.location, "location", CodeableConcept.class, Address.class, Reference.class);
+                ValidationSupport.checkList(item.udi, "udi", Reference.class);
+                ValidationSupport.checkList(item.subSite, "subSite", CodeableConcept.class);
+                ValidationSupport.checkList(item.encounter, "encounter", Reference.class);
+                ValidationSupport.checkList(item.detail, "detail", Detail.class);
+                ValidationSupport.checkReferenceType(item.location, "location", "Location");
+                ValidationSupport.checkReferenceType(item.udi, "udi", "Device");
+                ValidationSupport.checkReferenceType(item.encounter, "encounter", "Encounter");
+                ValidationSupport.requireValueOrChildren(item);
             }
 
             protected Builder from(Item item) {
@@ -5886,20 +6015,18 @@ public static class Detail extends BackboneElement {
 
             private Detail(Builder builder) {
                 super(builder);
-                sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
+                sequence = builder.sequence;
                 revenue = builder.revenue;
                 category = builder.category;
-                productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-                modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
-                programCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.programCode, "programCode", CodeableConcept.class));
+                productOrService = builder.productOrService;
+                modifier = Collections.unmodifiableList(builder.modifier);
+                programCode = Collections.unmodifiableList(builder.programCode);
                 quantity = builder.quantity;
                 unitPrice = builder.unitPrice;
                 factor = builder.factor;
                 net = builder.net;
-                udi = Collections.unmodifiableList(ValidationSupport.checkList(builder.udi, "udi", Reference.class));
-                subDetail = Collections.unmodifiableList(ValidationSupport.checkList(builder.subDetail, "subDetail", SubDetail.class));
-                ValidationSupport.checkReferenceType(udi, "udi", "Device");
-                ValidationSupport.requireValueOrChildren(this);
+                udi = Collections.unmodifiableList(builder.udi);
+                subDetail = Collections.unmodifiableList(builder.subDetail);
             }
 
             /**
@@ -6531,7 +6658,23 @@ public Builder subDetail(Collection<SubDetail> subDetail) {
                  */
                 @Override
                 public Detail build() {
-                    return new Detail(this);
+                    Detail detail = new Detail(this);
+                    if (validating) {
+                        validate(detail);
+                    }
+                    return detail;
+                }
+
+                protected void validate(Detail detail) {
+                    super.validate(detail);
+                    ValidationSupport.requireNonNull(detail.sequence, "sequence");
+                    ValidationSupport.requireNonNull(detail.productOrService, "productOrService");
+                    ValidationSupport.checkList(detail.modifier, "modifier", CodeableConcept.class);
+                    ValidationSupport.checkList(detail.programCode, "programCode", CodeableConcept.class);
+                    ValidationSupport.checkList(detail.udi, "udi", Reference.class);
+                    ValidationSupport.checkList(detail.subDetail, "subDetail", SubDetail.class);
+                    ValidationSupport.checkReferenceType(detail.udi, "udi", "Device");
+                    ValidationSupport.requireValueOrChildren(detail);
                 }
 
                 protected Builder from(Detail detail) {
@@ -6603,19 +6746,17 @@ public static class SubDetail extends BackboneElement {
 
                 private SubDetail(Builder builder) {
                     super(builder);
-                    sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
+                    sequence = builder.sequence;
                     revenue = builder.revenue;
                     category = builder.category;
-                    productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-                    modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
-                    programCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.programCode, "programCode", CodeableConcept.class));
+                    productOrService = builder.productOrService;
+                    modifier = Collections.unmodifiableList(builder.modifier);
+                    programCode = Collections.unmodifiableList(builder.programCode);
                     quantity = builder.quantity;
                     unitPrice = builder.unitPrice;
                     factor = builder.factor;
                     net = builder.net;
-                    udi = Collections.unmodifiableList(ValidationSupport.checkList(builder.udi, "udi", Reference.class));
-                    ValidationSupport.checkReferenceType(udi, "udi", "Device");
-                    ValidationSupport.requireValueOrChildren(this);
+                    udi = Collections.unmodifiableList(builder.udi);
                 }
 
                 /**
@@ -7198,7 +7339,22 @@ public Builder udi(Collection<Reference> udi) {
                      */
                     @Override
                     public SubDetail build() {
-                        return new SubDetail(this);
+                        SubDetail subDetail = new SubDetail(this);
+                        if (validating) {
+                            validate(subDetail);
+                        }
+                        return subDetail;
+                    }
+
+                    protected void validate(SubDetail subDetail) {
+                        super.validate(subDetail);
+                        ValidationSupport.requireNonNull(subDetail.sequence, "sequence");
+                        ValidationSupport.requireNonNull(subDetail.productOrService, "productOrService");
+                        ValidationSupport.checkList(subDetail.modifier, "modifier", CodeableConcept.class);
+                        ValidationSupport.checkList(subDetail.programCode, "programCode", CodeableConcept.class);
+                        ValidationSupport.checkList(subDetail.udi, "udi", Reference.class);
+                        ValidationSupport.checkReferenceType(subDetail.udi, "udi", "Device");
+                        ValidationSupport.requireValueOrChildren(subDetail);
                     }
 
                     protected Builder from(SubDetail subDetail) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ClaimResponse.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ClaimResponse.java
index 024b942fa3b..1a67bf84132 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ClaimResponse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ClaimResponse.java
@@ -177,38 +177,33 @@ public class ClaimResponse extends DomainResource {
 
     private ClaimResponse(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        type = builder.type;
         subType = builder.subType;
-        use = ValidationSupport.requireNonNull(builder.use, "use");
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
-        created = ValidationSupport.requireNonNull(builder.created, "created");
-        insurer = ValidationSupport.requireNonNull(builder.insurer, "insurer");
+        use = builder.use;
+        patient = builder.patient;
+        created = builder.created;
+        insurer = builder.insurer;
         requestor = builder.requestor;
         request = builder.request;
-        outcome = ValidationSupport.requireNonNull(builder.outcome, "outcome");
+        outcome = builder.outcome;
         disposition = builder.disposition;
         preAuthRef = builder.preAuthRef;
         preAuthPeriod = builder.preAuthPeriod;
         payeeType = builder.payeeType;
-        item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", Item.class));
-        addItem = Collections.unmodifiableList(ValidationSupport.checkList(builder.addItem, "addItem", AddItem.class));
-        adjudication = Collections.unmodifiableList(ValidationSupport.checkList(builder.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class));
-        total = Collections.unmodifiableList(ValidationSupport.checkList(builder.total, "total", Total.class));
+        item = Collections.unmodifiableList(builder.item);
+        addItem = Collections.unmodifiableList(builder.addItem);
+        adjudication = Collections.unmodifiableList(builder.adjudication);
+        total = Collections.unmodifiableList(builder.total);
         payment = builder.payment;
         fundsReserve = builder.fundsReserve;
         formCode = builder.formCode;
         form = builder.form;
-        processNote = Collections.unmodifiableList(ValidationSupport.checkList(builder.processNote, "processNote", ProcessNote.class));
-        communicationRequest = Collections.unmodifiableList(ValidationSupport.checkList(builder.communicationRequest, "communicationRequest", Reference.class));
-        insurance = Collections.unmodifiableList(ValidationSupport.checkList(builder.insurance, "insurance", Insurance.class));
-        error = Collections.unmodifiableList(ValidationSupport.checkList(builder.error, "error", Error.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(insurer, "insurer", "Organization");
-        ValidationSupport.checkReferenceType(requestor, "requestor", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(request, "request", "Claim");
-        ValidationSupport.checkReferenceType(communicationRequest, "communicationRequest", "CommunicationRequest");
+        processNote = Collections.unmodifiableList(builder.processNote);
+        communicationRequest = Collections.unmodifiableList(builder.communicationRequest);
+        insurance = Collections.unmodifiableList(builder.insurance);
+        error = Collections.unmodifiableList(builder.error);
     }
 
     /**
@@ -1531,7 +1526,36 @@ public Builder error(Collection<Error> error) {
          */
         @Override
         public ClaimResponse build() {
-            return new ClaimResponse(this);
+            ClaimResponse claimResponse = new ClaimResponse(this);
+            if (validating) {
+                validate(claimResponse);
+            }
+            return claimResponse;
+        }
+
+        protected void validate(ClaimResponse claimResponse) {
+            super.validate(claimResponse);
+            ValidationSupport.checkList(claimResponse.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(claimResponse.status, "status");
+            ValidationSupport.requireNonNull(claimResponse.type, "type");
+            ValidationSupport.requireNonNull(claimResponse.use, "use");
+            ValidationSupport.requireNonNull(claimResponse.patient, "patient");
+            ValidationSupport.requireNonNull(claimResponse.created, "created");
+            ValidationSupport.requireNonNull(claimResponse.insurer, "insurer");
+            ValidationSupport.requireNonNull(claimResponse.outcome, "outcome");
+            ValidationSupport.checkList(claimResponse.item, "item", Item.class);
+            ValidationSupport.checkList(claimResponse.addItem, "addItem", AddItem.class);
+            ValidationSupport.checkList(claimResponse.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class);
+            ValidationSupport.checkList(claimResponse.total, "total", Total.class);
+            ValidationSupport.checkList(claimResponse.processNote, "processNote", ProcessNote.class);
+            ValidationSupport.checkList(claimResponse.communicationRequest, "communicationRequest", Reference.class);
+            ValidationSupport.checkList(claimResponse.insurance, "insurance", Insurance.class);
+            ValidationSupport.checkList(claimResponse.error, "error", Error.class);
+            ValidationSupport.checkReferenceType(claimResponse.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(claimResponse.insurer, "insurer", "Organization");
+            ValidationSupport.checkReferenceType(claimResponse.requestor, "requestor", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(claimResponse.request, "request", "Claim");
+            ValidationSupport.checkReferenceType(claimResponse.communicationRequest, "communicationRequest", "CommunicationRequest");
         }
 
         protected Builder from(ClaimResponse claimResponse) {
@@ -1581,11 +1605,10 @@ public static class Item extends BackboneElement {
 
         private Item(Builder builder) {
             super(builder);
-            itemSequence = ValidationSupport.requireNonNull(builder.itemSequence, "itemSequence");
-            noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-            adjudication = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.adjudication, "adjudication", Adjudication.class));
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Detail.class));
-            ValidationSupport.requireValueOrChildren(this);
+            itemSequence = builder.itemSequence;
+            noteNumber = Collections.unmodifiableList(builder.noteNumber);
+            adjudication = Collections.unmodifiableList(builder.adjudication);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -1954,7 +1977,20 @@ public Builder detail(Collection<Detail> detail) {
              */
             @Override
             public Item build() {
-                return new Item(this);
+                Item item = new Item(this);
+                if (validating) {
+                    validate(item);
+                }
+                return item;
+            }
+
+            protected void validate(Item item) {
+                super.validate(item);
+                ValidationSupport.requireNonNull(item.itemSequence, "itemSequence");
+                ValidationSupport.checkList(item.noteNumber, "noteNumber", PositiveInt.class);
+                ValidationSupport.checkNonEmptyList(item.adjudication, "adjudication", Adjudication.class);
+                ValidationSupport.checkList(item.detail, "detail", Detail.class);
+                ValidationSupport.requireValueOrChildren(item);
             }
 
             protected Builder from(Item item) {
@@ -1992,11 +2028,10 @@ public static class Adjudication extends BackboneElement {
 
             private Adjudication(Builder builder) {
                 super(builder);
-                category = ValidationSupport.requireNonNull(builder.category, "category");
+                category = builder.category;
                 reason = builder.reason;
                 amount = builder.amount;
                 value = builder.value;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2301,7 +2336,17 @@ public Builder value(Decimal value) {
                  */
                 @Override
                 public Adjudication build() {
-                    return new Adjudication(this);
+                    Adjudication adjudication = new Adjudication(this);
+                    if (validating) {
+                        validate(adjudication);
+                    }
+                    return adjudication;
+                }
+
+                protected void validate(Adjudication adjudication) {
+                    super.validate(adjudication);
+                    ValidationSupport.requireNonNull(adjudication.category, "category");
+                    ValidationSupport.requireValueOrChildren(adjudication);
                 }
 
                 protected Builder from(Adjudication adjudication) {
@@ -2328,11 +2373,10 @@ public static class Detail extends BackboneElement {
 
             private Detail(Builder builder) {
                 super(builder);
-                detailSequence = ValidationSupport.requireNonNull(builder.detailSequence, "detailSequence");
-                noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-                adjudication = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class));
-                subDetail = Collections.unmodifiableList(ValidationSupport.checkList(builder.subDetail, "subDetail", SubDetail.class));
-                ValidationSupport.requireValueOrChildren(this);
+                detailSequence = builder.detailSequence;
+                noteNumber = Collections.unmodifiableList(builder.noteNumber);
+                adjudication = Collections.unmodifiableList(builder.adjudication);
+                subDetail = Collections.unmodifiableList(builder.subDetail);
             }
 
             /**
@@ -2698,7 +2742,20 @@ public Builder subDetail(Collection<SubDetail> subDetail) {
                  */
                 @Override
                 public Detail build() {
-                    return new Detail(this);
+                    Detail detail = new Detail(this);
+                    if (validating) {
+                        validate(detail);
+                    }
+                    return detail;
+                }
+
+                protected void validate(Detail detail) {
+                    super.validate(detail);
+                    ValidationSupport.requireNonNull(detail.detailSequence, "detailSequence");
+                    ValidationSupport.checkList(detail.noteNumber, "noteNumber", PositiveInt.class);
+                    ValidationSupport.checkNonEmptyList(detail.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class);
+                    ValidationSupport.checkList(detail.subDetail, "subDetail", SubDetail.class);
+                    ValidationSupport.requireValueOrChildren(detail);
                 }
 
                 protected Builder from(Detail detail) {
@@ -2722,10 +2779,9 @@ public static class SubDetail extends BackboneElement {
 
                 private SubDetail(Builder builder) {
                     super(builder);
-                    subDetailSequence = ValidationSupport.requireNonNull(builder.subDetailSequence, "subDetailSequence");
-                    noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-                    adjudication = Collections.unmodifiableList(ValidationSupport.checkList(builder.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    subDetailSequence = builder.subDetailSequence;
+                    noteNumber = Collections.unmodifiableList(builder.noteNumber);
+                    adjudication = Collections.unmodifiableList(builder.adjudication);
                 }
 
                 /**
@@ -3037,7 +3093,19 @@ public Builder adjudication(Collection<ClaimResponse.Item.Adjudication> adjudica
                      */
                     @Override
                     public SubDetail build() {
-                        return new SubDetail(this);
+                        SubDetail subDetail = new SubDetail(this);
+                        if (validating) {
+                            validate(subDetail);
+                        }
+                        return subDetail;
+                    }
+
+                    protected void validate(SubDetail subDetail) {
+                        super.validate(subDetail);
+                        ValidationSupport.requireNonNull(subDetail.subDetailSequence, "subDetailSequence");
+                        ValidationSupport.checkList(subDetail.noteNumber, "noteNumber", PositiveInt.class);
+                        ValidationSupport.checkList(subDetail.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class);
+                        ValidationSupport.requireValueOrChildren(subDetail);
                     }
 
                     protected Builder from(SubDetail subDetail) {
@@ -3119,27 +3187,24 @@ public static class AddItem extends BackboneElement {
 
         private AddItem(Builder builder) {
             super(builder);
-            itemSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.itemSequence, "itemSequence", PositiveInt.class));
-            detailSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.detailSequence, "detailSequence", PositiveInt.class));
-            subdetailSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.subdetailSequence, "subdetailSequence", PositiveInt.class));
-            provider = Collections.unmodifiableList(ValidationSupport.checkList(builder.provider, "provider", Reference.class));
-            productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-            modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
-            programCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.programCode, "programCode", CodeableConcept.class));
-            serviced = ValidationSupport.choiceElement(builder.serviced, "serviced", Date.class, Period.class);
-            location = ValidationSupport.choiceElement(builder.location, "location", CodeableConcept.class, Address.class, Reference.class);
+            itemSequence = Collections.unmodifiableList(builder.itemSequence);
+            detailSequence = Collections.unmodifiableList(builder.detailSequence);
+            subdetailSequence = Collections.unmodifiableList(builder.subdetailSequence);
+            provider = Collections.unmodifiableList(builder.provider);
+            productOrService = builder.productOrService;
+            modifier = Collections.unmodifiableList(builder.modifier);
+            programCode = Collections.unmodifiableList(builder.programCode);
+            serviced = builder.serviced;
+            location = builder.location;
             quantity = builder.quantity;
             unitPrice = builder.unitPrice;
             factor = builder.factor;
             net = builder.net;
             bodySite = builder.bodySite;
-            subSite = Collections.unmodifiableList(ValidationSupport.checkList(builder.subSite, "subSite", CodeableConcept.class));
-            noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-            adjudication = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class));
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Detail.class));
-            ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.checkReferenceType(location, "location", "Location");
-            ValidationSupport.requireValueOrChildren(this);
+            subSite = Collections.unmodifiableList(builder.subSite);
+            noteNumber = Collections.unmodifiableList(builder.noteNumber);
+            adjudication = Collections.unmodifiableList(builder.adjudication);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -4089,7 +4154,31 @@ public Builder detail(Collection<Detail> detail) {
              */
             @Override
             public AddItem build() {
-                return new AddItem(this);
+                AddItem addItem = new AddItem(this);
+                if (validating) {
+                    validate(addItem);
+                }
+                return addItem;
+            }
+
+            protected void validate(AddItem addItem) {
+                super.validate(addItem);
+                ValidationSupport.checkList(addItem.itemSequence, "itemSequence", PositiveInt.class);
+                ValidationSupport.checkList(addItem.detailSequence, "detailSequence", PositiveInt.class);
+                ValidationSupport.checkList(addItem.subdetailSequence, "subdetailSequence", PositiveInt.class);
+                ValidationSupport.checkList(addItem.provider, "provider", Reference.class);
+                ValidationSupport.requireNonNull(addItem.productOrService, "productOrService");
+                ValidationSupport.checkList(addItem.modifier, "modifier", CodeableConcept.class);
+                ValidationSupport.checkList(addItem.programCode, "programCode", CodeableConcept.class);
+                ValidationSupport.choiceElement(addItem.serviced, "serviced", Date.class, Period.class);
+                ValidationSupport.choiceElement(addItem.location, "location", CodeableConcept.class, Address.class, Reference.class);
+                ValidationSupport.checkList(addItem.subSite, "subSite", CodeableConcept.class);
+                ValidationSupport.checkList(addItem.noteNumber, "noteNumber", PositiveInt.class);
+                ValidationSupport.checkNonEmptyList(addItem.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class);
+                ValidationSupport.checkList(addItem.detail, "detail", Detail.class);
+                ValidationSupport.checkReferenceType(addItem.provider, "provider", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.checkReferenceType(addItem.location, "location", "Location");
+                ValidationSupport.requireValueOrChildren(addItem);
             }
 
             protected Builder from(AddItem addItem) {
@@ -4146,16 +4235,15 @@ public static class Detail extends BackboneElement {
 
             private Detail(Builder builder) {
                 super(builder);
-                productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-                modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
+                productOrService = builder.productOrService;
+                modifier = Collections.unmodifiableList(builder.modifier);
                 quantity = builder.quantity;
                 unitPrice = builder.unitPrice;
                 factor = builder.factor;
                 net = builder.net;
-                noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-                adjudication = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class));
-                subDetail = Collections.unmodifiableList(ValidationSupport.checkList(builder.subDetail, "subDetail", SubDetail.class));
-                ValidationSupport.requireValueOrChildren(this);
+                noteNumber = Collections.unmodifiableList(builder.noteNumber);
+                adjudication = Collections.unmodifiableList(builder.adjudication);
+                subDetail = Collections.unmodifiableList(builder.subDetail);
             }
 
             /**
@@ -4692,7 +4780,21 @@ public Builder subDetail(Collection<SubDetail> subDetail) {
                  */
                 @Override
                 public Detail build() {
-                    return new Detail(this);
+                    Detail detail = new Detail(this);
+                    if (validating) {
+                        validate(detail);
+                    }
+                    return detail;
+                }
+
+                protected void validate(Detail detail) {
+                    super.validate(detail);
+                    ValidationSupport.requireNonNull(detail.productOrService, "productOrService");
+                    ValidationSupport.checkList(detail.modifier, "modifier", CodeableConcept.class);
+                    ValidationSupport.checkList(detail.noteNumber, "noteNumber", PositiveInt.class);
+                    ValidationSupport.checkNonEmptyList(detail.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class);
+                    ValidationSupport.checkList(detail.subDetail, "subDetail", SubDetail.class);
+                    ValidationSupport.requireValueOrChildren(detail);
                 }
 
                 protected Builder from(Detail detail) {
@@ -4739,15 +4841,14 @@ public static class SubDetail extends BackboneElement {
 
                 private SubDetail(Builder builder) {
                     super(builder);
-                    productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-                    modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
+                    productOrService = builder.productOrService;
+                    modifier = Collections.unmodifiableList(builder.modifier);
                     quantity = builder.quantity;
                     unitPrice = builder.unitPrice;
                     factor = builder.factor;
                     net = builder.net;
-                    noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-                    adjudication = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    noteNumber = Collections.unmodifiableList(builder.noteNumber);
+                    adjudication = Collections.unmodifiableList(builder.adjudication);
                 }
 
                 /**
@@ -5235,7 +5336,20 @@ public Builder adjudication(Collection<ClaimResponse.Item.Adjudication> adjudica
                      */
                     @Override
                     public SubDetail build() {
-                        return new SubDetail(this);
+                        SubDetail subDetail = new SubDetail(this);
+                        if (validating) {
+                            validate(subDetail);
+                        }
+                        return subDetail;
+                    }
+
+                    protected void validate(SubDetail subDetail) {
+                        super.validate(subDetail);
+                        ValidationSupport.requireNonNull(subDetail.productOrService, "productOrService");
+                        ValidationSupport.checkList(subDetail.modifier, "modifier", CodeableConcept.class);
+                        ValidationSupport.checkList(subDetail.noteNumber, "noteNumber", PositiveInt.class);
+                        ValidationSupport.checkNonEmptyList(subDetail.adjudication, "adjudication", ClaimResponse.Item.Adjudication.class);
+                        ValidationSupport.requireValueOrChildren(subDetail);
                     }
 
                     protected Builder from(SubDetail subDetail) {
@@ -5274,9 +5388,8 @@ public static class Total extends BackboneElement {
 
         private Total(Builder builder) {
             super(builder);
-            category = ValidationSupport.requireNonNull(builder.category, "category");
-            amount = ValidationSupport.requireNonNull(builder.amount, "amount");
-            ValidationSupport.requireValueOrChildren(this);
+            category = builder.category;
+            amount = builder.amount;
         }
 
         /**
@@ -5526,7 +5639,18 @@ public Builder amount(Money amount) {
              */
             @Override
             public Total build() {
-                return new Total(this);
+                Total total = new Total(this);
+                if (validating) {
+                    validate(total);
+                }
+                return total;
+            }
+
+            protected void validate(Total total) {
+                super.validate(total);
+                ValidationSupport.requireNonNull(total.category, "category");
+                ValidationSupport.requireNonNull(total.amount, "amount");
+                ValidationSupport.requireValueOrChildren(total);
             }
 
             protected Builder from(Total total) {
@@ -5565,13 +5689,12 @@ public static class Payment extends BackboneElement {
 
         private Payment(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            type = builder.type;
             adjustment = builder.adjustment;
             adjustmentReason = builder.adjustmentReason;
             date = builder.date;
-            amount = ValidationSupport.requireNonNull(builder.amount, "amount");
+            amount = builder.amount;
             identifier = builder.identifier;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -5935,7 +6058,18 @@ public Builder identifier(Identifier identifier) {
              */
             @Override
             public Payment build() {
-                return new Payment(this);
+                Payment payment = new Payment(this);
+                if (validating) {
+                    validate(payment);
+                }
+                return payment;
+            }
+
+            protected void validate(Payment payment) {
+                super.validate(payment);
+                ValidationSupport.requireNonNull(payment.type, "type");
+                ValidationSupport.requireNonNull(payment.amount, "amount");
+                ValidationSupport.requireValueOrChildren(payment);
             }
 
             protected Builder from(Payment payment) {
@@ -5978,10 +6112,8 @@ private ProcessNote(Builder builder) {
             super(builder);
             number = builder.number;
             type = builder.type;
-            text = ValidationSupport.requireNonNull(builder.text, "text");
+            text = builder.text;
             language = builder.language;
-            ValidationSupport.checkValueSetBinding(language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -6282,7 +6414,18 @@ public Builder language(CodeableConcept language) {
              */
             @Override
             public ProcessNote build() {
-                return new ProcessNote(this);
+                ProcessNote processNote = new ProcessNote(this);
+                if (validating) {
+                    validate(processNote);
+                }
+                return processNote;
+            }
+
+            protected void validate(ProcessNote processNote) {
+                super.validate(processNote);
+                ValidationSupport.requireNonNull(processNote.text, "text");
+                ValidationSupport.checkValueSetBinding(processNote.language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+                ValidationSupport.requireValueOrChildren(processNote);
             }
 
             protected Builder from(ProcessNote processNote) {
@@ -6313,14 +6456,11 @@ public static class Insurance extends BackboneElement {
 
         private Insurance(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            focal = ValidationSupport.requireNonNull(builder.focal, "focal");
-            coverage = ValidationSupport.requireNonNull(builder.coverage, "coverage");
+            sequence = builder.sequence;
+            focal = builder.focal;
+            coverage = builder.coverage;
             businessArrangement = builder.businessArrangement;
             claimResponse = builder.claimResponse;
-            ValidationSupport.checkReferenceType(coverage, "coverage", "Coverage");
-            ValidationSupport.checkReferenceType(claimResponse, "claimResponse", "ClaimResponse");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -6670,7 +6810,21 @@ public Builder claimResponse(Reference claimResponse) {
              */
             @Override
             public Insurance build() {
-                return new Insurance(this);
+                Insurance insurance = new Insurance(this);
+                if (validating) {
+                    validate(insurance);
+                }
+                return insurance;
+            }
+
+            protected void validate(Insurance insurance) {
+                super.validate(insurance);
+                ValidationSupport.requireNonNull(insurance.sequence, "sequence");
+                ValidationSupport.requireNonNull(insurance.focal, "focal");
+                ValidationSupport.requireNonNull(insurance.coverage, "coverage");
+                ValidationSupport.checkReferenceType(insurance.coverage, "coverage", "Coverage");
+                ValidationSupport.checkReferenceType(insurance.claimResponse, "claimResponse", "ClaimResponse");
+                ValidationSupport.requireValueOrChildren(insurance);
             }
 
             protected Builder from(Insurance insurance) {
@@ -6706,8 +6860,7 @@ private Error(Builder builder) {
             itemSequence = builder.itemSequence;
             detailSequence = builder.detailSequence;
             subDetailSequence = builder.subDetailSequence;
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            ValidationSupport.requireValueOrChildren(this);
+            code = builder.code;
         }
 
         /**
@@ -7014,7 +7167,17 @@ public Builder code(CodeableConcept code) {
              */
             @Override
             public Error build() {
-                return new Error(this);
+                Error error = new Error(this);
+                if (validating) {
+                    validate(error);
+                }
+                return error;
+            }
+
+            protected void validate(Error error) {
+                super.validate(error);
+                ValidationSupport.requireNonNull(error.code, "code");
+                ValidationSupport.requireValueOrChildren(error);
             }
 
             protected Builder from(Error error) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ClinicalImpression.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ClinicalImpression.java
index dfc35d990d6..d4c214b123d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ClinicalImpression.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ClinicalImpression.java
@@ -119,32 +119,26 @@ public class ClinicalImpression extends DomainResource {
 
     private ClinicalImpression(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         statusReason = builder.statusReason;
         code = builder.code;
         description = builder.description;
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        subject = builder.subject;
         encounter = builder.encounter;
-        effective = ValidationSupport.choiceElement(builder.effective, "effective", DateTime.class, Period.class);
+        effective = builder.effective;
         date = builder.date;
         assessor = builder.assessor;
         previous = builder.previous;
-        problem = Collections.unmodifiableList(ValidationSupport.checkList(builder.problem, "problem", Reference.class));
-        investigation = Collections.unmodifiableList(ValidationSupport.checkList(builder.investigation, "investigation", Investigation.class));
-        protocol = Collections.unmodifiableList(ValidationSupport.checkList(builder.protocol, "protocol", Uri.class));
+        problem = Collections.unmodifiableList(builder.problem);
+        investigation = Collections.unmodifiableList(builder.investigation);
+        protocol = Collections.unmodifiableList(builder.protocol);
         summary = builder.summary;
-        finding = Collections.unmodifiableList(ValidationSupport.checkList(builder.finding, "finding", Finding.class));
-        prognosisCodeableConcept = Collections.unmodifiableList(ValidationSupport.checkList(builder.prognosisCodeableConcept, "prognosisCodeableConcept", CodeableConcept.class));
-        prognosisReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.prognosisReference, "prognosisReference", Reference.class));
-        supportingInfo = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInfo, "supportingInfo", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(assessor, "assessor", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(previous, "previous", "ClinicalImpression");
-        ValidationSupport.checkReferenceType(problem, "problem", "Condition", "AllergyIntolerance");
-        ValidationSupport.checkReferenceType(prognosisReference, "prognosisReference", "RiskAssessment");
+        finding = Collections.unmodifiableList(builder.finding);
+        prognosisCodeableConcept = Collections.unmodifiableList(builder.prognosisCodeableConcept);
+        prognosisReference = Collections.unmodifiableList(builder.prognosisReference);
+        supportingInfo = Collections.unmodifiableList(builder.supportingInfo);
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -1275,7 +1269,33 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public ClinicalImpression build() {
-            return new ClinicalImpression(this);
+            ClinicalImpression clinicalImpression = new ClinicalImpression(this);
+            if (validating) {
+                validate(clinicalImpression);
+            }
+            return clinicalImpression;
+        }
+
+        protected void validate(ClinicalImpression clinicalImpression) {
+            super.validate(clinicalImpression);
+            ValidationSupport.checkList(clinicalImpression.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(clinicalImpression.status, "status");
+            ValidationSupport.requireNonNull(clinicalImpression.subject, "subject");
+            ValidationSupport.choiceElement(clinicalImpression.effective, "effective", DateTime.class, Period.class);
+            ValidationSupport.checkList(clinicalImpression.problem, "problem", Reference.class);
+            ValidationSupport.checkList(clinicalImpression.investigation, "investigation", Investigation.class);
+            ValidationSupport.checkList(clinicalImpression.protocol, "protocol", Uri.class);
+            ValidationSupport.checkList(clinicalImpression.finding, "finding", Finding.class);
+            ValidationSupport.checkList(clinicalImpression.prognosisCodeableConcept, "prognosisCodeableConcept", CodeableConcept.class);
+            ValidationSupport.checkList(clinicalImpression.prognosisReference, "prognosisReference", Reference.class);
+            ValidationSupport.checkList(clinicalImpression.supportingInfo, "supportingInfo", Reference.class);
+            ValidationSupport.checkList(clinicalImpression.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(clinicalImpression.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(clinicalImpression.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(clinicalImpression.assessor, "assessor", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(clinicalImpression.previous, "previous", "ClinicalImpression");
+            ValidationSupport.checkReferenceType(clinicalImpression.problem, "problem", "Condition", "AllergyIntolerance");
+            ValidationSupport.checkReferenceType(clinicalImpression.prognosisReference, "prognosisReference", "RiskAssessment");
         }
 
         protected Builder from(ClinicalImpression clinicalImpression) {
@@ -1323,10 +1343,8 @@ public static class Investigation extends BackboneElement {
 
         private Investigation(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", Reference.class));
-            ValidationSupport.checkReferenceType(item, "item", "Observation", "QuestionnaireResponse", "FamilyMemberHistory", "DiagnosticReport", "RiskAssessment", "ImagingStudy", "Media");
-            ValidationSupport.requireValueOrChildren(this);
+            code = builder.code;
+            item = Collections.unmodifiableList(builder.item);
         }
 
         /**
@@ -1615,7 +1633,19 @@ public Builder item(Collection<Reference> item) {
              */
             @Override
             public Investigation build() {
-                return new Investigation(this);
+                Investigation investigation = new Investigation(this);
+                if (validating) {
+                    validate(investigation);
+                }
+                return investigation;
+            }
+
+            protected void validate(Investigation investigation) {
+                super.validate(investigation);
+                ValidationSupport.requireNonNull(investigation.code, "code");
+                ValidationSupport.checkList(investigation.item, "item", Reference.class);
+                ValidationSupport.checkReferenceType(investigation.item, "item", "Observation", "QuestionnaireResponse", "FamilyMemberHistory", "DiagnosticReport", "RiskAssessment", "ImagingStudy", "Media");
+                ValidationSupport.requireValueOrChildren(investigation);
             }
 
             protected Builder from(Investigation investigation) {
@@ -1647,8 +1677,6 @@ private Finding(Builder builder) {
             itemCodeableConcept = builder.itemCodeableConcept;
             itemReference = builder.itemReference;
             basis = builder.basis;
-            ValidationSupport.checkReferenceType(itemReference, "itemReference", "Condition", "Observation", "Media");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1920,7 +1948,17 @@ public Builder basis(String basis) {
              */
             @Override
             public Finding build() {
-                return new Finding(this);
+                Finding finding = new Finding(this);
+                if (validating) {
+                    validate(finding);
+                }
+                return finding;
+            }
+
+            protected void validate(Finding finding) {
+                super.validate(finding);
+                ValidationSupport.checkReferenceType(finding.itemReference, "itemReference", "Condition", "Observation", "Media");
+                ValidationSupport.requireValueOrChildren(finding);
             }
 
             protected Builder from(Finding finding) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CodeSystem.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CodeSystem.java
index 736c9f99f65..f8a80b585ac 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CodeSystem.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CodeSystem.java
@@ -178,18 +178,18 @@ public class CodeSystem extends DomainResource {
     private CodeSystem(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         copyright = builder.copyright;
         caseSensitive = builder.caseSensitive;
@@ -197,12 +197,12 @@ private CodeSystem(Builder builder) {
         hierarchyMeaning = builder.hierarchyMeaning;
         compositional = builder.compositional;
         versionNeeded = builder.versionNeeded;
-        content = ValidationSupport.requireNonNull(builder.content, "content");
+        content = builder.content;
         supplements = builder.supplements;
         count = builder.count;
-        filter = Collections.unmodifiableList(ValidationSupport.checkList(builder.filter, "filter", Filter.class));
-        property = Collections.unmodifiableList(ValidationSupport.checkList(builder.property, "property", Property.class));
-        concept = Collections.unmodifiableList(ValidationSupport.checkList(builder.concept, "concept", Concept.class));
+        filter = Collections.unmodifiableList(builder.filter);
+        property = Collections.unmodifiableList(builder.property);
+        concept = Collections.unmodifiableList(builder.concept);
     }
 
     /**
@@ -1438,7 +1438,24 @@ public Builder concept(Collection<Concept> concept) {
          */
         @Override
         public CodeSystem build() {
-            return new CodeSystem(this);
+            CodeSystem codeSystem = new CodeSystem(this);
+            if (validating) {
+                validate(codeSystem);
+            }
+            return codeSystem;
+        }
+
+        protected void validate(CodeSystem codeSystem) {
+            super.validate(codeSystem);
+            ValidationSupport.checkList(codeSystem.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(codeSystem.status, "status");
+            ValidationSupport.checkList(codeSystem.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(codeSystem.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(codeSystem.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.requireNonNull(codeSystem.content, "content");
+            ValidationSupport.checkList(codeSystem.filter, "filter", Filter.class);
+            ValidationSupport.checkList(codeSystem.property, "property", Property.class);
+            ValidationSupport.checkList(codeSystem.concept, "concept", Concept.class);
         }
 
         protected Builder from(CodeSystem codeSystem) {
@@ -1497,11 +1514,10 @@ public static class Filter extends BackboneElement {
 
         private Filter(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            code = builder.code;
             description = builder.description;
-            operator = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.operator, "operator", FilterOperator.class));
-            value = ValidationSupport.requireNonNull(builder.value, "value");
-            ValidationSupport.requireValueOrChildren(this);
+            operator = Collections.unmodifiableList(builder.operator);
+            value = builder.value;
         }
 
         /**
@@ -1830,7 +1846,19 @@ public Builder value(String value) {
              */
             @Override
             public Filter build() {
-                return new Filter(this);
+                Filter filter = new Filter(this);
+                if (validating) {
+                    validate(filter);
+                }
+                return filter;
+            }
+
+            protected void validate(Filter filter) {
+                super.validate(filter);
+                ValidationSupport.requireNonNull(filter.code, "code");
+                ValidationSupport.checkNonEmptyList(filter.operator, "operator", FilterOperator.class);
+                ValidationSupport.requireNonNull(filter.value, "value");
+                ValidationSupport.requireValueOrChildren(filter);
             }
 
             protected Builder from(Filter filter) {
@@ -1867,11 +1895,10 @@ public static class Property extends BackboneElement {
 
         private Property(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            code = builder.code;
             uri = builder.uri;
             description = builder.description;
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
         }
 
         /**
@@ -2181,7 +2208,18 @@ public Builder type(PropertyType type) {
              */
             @Override
             public Property build() {
-                return new Property(this);
+                Property property = new Property(this);
+                if (validating) {
+                    validate(property);
+                }
+                return property;
+            }
+
+            protected void validate(Property property) {
+                super.validate(property);
+                ValidationSupport.requireNonNull(property.code, "code");
+                ValidationSupport.requireNonNull(property.type, "type");
+                ValidationSupport.requireValueOrChildren(property);
             }
 
             protected Builder from(Property property) {
@@ -2210,13 +2248,12 @@ public static class Concept extends BackboneElement {
 
         private Concept(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            code = builder.code;
             display = builder.display;
             definition = builder.definition;
-            designation = Collections.unmodifiableList(ValidationSupport.checkList(builder.designation, "designation", Designation.class));
-            property = Collections.unmodifiableList(ValidationSupport.checkList(builder.property, "property", Property.class));
-            concept = Collections.unmodifiableList(ValidationSupport.checkList(builder.concept, "concept", CodeSystem.Concept.class));
-            ValidationSupport.requireValueOrChildren(this);
+            designation = Collections.unmodifiableList(builder.designation);
+            property = Collections.unmodifiableList(builder.property);
+            concept = Collections.unmodifiableList(builder.concept);
         }
 
         /**
@@ -2645,7 +2682,20 @@ public Builder concept(Collection<CodeSystem.Concept> concept) {
              */
             @Override
             public Concept build() {
-                return new Concept(this);
+                Concept concept = new Concept(this);
+                if (validating) {
+                    validate(concept);
+                }
+                return concept;
+            }
+
+            protected void validate(Concept concept) {
+                super.validate(concept);
+                ValidationSupport.requireNonNull(concept.code, "code");
+                ValidationSupport.checkList(concept.designation, "designation", Designation.class);
+                ValidationSupport.checkList(concept.property, "property", Property.class);
+                ValidationSupport.checkList(concept.concept, "concept", CodeSystem.Concept.class);
+                ValidationSupport.requireValueOrChildren(concept);
             }
 
             protected Builder from(Concept concept) {
@@ -2687,9 +2737,7 @@ private Designation(Builder builder) {
                 super(builder);
                 language = builder.language;
                 use = builder.use;
-                value = ValidationSupport.requireNonNull(builder.value, "value");
-                ValidationSupport.checkValueSetBinding(language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
-                ValidationSupport.requireValueOrChildren(this);
+                value = builder.value;
             }
 
             /**
@@ -2961,7 +3009,18 @@ public Builder value(String value) {
                  */
                 @Override
                 public Designation build() {
-                    return new Designation(this);
+                    Designation designation = new Designation(this);
+                    if (validating) {
+                        validate(designation);
+                    }
+                    return designation;
+                }
+
+                protected void validate(Designation designation) {
+                    super.validate(designation);
+                    ValidationSupport.requireNonNull(designation.value, "value");
+                    ValidationSupport.checkValueSetBinding(designation.language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+                    ValidationSupport.requireValueOrChildren(designation);
                 }
 
                 protected Builder from(Designation designation) {
@@ -2986,9 +3045,8 @@ public static class Property extends BackboneElement {
 
             private Property(Builder builder) {
                 super(builder);
-                code = ValidationSupport.requireNonNull(builder.code, "code");
-                value = ValidationSupport.requireChoiceElement(builder.value, "value", Code.class, Coding.class, String.class, Integer.class, Boolean.class, DateTime.class, Decimal.class);
-                ValidationSupport.requireValueOrChildren(this);
+                code = builder.code;
+                value = builder.value;
             }
 
             /**
@@ -3245,7 +3303,18 @@ public Builder value(Element value) {
                  */
                 @Override
                 public Property build() {
-                    return new Property(this);
+                    Property property = new Property(this);
+                    if (validating) {
+                        validate(property);
+                    }
+                    return property;
+                }
+
+                protected void validate(Property property) {
+                    super.validate(property);
+                    ValidationSupport.requireNonNull(property.code, "code");
+                    ValidationSupport.requireChoiceElement(property.value, "value", Code.class, Coding.class, String.class, Integer.class, Boolean.class, DateTime.class, Decimal.class);
+                    ValidationSupport.requireValueOrChildren(property);
                 }
 
                 protected Builder from(Property property) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Communication.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Communication.java
index 1e35e5984c9..4b45b2b6bce 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Communication.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Communication.java
@@ -141,35 +141,29 @@ public class Communication extends DomainResource {
 
     private Communication(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-        instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        inResponseTo = Collections.unmodifiableList(ValidationSupport.checkList(builder.inResponseTo, "inResponseTo", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+        instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        inResponseTo = Collections.unmodifiableList(builder.inResponseTo);
+        status = builder.status;
         statusReason = builder.statusReason;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        category = Collections.unmodifiableList(builder.category);
         priority = builder.priority;
-        medium = Collections.unmodifiableList(ValidationSupport.checkList(builder.medium, "medium", CodeableConcept.class));
+        medium = Collections.unmodifiableList(builder.medium);
         subject = builder.subject;
         topic = builder.topic;
-        about = Collections.unmodifiableList(ValidationSupport.checkList(builder.about, "about", Reference.class));
+        about = Collections.unmodifiableList(builder.about);
         encounter = builder.encounter;
         sent = builder.sent;
         received = builder.received;
-        recipient = Collections.unmodifiableList(ValidationSupport.checkList(builder.recipient, "recipient", Reference.class));
+        recipient = Collections.unmodifiableList(builder.recipient);
         sender = builder.sender;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        payload = Collections.unmodifiableList(ValidationSupport.checkList(builder.payload, "payload", Payload.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(inResponseTo, "inResponseTo", "Communication");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(recipient, "recipient", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Group", "CareTeam", "HealthcareService");
-        ValidationSupport.checkReferenceType(sender, "sender", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "HealthcareService");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        payload = Collections.unmodifiableList(builder.payload);
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -1509,7 +1503,36 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public Communication build() {
-            return new Communication(this);
+            Communication communication = new Communication(this);
+            if (validating) {
+                validate(communication);
+            }
+            return communication;
+        }
+
+        protected void validate(Communication communication) {
+            super.validate(communication);
+            ValidationSupport.checkList(communication.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(communication.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+            ValidationSupport.checkList(communication.instantiatesUri, "instantiatesUri", Uri.class);
+            ValidationSupport.checkList(communication.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(communication.partOf, "partOf", Reference.class);
+            ValidationSupport.checkList(communication.inResponseTo, "inResponseTo", Reference.class);
+            ValidationSupport.requireNonNull(communication.status, "status");
+            ValidationSupport.checkList(communication.category, "category", CodeableConcept.class);
+            ValidationSupport.checkList(communication.medium, "medium", CodeableConcept.class);
+            ValidationSupport.checkList(communication.about, "about", Reference.class);
+            ValidationSupport.checkList(communication.recipient, "recipient", Reference.class);
+            ValidationSupport.checkList(communication.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(communication.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(communication.payload, "payload", Payload.class);
+            ValidationSupport.checkList(communication.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(communication.inResponseTo, "inResponseTo", "Communication");
+            ValidationSupport.checkReferenceType(communication.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(communication.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(communication.recipient, "recipient", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Group", "CareTeam", "HealthcareService");
+            ValidationSupport.checkReferenceType(communication.sender, "sender", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "HealthcareService");
+            ValidationSupport.checkReferenceType(communication.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
         }
 
         protected Builder from(Communication communication) {
@@ -1551,8 +1574,7 @@ public static class Payload extends BackboneElement {
 
         private Payload(Builder builder) {
             super(builder);
-            content = ValidationSupport.requireChoiceElement(builder.content, "content", String.class, Attachment.class, Reference.class);
-            ValidationSupport.requireValueOrChildren(this);
+            content = builder.content;
         }
 
         /**
@@ -1773,7 +1795,17 @@ public Builder content(Element content) {
              */
             @Override
             public Payload build() {
-                return new Payload(this);
+                Payload payload = new Payload(this);
+                if (validating) {
+                    validate(payload);
+                }
+                return payload;
+            }
+
+            protected void validate(Payload payload) {
+                super.validate(payload);
+                ValidationSupport.requireChoiceElement(payload.content, "content", String.class, Attachment.class, Reference.class);
+                ValidationSupport.requireValueOrChildren(payload);
             }
 
             protected Builder from(Payload payload) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CommunicationRequest.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CommunicationRequest.java
index 16804eeaea9..67935aebd99 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CommunicationRequest.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CommunicationRequest.java
@@ -138,35 +138,28 @@ public class CommunicationRequest extends DomainResource {
 
     private CommunicationRequest(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        replaces = Collections.unmodifiableList(ValidationSupport.checkList(builder.replaces, "replaces", Reference.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        replaces = Collections.unmodifiableList(builder.replaces);
         groupIdentifier = builder.groupIdentifier;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         statusReason = builder.statusReason;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        category = Collections.unmodifiableList(builder.category);
         priority = builder.priority;
         doNotPerform = builder.doNotPerform;
-        medium = Collections.unmodifiableList(ValidationSupport.checkList(builder.medium, "medium", CodeableConcept.class));
+        medium = Collections.unmodifiableList(builder.medium);
         subject = builder.subject;
-        about = Collections.unmodifiableList(ValidationSupport.checkList(builder.about, "about", Reference.class));
+        about = Collections.unmodifiableList(builder.about);
         encounter = builder.encounter;
-        payload = Collections.unmodifiableList(ValidationSupport.checkList(builder.payload, "payload", Payload.class));
-        occurrence = ValidationSupport.choiceElement(builder.occurrence, "occurrence", DateTime.class, Period.class);
+        payload = Collections.unmodifiableList(builder.payload);
+        occurrence = builder.occurrence;
         authoredOn = builder.authoredOn;
         requester = builder.requester;
-        recipient = Collections.unmodifiableList(ValidationSupport.checkList(builder.recipient, "recipient", Reference.class));
+        recipient = Collections.unmodifiableList(builder.recipient);
         sender = builder.sender;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(replaces, "replaces", "CommunicationRequest");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(requester, "requester", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
-        ValidationSupport.checkReferenceType(recipient, "recipient", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Group", "CareTeam", "HealthcareService");
-        ValidationSupport.checkReferenceType(sender, "sender", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "HealthcareService");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -1426,7 +1419,35 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public CommunicationRequest build() {
-            return new CommunicationRequest(this);
+            CommunicationRequest communicationRequest = new CommunicationRequest(this);
+            if (validating) {
+                validate(communicationRequest);
+            }
+            return communicationRequest;
+        }
+
+        protected void validate(CommunicationRequest communicationRequest) {
+            super.validate(communicationRequest);
+            ValidationSupport.checkList(communicationRequest.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(communicationRequest.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(communicationRequest.replaces, "replaces", Reference.class);
+            ValidationSupport.requireNonNull(communicationRequest.status, "status");
+            ValidationSupport.checkList(communicationRequest.category, "category", CodeableConcept.class);
+            ValidationSupport.checkList(communicationRequest.medium, "medium", CodeableConcept.class);
+            ValidationSupport.checkList(communicationRequest.about, "about", Reference.class);
+            ValidationSupport.checkList(communicationRequest.payload, "payload", Payload.class);
+            ValidationSupport.choiceElement(communicationRequest.occurrence, "occurrence", DateTime.class, Period.class);
+            ValidationSupport.checkList(communicationRequest.recipient, "recipient", Reference.class);
+            ValidationSupport.checkList(communicationRequest.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(communicationRequest.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(communicationRequest.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(communicationRequest.replaces, "replaces", "CommunicationRequest");
+            ValidationSupport.checkReferenceType(communicationRequest.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(communicationRequest.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(communicationRequest.requester, "requester", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
+            ValidationSupport.checkReferenceType(communicationRequest.recipient, "recipient", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Group", "CareTeam", "HealthcareService");
+            ValidationSupport.checkReferenceType(communicationRequest.sender, "sender", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "HealthcareService");
+            ValidationSupport.checkReferenceType(communicationRequest.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
         }
 
         protected Builder from(CommunicationRequest communicationRequest) {
@@ -1467,8 +1488,7 @@ public static class Payload extends BackboneElement {
 
         private Payload(Builder builder) {
             super(builder);
-            content = ValidationSupport.requireChoiceElement(builder.content, "content", String.class, Attachment.class, Reference.class);
-            ValidationSupport.requireValueOrChildren(this);
+            content = builder.content;
         }
 
         /**
@@ -1689,7 +1709,17 @@ public Builder content(Element content) {
              */
             @Override
             public Payload build() {
-                return new Payload(this);
+                Payload payload = new Payload(this);
+                if (validating) {
+                    validate(payload);
+                }
+                return payload;
+            }
+
+            protected void validate(Payload payload) {
+                super.validate(payload);
+                ValidationSupport.requireChoiceElement(payload.content, "content", String.class, Attachment.class, Reference.class);
+                ValidationSupport.requireValueOrChildren(payload);
             }
 
             protected Builder from(Payload payload) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CompartmentDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CompartmentDefinition.java
index 185c80cf109..85bd9618e9e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CompartmentDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CompartmentDefinition.java
@@ -103,20 +103,20 @@ public class CompartmentDefinition extends DomainResource {
 
     private CompartmentDefinition(Builder builder) {
         super(builder);
-        url = ValidationSupport.requireNonNull(builder.url, "url");
+        url = builder.url;
         version = builder.version;
-        name = ValidationSupport.requireNonNull(builder.name, "name");
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        name = builder.name;
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
         purpose = builder.purpose;
-        code = ValidationSupport.requireNonNull(builder.code, "code");
-        search = ValidationSupport.requireNonNull(builder.search, "search");
-        resource = Collections.unmodifiableList(ValidationSupport.checkList(builder.resource, "resource", Resource.class));
+        code = builder.code;
+        search = builder.search;
+        resource = Collections.unmodifiableList(builder.resource);
     }
 
     /**
@@ -917,7 +917,23 @@ public Builder resource(Collection<Resource> resource) {
          */
         @Override
         public CompartmentDefinition build() {
-            return new CompartmentDefinition(this);
+            CompartmentDefinition compartmentDefinition = new CompartmentDefinition(this);
+            if (validating) {
+                validate(compartmentDefinition);
+            }
+            return compartmentDefinition;
+        }
+
+        protected void validate(CompartmentDefinition compartmentDefinition) {
+            super.validate(compartmentDefinition);
+            ValidationSupport.requireNonNull(compartmentDefinition.url, "url");
+            ValidationSupport.requireNonNull(compartmentDefinition.name, "name");
+            ValidationSupport.requireNonNull(compartmentDefinition.status, "status");
+            ValidationSupport.checkList(compartmentDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(compartmentDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.requireNonNull(compartmentDefinition.code, "code");
+            ValidationSupport.requireNonNull(compartmentDefinition.search, "search");
+            ValidationSupport.checkList(compartmentDefinition.resource, "resource", Resource.class);
         }
 
         protected Builder from(CompartmentDefinition compartmentDefinition) {
@@ -959,10 +975,9 @@ public static class Resource extends BackboneElement {
 
         private Resource(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            param = Collections.unmodifiableList(ValidationSupport.checkList(builder.param, "param", String.class));
+            code = builder.code;
+            param = Collections.unmodifiableList(builder.param);
             documentation = builder.documentation;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1257,7 +1272,18 @@ public Builder documentation(String documentation) {
              */
             @Override
             public Resource build() {
-                return new Resource(this);
+                Resource resource = new Resource(this);
+                if (validating) {
+                    validate(resource);
+                }
+                return resource;
+            }
+
+            protected void validate(Resource resource) {
+                super.validate(resource);
+                ValidationSupport.requireNonNull(resource.code, "code");
+                ValidationSupport.checkList(resource.param, "param", String.class);
+                ValidationSupport.requireValueOrChildren(resource);
             }
 
             protected Builder from(Resource resource) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Composition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Composition.java
index 421d5f6a2a7..e82ab7cc7c7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Composition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Composition.java
@@ -161,23 +161,20 @@ public class Composition extends DomainResource {
     private Composition(Builder builder) {
         super(builder);
         identifier = builder.identifier;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        type = ValidationSupport.requireNonNull(builder.type, "type");
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        status = builder.status;
+        type = builder.type;
+        category = Collections.unmodifiableList(builder.category);
         subject = builder.subject;
         encounter = builder.encounter;
-        date = ValidationSupport.requireNonNull(builder.date, "date");
-        author = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.author, "author", Reference.class));
-        title = ValidationSupport.requireNonNull(builder.title, "title");
+        date = builder.date;
+        author = Collections.unmodifiableList(builder.author);
+        title = builder.title;
         confidentiality = builder.confidentiality;
-        attester = Collections.unmodifiableList(ValidationSupport.checkList(builder.attester, "attester", Attester.class));
+        attester = Collections.unmodifiableList(builder.attester);
         custodian = builder.custodian;
-        relatesTo = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatesTo, "relatesTo", RelatesTo.class));
-        event = Collections.unmodifiableList(ValidationSupport.checkList(builder.event, "event", Event.class));
-        section = Collections.unmodifiableList(ValidationSupport.checkList(builder.section, "section", Section.class));
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole", "Device", "Patient", "RelatedPerson", "Organization");
-        ValidationSupport.checkReferenceType(custodian, "custodian", "Organization");
+        relatesTo = Collections.unmodifiableList(builder.relatesTo);
+        event = Collections.unmodifiableList(builder.event);
+        section = Collections.unmodifiableList(builder.section);
     }
 
     /**
@@ -1084,7 +1081,28 @@ public Builder section(Collection<Section> section) {
          */
         @Override
         public Composition build() {
-            return new Composition(this);
+            Composition composition = new Composition(this);
+            if (validating) {
+                validate(composition);
+            }
+            return composition;
+        }
+
+        protected void validate(Composition composition) {
+            super.validate(composition);
+            ValidationSupport.requireNonNull(composition.status, "status");
+            ValidationSupport.requireNonNull(composition.type, "type");
+            ValidationSupport.checkList(composition.category, "category", CodeableConcept.class);
+            ValidationSupport.requireNonNull(composition.date, "date");
+            ValidationSupport.checkNonEmptyList(composition.author, "author", Reference.class);
+            ValidationSupport.requireNonNull(composition.title, "title");
+            ValidationSupport.checkList(composition.attester, "attester", Attester.class);
+            ValidationSupport.checkList(composition.relatesTo, "relatesTo", RelatesTo.class);
+            ValidationSupport.checkList(composition.event, "event", Event.class);
+            ValidationSupport.checkList(composition.section, "section", Section.class);
+            ValidationSupport.checkReferenceType(composition.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(composition.author, "author", "Practitioner", "PractitionerRole", "Device", "Patient", "RelatedPerson", "Organization");
+            ValidationSupport.checkReferenceType(composition.custodian, "custodian", "Organization");
         }
 
         protected Builder from(Composition composition) {
@@ -1126,11 +1144,9 @@ public static class Attester extends BackboneElement {
 
         private Attester(Builder builder) {
             super(builder);
-            mode = ValidationSupport.requireNonNull(builder.mode, "mode");
+            mode = builder.mode;
             time = builder.time;
             party = builder.party;
-            ValidationSupport.checkReferenceType(party, "party", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1411,7 +1427,18 @@ public Builder party(Reference party) {
              */
             @Override
             public Attester build() {
-                return new Attester(this);
+                Attester attester = new Attester(this);
+                if (validating) {
+                    validate(attester);
+                }
+                return attester;
+            }
+
+            protected void validate(Attester attester) {
+                super.validate(attester);
+                ValidationSupport.requireNonNull(attester.mode, "mode");
+                ValidationSupport.checkReferenceType(attester.party, "party", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.requireValueOrChildren(attester);
             }
 
             protected Builder from(Attester attester) {
@@ -1443,10 +1470,8 @@ public static class RelatesTo extends BackboneElement {
 
         private RelatesTo(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            target = ValidationSupport.requireChoiceElement(builder.target, "target", Identifier.class, Reference.class);
-            ValidationSupport.checkReferenceType(target, "target", "Composition");
-            ValidationSupport.requireValueOrChildren(this);
+            code = builder.code;
+            target = builder.target;
         }
 
         /**
@@ -1703,7 +1728,19 @@ public Builder target(Element target) {
              */
             @Override
             public RelatesTo build() {
-                return new RelatesTo(this);
+                RelatesTo relatesTo = new RelatesTo(this);
+                if (validating) {
+                    validate(relatesTo);
+                }
+                return relatesTo;
+            }
+
+            protected void validate(RelatesTo relatesTo) {
+                super.validate(relatesTo);
+                ValidationSupport.requireNonNull(relatesTo.code, "code");
+                ValidationSupport.requireChoiceElement(relatesTo.target, "target", Identifier.class, Reference.class);
+                ValidationSupport.checkReferenceType(relatesTo.target, "target", "Composition");
+                ValidationSupport.requireValueOrChildren(relatesTo);
             }
 
             protected Builder from(RelatesTo relatesTo) {
@@ -1734,10 +1771,9 @@ public static class Event extends BackboneElement {
 
         private Event(Builder builder) {
             super(builder);
-            code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
+            code = Collections.unmodifiableList(builder.code);
             period = builder.period;
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Reference.class));
-            ValidationSupport.requireValueOrChildren(this);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -2053,7 +2089,18 @@ public Builder detail(Collection<Reference> detail) {
              */
             @Override
             public Event build() {
-                return new Event(this);
+                Event event = new Event(this);
+                if (validating) {
+                    validate(event);
+                }
+                return event;
+            }
+
+            protected void validate(Event event) {
+                super.validate(event);
+                ValidationSupport.checkList(event.code, "code", CodeableConcept.class);
+                ValidationSupport.checkList(event.detail, "detail", Reference.class);
+                ValidationSupport.requireValueOrChildren(event);
             }
 
             protected Builder from(Event event) {
@@ -2110,16 +2157,14 @@ private Section(Builder builder) {
             super(builder);
             title = builder.title;
             code = builder.code;
-            author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", Reference.class));
+            author = Collections.unmodifiableList(builder.author);
             focus = builder.focus;
             text = builder.text;
             mode = builder.mode;
             orderedBy = builder.orderedBy;
-            entry = Collections.unmodifiableList(ValidationSupport.checkList(builder.entry, "entry", Reference.class));
+            entry = Collections.unmodifiableList(builder.entry);
             emptyReason = builder.emptyReason;
-            section = Collections.unmodifiableList(ValidationSupport.checkList(builder.section, "section", Composition.Section.class));
-            ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole", "Device", "Patient", "RelatedPerson", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
+            section = Collections.unmodifiableList(builder.section);
         }
 
         /**
@@ -2685,7 +2730,20 @@ public Builder section(Collection<Composition.Section> section) {
              */
             @Override
             public Section build() {
-                return new Section(this);
+                Section section = new Section(this);
+                if (validating) {
+                    validate(section);
+                }
+                return section;
+            }
+
+            protected void validate(Section section) {
+                super.validate(section);
+                ValidationSupport.checkList(section.author, "author", Reference.class);
+                ValidationSupport.checkList(section.entry, "entry", Reference.class);
+                ValidationSupport.checkList(section.section, "section", Composition.Section.class);
+                ValidationSupport.checkReferenceType(section.author, "author", "Practitioner", "PractitionerRole", "Device", "Patient", "RelatedPerson", "Organization");
+                ValidationSupport.requireValueOrChildren(section);
             }
 
             protected Builder from(Section section) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ConceptMap.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ConceptMap.java
index d5de6810ae7..c9b1325cd94 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ConceptMap.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ConceptMap.java
@@ -147,19 +147,19 @@ private ConceptMap(Builder builder) {
         version = builder.version;
         name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         copyright = builder.copyright;
-        source = ValidationSupport.choiceElement(builder.source, "source", Uri.class, Canonical.class);
-        target = ValidationSupport.choiceElement(builder.target, "target", Uri.class, Canonical.class);
-        group = Collections.unmodifiableList(ValidationSupport.checkList(builder.group, "group", Group.class));
+        source = builder.source;
+        target = builder.target;
+        group = Collections.unmodifiableList(builder.group);
     }
 
     /**
@@ -1102,7 +1102,22 @@ public Builder group(Collection<Group> group) {
          */
         @Override
         public ConceptMap build() {
-            return new ConceptMap(this);
+            ConceptMap conceptMap = new ConceptMap(this);
+            if (validating) {
+                validate(conceptMap);
+            }
+            return conceptMap;
+        }
+
+        protected void validate(ConceptMap conceptMap) {
+            super.validate(conceptMap);
+            ValidationSupport.requireNonNull(conceptMap.status, "status");
+            ValidationSupport.checkList(conceptMap.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(conceptMap.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(conceptMap.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.choiceElement(conceptMap.source, "source", Uri.class, Canonical.class);
+            ValidationSupport.choiceElement(conceptMap.target, "target", Uri.class, Canonical.class);
+            ValidationSupport.checkList(conceptMap.group, "group", Group.class);
         }
 
         protected Builder from(ConceptMap conceptMap) {
@@ -1147,9 +1162,8 @@ private Group(Builder builder) {
             sourceVersion = builder.sourceVersion;
             target = builder.target;
             targetVersion = builder.targetVersion;
-            element = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.element, "element", Element.class));
+            element = Collections.unmodifiableList(builder.element);
             unmapped = builder.unmapped;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1532,7 +1546,17 @@ public Builder unmapped(Unmapped unmapped) {
              */
             @Override
             public Group build() {
-                return new Group(this);
+                Group group = new Group(this);
+                if (validating) {
+                    validate(group);
+                }
+                return group;
+            }
+
+            protected void validate(Group group) {
+                super.validate(group);
+                ValidationSupport.checkNonEmptyList(group.element, "element", Element.class);
+                ValidationSupport.requireValueOrChildren(group);
             }
 
             protected Builder from(Group group) {
@@ -1559,8 +1583,7 @@ private Element(Builder builder) {
                 super(builder);
                 code = builder.code;
                 display = builder.display;
-                target = Collections.unmodifiableList(ValidationSupport.checkList(builder.target, "target", Target.class));
-                ValidationSupport.requireValueOrChildren(this);
+                target = Collections.unmodifiableList(builder.target);
             }
 
             /**
@@ -1845,7 +1868,17 @@ public Builder target(Collection<Target> target) {
                  */
                 @Override
                 public Element build() {
-                    return new Element(this);
+                    Element element = new Element(this);
+                    if (validating) {
+                        validate(element);
+                    }
+                    return element;
+                }
+
+                protected void validate(Element element) {
+                    super.validate(element);
+                    ValidationSupport.checkList(element.target, "target", Target.class);
+                    ValidationSupport.requireValueOrChildren(element);
                 }
 
                 protected Builder from(Element element) {
@@ -1879,11 +1912,10 @@ private Target(Builder builder) {
                     super(builder);
                     code = builder.code;
                     display = builder.display;
-                    equivalence = ValidationSupport.requireNonNull(builder.equivalence, "equivalence");
+                    equivalence = builder.equivalence;
                     comment = builder.comment;
-                    dependsOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.dependsOn, "dependsOn", DependsOn.class));
-                    product = Collections.unmodifiableList(ValidationSupport.checkList(builder.product, "product", ConceptMap.Group.Element.Target.DependsOn.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    dependsOn = Collections.unmodifiableList(builder.dependsOn);
+                    product = Collections.unmodifiableList(builder.product);
                 }
 
                 /**
@@ -2293,7 +2325,19 @@ public Builder product(Collection<ConceptMap.Group.Element.Target.DependsOn> pro
                      */
                     @Override
                     public Target build() {
-                        return new Target(this);
+                        Target target = new Target(this);
+                        if (validating) {
+                            validate(target);
+                        }
+                        return target;
+                    }
+
+                    protected void validate(Target target) {
+                        super.validate(target);
+                        ValidationSupport.requireNonNull(target.equivalence, "equivalence");
+                        ValidationSupport.checkList(target.dependsOn, "dependsOn", DependsOn.class);
+                        ValidationSupport.checkList(target.product, "product", ConceptMap.Group.Element.Target.DependsOn.class);
+                        ValidationSupport.requireValueOrChildren(target);
                     }
 
                     protected Builder from(Target target) {
@@ -2322,11 +2366,10 @@ public static class DependsOn extends BackboneElement {
 
                     private DependsOn(Builder builder) {
                         super(builder);
-                        property = ValidationSupport.requireNonNull(builder.property, "property");
+                        property = builder.property;
                         system = builder.system;
-                        value = ValidationSupport.requireNonNull(builder.value, "value");
+                        value = builder.value;
                         display = builder.display;
-                        ValidationSupport.requireValueOrChildren(this);
                     }
 
                     /**
@@ -2634,7 +2677,18 @@ public Builder display(String display) {
                          */
                         @Override
                         public DependsOn build() {
-                            return new DependsOn(this);
+                            DependsOn dependsOn = new DependsOn(this);
+                            if (validating) {
+                                validate(dependsOn);
+                            }
+                            return dependsOn;
+                        }
+
+                        protected void validate(DependsOn dependsOn) {
+                            super.validate(dependsOn);
+                            ValidationSupport.requireNonNull(dependsOn.property, "property");
+                            ValidationSupport.requireNonNull(dependsOn.value, "value");
+                            ValidationSupport.requireValueOrChildren(dependsOn);
                         }
 
                         protected Builder from(DependsOn dependsOn) {
@@ -2669,11 +2723,10 @@ public static class Unmapped extends BackboneElement {
 
             private Unmapped(Builder builder) {
                 super(builder);
-                mode = ValidationSupport.requireNonNull(builder.mode, "mode");
+                mode = builder.mode;
                 code = builder.code;
                 display = builder.display;
                 url = builder.url;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2982,7 +3035,17 @@ public Builder url(Canonical url) {
                  */
                 @Override
                 public Unmapped build() {
-                    return new Unmapped(this);
+                    Unmapped unmapped = new Unmapped(this);
+                    if (validating) {
+                        validate(unmapped);
+                    }
+                    return unmapped;
+                }
+
+                protected void validate(Unmapped unmapped) {
+                    super.validate(unmapped);
+                    ValidationSupport.requireNonNull(unmapped.mode, "mode");
+                    ValidationSupport.requireValueOrChildren(unmapped);
                 }
 
                 protected Builder from(Unmapped unmapped) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Condition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Condition.java
index f56367fa73b..9a41eb52463 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Condition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Condition.java
@@ -179,29 +179,23 @@ public class Condition extends DomainResource {
 
     private Condition(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         clinicalStatus = builder.clinicalStatus;
         verificationStatus = builder.verificationStatus;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        category = Collections.unmodifiableList(builder.category);
         severity = builder.severity;
         code = builder.code;
-        bodySite = Collections.unmodifiableList(ValidationSupport.checkList(builder.bodySite, "bodySite", CodeableConcept.class));
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        bodySite = Collections.unmodifiableList(builder.bodySite);
+        subject = builder.subject;
         encounter = builder.encounter;
-        onset = ValidationSupport.choiceElement(builder.onset, "onset", DateTime.class, Age.class, Period.class, Range.class, String.class);
-        abatement = ValidationSupport.choiceElement(builder.abatement, "abatement", DateTime.class, Age.class, Period.class, Range.class, String.class);
+        onset = builder.onset;
+        abatement = builder.abatement;
         recordedDate = builder.recordedDate;
         recorder = builder.recorder;
         asserter = builder.asserter;
-        stage = Collections.unmodifiableList(ValidationSupport.checkList(builder.stage, "stage", Stage.class));
-        evidence = Collections.unmodifiableList(ValidationSupport.checkList(builder.evidence, "evidence", Evidence.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkValueSetBinding(clinicalStatus, "clinicalStatus", "http://hl7.org/fhir/ValueSet/condition-clinical", "http://terminology.hl7.org/CodeSystem/condition-clinical", "active", "recurrence", "relapse", "inactive", "remission", "resolved");
-        ValidationSupport.checkValueSetBinding(verificationStatus, "verificationStatus", "http://hl7.org/fhir/ValueSet/condition-ver-status", "http://terminology.hl7.org/CodeSystem/condition-ver-status", "unconfirmed", "provisional", "differential", "confirmed", "refuted", "entered-in-error");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(recorder, "recorder", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson");
-        ValidationSupport.checkReferenceType(asserter, "asserter", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson");
+        stage = Collections.unmodifiableList(builder.stage);
+        evidence = Collections.unmodifiableList(builder.evidence);
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -1169,7 +1163,30 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public Condition build() {
-            return new Condition(this);
+            Condition condition = new Condition(this);
+            if (validating) {
+                validate(condition);
+            }
+            return condition;
+        }
+
+        protected void validate(Condition condition) {
+            super.validate(condition);
+            ValidationSupport.checkList(condition.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(condition.category, "category", CodeableConcept.class);
+            ValidationSupport.checkList(condition.bodySite, "bodySite", CodeableConcept.class);
+            ValidationSupport.requireNonNull(condition.subject, "subject");
+            ValidationSupport.choiceElement(condition.onset, "onset", DateTime.class, Age.class, Period.class, Range.class, String.class);
+            ValidationSupport.choiceElement(condition.abatement, "abatement", DateTime.class, Age.class, Period.class, Range.class, String.class);
+            ValidationSupport.checkList(condition.stage, "stage", Stage.class);
+            ValidationSupport.checkList(condition.evidence, "evidence", Evidence.class);
+            ValidationSupport.checkList(condition.note, "note", Annotation.class);
+            ValidationSupport.checkValueSetBinding(condition.clinicalStatus, "clinicalStatus", "http://hl7.org/fhir/ValueSet/condition-clinical", "http://terminology.hl7.org/CodeSystem/condition-clinical", "active", "recurrence", "relapse", "inactive", "remission", "resolved");
+            ValidationSupport.checkValueSetBinding(condition.verificationStatus, "verificationStatus", "http://hl7.org/fhir/ValueSet/condition-ver-status", "http://terminology.hl7.org/CodeSystem/condition-ver-status", "unconfirmed", "provisional", "differential", "confirmed", "refuted", "entered-in-error");
+            ValidationSupport.checkReferenceType(condition.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(condition.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(condition.recorder, "recorder", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson");
+            ValidationSupport.checkReferenceType(condition.asserter, "asserter", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson");
         }
 
         protected Builder from(Condition condition) {
@@ -1219,10 +1236,8 @@ public static class Stage extends BackboneElement {
         private Stage(Builder builder) {
             super(builder);
             summary = builder.summary;
-            assessment = Collections.unmodifiableList(ValidationSupport.checkList(builder.assessment, "assessment", Reference.class));
+            assessment = Collections.unmodifiableList(builder.assessment);
             type = builder.type;
-            ValidationSupport.checkReferenceType(assessment, "assessment", "ClinicalImpression", "DiagnosticReport", "Observation");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1521,7 +1536,18 @@ public Builder type(CodeableConcept type) {
              */
             @Override
             public Stage build() {
-                return new Stage(this);
+                Stage stage = new Stage(this);
+                if (validating) {
+                    validate(stage);
+                }
+                return stage;
+            }
+
+            protected void validate(Stage stage) {
+                super.validate(stage);
+                ValidationSupport.checkList(stage.assessment, "assessment", Reference.class);
+                ValidationSupport.checkReferenceType(stage.assessment, "assessment", "ClinicalImpression", "DiagnosticReport", "Observation");
+                ValidationSupport.requireValueOrChildren(stage);
             }
 
             protected Builder from(Stage stage) {
@@ -1552,9 +1578,8 @@ public static class Evidence extends BackboneElement {
 
         private Evidence(Builder builder) {
             super(builder);
-            code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Reference.class));
-            ValidationSupport.requireValueOrChildren(this);
+            code = Collections.unmodifiableList(builder.code);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -1830,7 +1855,18 @@ public Builder detail(Collection<Reference> detail) {
              */
             @Override
             public Evidence build() {
-                return new Evidence(this);
+                Evidence evidence = new Evidence(this);
+                if (validating) {
+                    validate(evidence);
+                }
+                return evidence;
+            }
+
+            protected void validate(Evidence evidence) {
+                super.validate(evidence);
+                ValidationSupport.checkList(evidence.code, "code", CodeableConcept.class);
+                ValidationSupport.checkList(evidence.detail, "detail", Reference.class);
+                ValidationSupport.requireValueOrChildren(evidence);
             }
 
             protected Builder from(Evidence evidence) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Consent.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Consent.java
index b7385a3b3ba..dc55ea26c1b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Consent.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Consent.java
@@ -207,23 +207,19 @@ public class Consent extends DomainResource {
 
     private Consent(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        scope = ValidationSupport.requireNonNull(builder.scope, "scope");
-        category = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.category, "category", CodeableConcept.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        scope = builder.scope;
+        category = Collections.unmodifiableList(builder.category);
         patient = builder.patient;
         dateTime = builder.dateTime;
-        performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Reference.class));
-        organization = Collections.unmodifiableList(ValidationSupport.checkList(builder.organization, "organization", Reference.class));
-        source = ValidationSupport.choiceElement(builder.source, "source", Attachment.class, Reference.class);
-        policy = Collections.unmodifiableList(ValidationSupport.checkList(builder.policy, "policy", Policy.class));
+        performer = Collections.unmodifiableList(builder.performer);
+        organization = Collections.unmodifiableList(builder.organization);
+        source = builder.source;
+        policy = Collections.unmodifiableList(builder.policy);
         policyRule = builder.policyRule;
-        verification = Collections.unmodifiableList(ValidationSupport.checkList(builder.verification, "verification", Verification.class));
+        verification = Collections.unmodifiableList(builder.verification);
         provision = builder.provision;
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(performer, "performer", "Organization", "Patient", "Practitioner", "RelatedPerson", "PractitionerRole");
-        ValidationSupport.checkReferenceType(organization, "organization", "Organization");
-        ValidationSupport.checkReferenceType(source, "source", "Consent", "DocumentReference", "Contract", "QuestionnaireResponse");
     }
 
     /**
@@ -1089,7 +1085,28 @@ public Builder provision(Provision provision) {
          */
         @Override
         public Consent build() {
-            return new Consent(this);
+            Consent consent = new Consent(this);
+            if (validating) {
+                validate(consent);
+            }
+            return consent;
+        }
+
+        protected void validate(Consent consent) {
+            super.validate(consent);
+            ValidationSupport.checkList(consent.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(consent.status, "status");
+            ValidationSupport.requireNonNull(consent.scope, "scope");
+            ValidationSupport.checkNonEmptyList(consent.category, "category", CodeableConcept.class);
+            ValidationSupport.checkList(consent.performer, "performer", Reference.class);
+            ValidationSupport.checkList(consent.organization, "organization", Reference.class);
+            ValidationSupport.choiceElement(consent.source, "source", Attachment.class, Reference.class);
+            ValidationSupport.checkList(consent.policy, "policy", Policy.class);
+            ValidationSupport.checkList(consent.verification, "verification", Verification.class);
+            ValidationSupport.checkReferenceType(consent.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(consent.performer, "performer", "Organization", "Patient", "Practitioner", "RelatedPerson", "PractitionerRole");
+            ValidationSupport.checkReferenceType(consent.organization, "organization", "Organization");
+            ValidationSupport.checkReferenceType(consent.source, "source", "Consent", "DocumentReference", "Contract", "QuestionnaireResponse");
         }
 
         protected Builder from(Consent consent) {
@@ -1123,7 +1140,6 @@ private Policy(Builder builder) {
             super(builder);
             authority = builder.authority;
             uri = builder.uri;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1363,7 +1379,16 @@ public Builder uri(Uri uri) {
              */
             @Override
             public Policy build() {
-                return new Policy(this);
+                Policy policy = new Policy(this);
+                if (validating) {
+                    validate(policy);
+                }
+                return policy;
+            }
+
+            protected void validate(Policy policy) {
+                super.validate(policy);
+                ValidationSupport.requireValueOrChildren(policy);
             }
 
             protected Builder from(Policy policy) {
@@ -1389,11 +1414,9 @@ public static class Verification extends BackboneElement {
 
         private Verification(Builder builder) {
             super(builder);
-            verified = ValidationSupport.requireNonNull(builder.verified, "verified");
+            verified = builder.verified;
             verifiedWith = builder.verifiedWith;
             verificationDate = builder.verificationDate;
-            ValidationSupport.checkReferenceType(verifiedWith, "verifiedWith", "Patient", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1671,7 +1694,18 @@ public Builder verificationDate(DateTime verificationDate) {
              */
             @Override
             public Verification build() {
-                return new Verification(this);
+                Verification verification = new Verification(this);
+                if (validating) {
+                    validate(verification);
+                }
+                return verification;
+            }
+
+            protected void validate(Verification verification) {
+                super.validate(verification);
+                ValidationSupport.requireNonNull(verification.verified, "verified");
+                ValidationSupport.checkReferenceType(verification.verifiedWith, "verifiedWith", "Patient", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(verification);
             }
 
             protected Builder from(Verification verification) {
@@ -1749,16 +1783,15 @@ private Provision(Builder builder) {
             super(builder);
             type = builder.type;
             period = builder.period;
-            actor = Collections.unmodifiableList(ValidationSupport.checkList(builder.actor, "actor", Actor.class));
-            action = Collections.unmodifiableList(ValidationSupport.checkList(builder.action, "action", CodeableConcept.class));
-            securityLabel = Collections.unmodifiableList(ValidationSupport.checkList(builder.securityLabel, "securityLabel", Coding.class));
-            purpose = Collections.unmodifiableList(ValidationSupport.checkList(builder.purpose, "purpose", Coding.class));
-            clazz = Collections.unmodifiableList(ValidationSupport.checkList(builder.clazz, "class", Coding.class));
-            code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
+            actor = Collections.unmodifiableList(builder.actor);
+            action = Collections.unmodifiableList(builder.action);
+            securityLabel = Collections.unmodifiableList(builder.securityLabel);
+            purpose = Collections.unmodifiableList(builder.purpose);
+            clazz = Collections.unmodifiableList(builder.clazz);
+            code = Collections.unmodifiableList(builder.code);
             dataPeriod = builder.dataPeriod;
-            data = Collections.unmodifiableList(ValidationSupport.checkList(builder.data, "data", Data.class));
-            provision = Collections.unmodifiableList(ValidationSupport.checkList(builder.provision, "provision", Consent.Provision.class));
-            ValidationSupport.requireValueOrChildren(this);
+            data = Collections.unmodifiableList(builder.data);
+            provision = Collections.unmodifiableList(builder.provision);
         }
 
         /**
@@ -2426,7 +2459,24 @@ public Builder provision(Collection<Consent.Provision> provision) {
              */
             @Override
             public Provision build() {
-                return new Provision(this);
+                Provision provision = new Provision(this);
+                if (validating) {
+                    validate(provision);
+                }
+                return provision;
+            }
+
+            protected void validate(Provision provision) {
+                super.validate(provision);
+                ValidationSupport.checkList(provision.actor, "actor", Actor.class);
+                ValidationSupport.checkList(provision.action, "action", CodeableConcept.class);
+                ValidationSupport.checkList(provision.securityLabel, "securityLabel", Coding.class);
+                ValidationSupport.checkList(provision.purpose, "purpose", Coding.class);
+                ValidationSupport.checkList(provision.clazz, "class", Coding.class);
+                ValidationSupport.checkList(provision.code, "code", CodeableConcept.class);
+                ValidationSupport.checkList(provision.data, "data", Data.class);
+                ValidationSupport.checkList(provision.provision, "provision", Consent.Provision.class);
+                ValidationSupport.requireValueOrChildren(provision);
             }
 
             protected Builder from(Provision provision) {
@@ -2465,10 +2515,8 @@ public static class Actor extends BackboneElement {
 
             private Actor(Builder builder) {
                 super(builder);
-                role = ValidationSupport.requireNonNull(builder.role, "role");
-                reference = ValidationSupport.requireNonNull(builder.reference, "reference");
-                ValidationSupport.checkReferenceType(reference, "reference", "Device", "Group", "CareTeam", "Organization", "Patient", "Practitioner", "RelatedPerson", "PractitionerRole");
-                ValidationSupport.requireValueOrChildren(this);
+                role = builder.role;
+                reference = builder.reference;
             }
 
             /**
@@ -2728,7 +2776,19 @@ public Builder reference(Reference reference) {
                  */
                 @Override
                 public Actor build() {
-                    return new Actor(this);
+                    Actor actor = new Actor(this);
+                    if (validating) {
+                        validate(actor);
+                    }
+                    return actor;
+                }
+
+                protected void validate(Actor actor) {
+                    super.validate(actor);
+                    ValidationSupport.requireNonNull(actor.role, "role");
+                    ValidationSupport.requireNonNull(actor.reference, "reference");
+                    ValidationSupport.checkReferenceType(actor.reference, "reference", "Device", "Group", "CareTeam", "Organization", "Patient", "Practitioner", "RelatedPerson", "PractitionerRole");
+                    ValidationSupport.requireValueOrChildren(actor);
                 }
 
                 protected Builder from(Actor actor) {
@@ -2759,9 +2819,8 @@ public static class Data extends BackboneElement {
 
             private Data(Builder builder) {
                 super(builder);
-                meaning = ValidationSupport.requireNonNull(builder.meaning, "meaning");
-                reference = ValidationSupport.requireNonNull(builder.reference, "reference");
-                ValidationSupport.requireValueOrChildren(this);
+                meaning = builder.meaning;
+                reference = builder.reference;
             }
 
             /**
@@ -3007,7 +3066,18 @@ public Builder reference(Reference reference) {
                  */
                 @Override
                 public Data build() {
-                    return new Data(this);
+                    Data data = new Data(this);
+                    if (validating) {
+                        validate(data);
+                    }
+                    return data;
+                }
+
+                protected void validate(Data data) {
+                    super.validate(data);
+                    ValidationSupport.requireNonNull(data.meaning, "meaning");
+                    ValidationSupport.requireNonNull(data.reference, "reference");
+                    ValidationSupport.requireValueOrChildren(data);
                 }
 
                 protected Builder from(Data data) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Contract.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Contract.java
index 9f62649da4e..5af1d3f4be2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Contract.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Contract.java
@@ -196,7 +196,7 @@ public class Contract extends DomainResource {
 
     private Contract(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         url = builder.url;
         version = builder.version;
         status = builder.status;
@@ -207,35 +207,28 @@ private Contract(Builder builder) {
         issued = builder.issued;
         applies = builder.applies;
         expirationType = builder.expirationType;
-        subject = Collections.unmodifiableList(ValidationSupport.checkList(builder.subject, "subject", Reference.class));
-        authority = Collections.unmodifiableList(ValidationSupport.checkList(builder.authority, "authority", Reference.class));
-        domain = Collections.unmodifiableList(ValidationSupport.checkList(builder.domain, "domain", Reference.class));
-        site = Collections.unmodifiableList(ValidationSupport.checkList(builder.site, "site", Reference.class));
+        subject = Collections.unmodifiableList(builder.subject);
+        authority = Collections.unmodifiableList(builder.authority);
+        domain = Collections.unmodifiableList(builder.domain);
+        site = Collections.unmodifiableList(builder.site);
         name = builder.name;
         title = builder.title;
         subtitle = builder.subtitle;
-        alias = Collections.unmodifiableList(ValidationSupport.checkList(builder.alias, "alias", String.class));
+        alias = Collections.unmodifiableList(builder.alias);
         author = builder.author;
         scope = builder.scope;
-        topic = ValidationSupport.choiceElement(builder.topic, "topic", CodeableConcept.class, Reference.class);
+        topic = builder.topic;
         type = builder.type;
-        subType = Collections.unmodifiableList(ValidationSupport.checkList(builder.subType, "subType", CodeableConcept.class));
+        subType = Collections.unmodifiableList(builder.subType);
         contentDefinition = builder.contentDefinition;
-        term = Collections.unmodifiableList(ValidationSupport.checkList(builder.term, "term", Term.class));
-        supportingInfo = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInfo, "supportingInfo", Reference.class));
-        relevantHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.relevantHistory, "relevantHistory", Reference.class));
-        signer = Collections.unmodifiableList(ValidationSupport.checkList(builder.signer, "signer", Signer.class));
-        friendly = Collections.unmodifiableList(ValidationSupport.checkList(builder.friendly, "friendly", Friendly.class));
-        legal = Collections.unmodifiableList(ValidationSupport.checkList(builder.legal, "legal", Legal.class));
-        rule = Collections.unmodifiableList(ValidationSupport.checkList(builder.rule, "rule", Rule.class));
-        legallyBinding = ValidationSupport.choiceElement(builder.legallyBinding, "legallyBinding", Attachment.class, Reference.class);
-        ValidationSupport.checkReferenceType(instantiatesCanonical, "instantiatesCanonical", "Contract");
-        ValidationSupport.checkReferenceType(authority, "authority", "Organization");
-        ValidationSupport.checkReferenceType(domain, "domain", "Location");
-        ValidationSupport.checkReferenceType(site, "site", "Location");
-        ValidationSupport.checkReferenceType(author, "author", "Patient", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(relevantHistory, "relevantHistory", "Provenance");
-        ValidationSupport.checkReferenceType(legallyBinding, "legallyBinding", "Composition", "DocumentReference", "QuestionnaireResponse", "Contract");
+        term = Collections.unmodifiableList(builder.term);
+        supportingInfo = Collections.unmodifiableList(builder.supportingInfo);
+        relevantHistory = Collections.unmodifiableList(builder.relevantHistory);
+        signer = Collections.unmodifiableList(builder.signer);
+        friendly = Collections.unmodifiableList(builder.friendly);
+        legal = Collections.unmodifiableList(builder.legal);
+        rule = Collections.unmodifiableList(builder.rule);
+        legallyBinding = builder.legallyBinding;
     }
 
     /**
@@ -1896,7 +1889,38 @@ public Builder legallyBinding(Element legallyBinding) {
          */
         @Override
         public Contract build() {
-            return new Contract(this);
+            Contract contract = new Contract(this);
+            if (validating) {
+                validate(contract);
+            }
+            return contract;
+        }
+
+        protected void validate(Contract contract) {
+            super.validate(contract);
+            ValidationSupport.checkList(contract.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(contract.subject, "subject", Reference.class);
+            ValidationSupport.checkList(contract.authority, "authority", Reference.class);
+            ValidationSupport.checkList(contract.domain, "domain", Reference.class);
+            ValidationSupport.checkList(contract.site, "site", Reference.class);
+            ValidationSupport.checkList(contract.alias, "alias", String.class);
+            ValidationSupport.choiceElement(contract.topic, "topic", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(contract.subType, "subType", CodeableConcept.class);
+            ValidationSupport.checkList(contract.term, "term", Term.class);
+            ValidationSupport.checkList(contract.supportingInfo, "supportingInfo", Reference.class);
+            ValidationSupport.checkList(contract.relevantHistory, "relevantHistory", Reference.class);
+            ValidationSupport.checkList(contract.signer, "signer", Signer.class);
+            ValidationSupport.checkList(contract.friendly, "friendly", Friendly.class);
+            ValidationSupport.checkList(contract.legal, "legal", Legal.class);
+            ValidationSupport.checkList(contract.rule, "rule", Rule.class);
+            ValidationSupport.choiceElement(contract.legallyBinding, "legallyBinding", Attachment.class, Reference.class);
+            ValidationSupport.checkReferenceType(contract.instantiatesCanonical, "instantiatesCanonical", "Contract");
+            ValidationSupport.checkReferenceType(contract.authority, "authority", "Organization");
+            ValidationSupport.checkReferenceType(contract.domain, "domain", "Location");
+            ValidationSupport.checkReferenceType(contract.site, "site", "Location");
+            ValidationSupport.checkReferenceType(contract.author, "author", "Patient", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(contract.relevantHistory, "relevantHistory", "Provenance");
+            ValidationSupport.checkReferenceType(contract.legallyBinding, "legallyBinding", "Composition", "DocumentReference", "QuestionnaireResponse", "Contract");
         }
 
         protected Builder from(Contract contract) {
@@ -1973,14 +1997,12 @@ public static class ContentDefinition extends BackboneElement {
 
         private ContentDefinition(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            type = builder.type;
             subType = builder.subType;
             publisher = builder.publisher;
             publicationDate = builder.publicationDate;
-            publicationStatus = ValidationSupport.requireNonNull(builder.publicationStatus, "publicationStatus");
+            publicationStatus = builder.publicationStatus;
             copyright = builder.copyright;
-            ValidationSupport.checkReferenceType(publisher, "publisher", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2360,7 +2382,19 @@ public Builder copyright(Markdown copyright) {
              */
             @Override
             public ContentDefinition build() {
-                return new ContentDefinition(this);
+                ContentDefinition contentDefinition = new ContentDefinition(this);
+                if (validating) {
+                    validate(contentDefinition);
+                }
+                return contentDefinition;
+            }
+
+            protected void validate(ContentDefinition contentDefinition) {
+                super.validate(contentDefinition);
+                ValidationSupport.requireNonNull(contentDefinition.type, "type");
+                ValidationSupport.requireNonNull(contentDefinition.publicationStatus, "publicationStatus");
+                ValidationSupport.checkReferenceType(contentDefinition.publisher, "publisher", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.requireValueOrChildren(contentDefinition);
             }
 
             protected Builder from(ContentDefinition contentDefinition) {
@@ -2416,16 +2450,15 @@ private Term(Builder builder) {
             identifier = builder.identifier;
             issued = builder.issued;
             applies = builder.applies;
-            topic = ValidationSupport.choiceElement(builder.topic, "topic", CodeableConcept.class, Reference.class);
+            topic = builder.topic;
             type = builder.type;
             subType = builder.subType;
             text = builder.text;
-            securityLabel = Collections.unmodifiableList(ValidationSupport.checkList(builder.securityLabel, "securityLabel", SecurityLabel.class));
-            offer = ValidationSupport.requireNonNull(builder.offer, "offer");
-            asset = Collections.unmodifiableList(ValidationSupport.checkList(builder.asset, "asset", Asset.class));
-            action = Collections.unmodifiableList(ValidationSupport.checkList(builder.action, "action", Action.class));
-            group = Collections.unmodifiableList(ValidationSupport.checkList(builder.group, "group", Contract.Term.class));
-            ValidationSupport.requireValueOrChildren(this);
+            securityLabel = Collections.unmodifiableList(builder.securityLabel);
+            offer = builder.offer;
+            asset = Collections.unmodifiableList(builder.asset);
+            action = Collections.unmodifiableList(builder.action);
+            group = Collections.unmodifiableList(builder.group);
         }
 
         /**
@@ -3054,7 +3087,22 @@ public Builder group(Collection<Contract.Term> group) {
              */
             @Override
             public Term build() {
-                return new Term(this);
+                Term term = new Term(this);
+                if (validating) {
+                    validate(term);
+                }
+                return term;
+            }
+
+            protected void validate(Term term) {
+                super.validate(term);
+                ValidationSupport.choiceElement(term.topic, "topic", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkList(term.securityLabel, "securityLabel", SecurityLabel.class);
+                ValidationSupport.requireNonNull(term.offer, "offer");
+                ValidationSupport.checkList(term.asset, "asset", Asset.class);
+                ValidationSupport.checkList(term.action, "action", Action.class);
+                ValidationSupport.checkList(term.group, "group", Contract.Term.class);
+                ValidationSupport.requireValueOrChildren(term);
             }
 
             protected Builder from(Term term) {
@@ -3106,11 +3154,10 @@ public static class SecurityLabel extends BackboneElement {
 
             private SecurityLabel(Builder builder) {
                 super(builder);
-                number = Collections.unmodifiableList(ValidationSupport.checkList(builder.number, "number", UnsignedInt.class));
-                classification = ValidationSupport.requireNonNull(builder.classification, "classification");
-                category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", Coding.class));
-                control = Collections.unmodifiableList(ValidationSupport.checkList(builder.control, "control", Coding.class));
-                ValidationSupport.requireValueOrChildren(this);
+                number = Collections.unmodifiableList(builder.number);
+                classification = builder.classification;
+                category = Collections.unmodifiableList(builder.category);
+                control = Collections.unmodifiableList(builder.control);
             }
 
             /**
@@ -3476,7 +3523,20 @@ public Builder control(Collection<Coding> control) {
                  */
                 @Override
                 public SecurityLabel build() {
-                    return new SecurityLabel(this);
+                    SecurityLabel securityLabel = new SecurityLabel(this);
+                    if (validating) {
+                        validate(securityLabel);
+                    }
+                    return securityLabel;
+                }
+
+                protected void validate(SecurityLabel securityLabel) {
+                    super.validate(securityLabel);
+                    ValidationSupport.checkList(securityLabel.number, "number", UnsignedInt.class);
+                    ValidationSupport.requireNonNull(securityLabel.classification, "classification");
+                    ValidationSupport.checkList(securityLabel.category, "category", Coding.class);
+                    ValidationSupport.checkList(securityLabel.control, "control", Coding.class);
+                    ValidationSupport.requireValueOrChildren(securityLabel);
                 }
 
                 protected Builder from(SecurityLabel securityLabel) {
@@ -3526,17 +3586,16 @@ public static class Offer extends BackboneElement {
 
             private Offer(Builder builder) {
                 super(builder);
-                identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-                party = Collections.unmodifiableList(ValidationSupport.checkList(builder.party, "party", Party.class));
+                identifier = Collections.unmodifiableList(builder.identifier);
+                party = Collections.unmodifiableList(builder.party);
                 topic = builder.topic;
                 type = builder.type;
                 decision = builder.decision;
-                decisionMode = Collections.unmodifiableList(ValidationSupport.checkList(builder.decisionMode, "decisionMode", CodeableConcept.class));
-                answer = Collections.unmodifiableList(ValidationSupport.checkList(builder.answer, "answer", Answer.class));
+                decisionMode = Collections.unmodifiableList(builder.decisionMode);
+                answer = Collections.unmodifiableList(builder.answer);
                 text = builder.text;
-                linkId = Collections.unmodifiableList(ValidationSupport.checkList(builder.linkId, "linkId", String.class));
-                securityLabelNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.securityLabelNumber, "securityLabelNumber", UnsignedInt.class));
-                ValidationSupport.requireValueOrChildren(this);
+                linkId = Collections.unmodifiableList(builder.linkId);
+                securityLabelNumber = Collections.unmodifiableList(builder.securityLabelNumber);
             }
 
             /**
@@ -4128,7 +4187,22 @@ public Builder securityLabelNumber(Collection<UnsignedInt> securityLabelNumber)
                  */
                 @Override
                 public Offer build() {
-                    return new Offer(this);
+                    Offer offer = new Offer(this);
+                    if (validating) {
+                        validate(offer);
+                    }
+                    return offer;
+                }
+
+                protected void validate(Offer offer) {
+                    super.validate(offer);
+                    ValidationSupport.checkList(offer.identifier, "identifier", Identifier.class);
+                    ValidationSupport.checkList(offer.party, "party", Party.class);
+                    ValidationSupport.checkList(offer.decisionMode, "decisionMode", CodeableConcept.class);
+                    ValidationSupport.checkList(offer.answer, "answer", Answer.class);
+                    ValidationSupport.checkList(offer.linkId, "linkId", String.class);
+                    ValidationSupport.checkList(offer.securityLabelNumber, "securityLabelNumber", UnsignedInt.class);
+                    ValidationSupport.requireValueOrChildren(offer);
                 }
 
                 protected Builder from(Offer offer) {
@@ -4165,10 +4239,8 @@ public static class Party extends BackboneElement {
 
                 private Party(Builder builder) {
                     super(builder);
-                    reference = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.reference, "reference", Reference.class));
-                    role = ValidationSupport.requireNonNull(builder.role, "role");
-                    ValidationSupport.checkReferenceType(reference, "reference", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole", "Device", "Group", "Organization");
-                    ValidationSupport.requireValueOrChildren(this);
+                    reference = Collections.unmodifiableList(builder.reference);
+                    role = builder.role;
                 }
 
                 /**
@@ -4458,7 +4530,19 @@ public Builder role(CodeableConcept role) {
                      */
                     @Override
                     public Party build() {
-                        return new Party(this);
+                        Party party = new Party(this);
+                        if (validating) {
+                            validate(party);
+                        }
+                        return party;
+                    }
+
+                    protected void validate(Party party) {
+                        super.validate(party);
+                        ValidationSupport.checkNonEmptyList(party.reference, "reference", Reference.class);
+                        ValidationSupport.requireNonNull(party.role, "role");
+                        ValidationSupport.checkReferenceType(party.reference, "reference", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole", "Device", "Group", "Organization");
+                        ValidationSupport.requireValueOrChildren(party);
                     }
 
                     protected Builder from(Party party) {
@@ -4480,8 +4564,7 @@ public static class Answer extends BackboneElement {
 
                 private Answer(Builder builder) {
                     super(builder);
-                    value = ValidationSupport.requireChoiceElement(builder.value, "value", Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Uri.class, Attachment.class, Coding.class, Quantity.class, Reference.class);
-                    ValidationSupport.requireValueOrChildren(this);
+                    value = builder.value;
                 }
 
                 /**
@@ -4715,7 +4798,17 @@ public Builder value(Element value) {
                      */
                     @Override
                     public Answer build() {
-                        return new Answer(this);
+                        Answer answer = new Answer(this);
+                        if (validating) {
+                            validate(answer);
+                        }
+                        return answer;
+                    }
+
+                    protected void validate(Answer answer) {
+                        super.validate(answer);
+                        ValidationSupport.requireChoiceElement(answer.value, "value", Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Uri.class, Attachment.class, Coding.class, Quantity.class, Reference.class);
+                        ValidationSupport.requireValueOrChildren(answer);
                     }
 
                     protected Builder from(Answer answer) {
@@ -4780,21 +4873,20 @@ public static class Asset extends BackboneElement {
             private Asset(Builder builder) {
                 super(builder);
                 scope = builder.scope;
-                type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
-                typeReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.typeReference, "typeReference", Reference.class));
-                subtype = Collections.unmodifiableList(ValidationSupport.checkList(builder.subtype, "subtype", CodeableConcept.class));
+                type = Collections.unmodifiableList(builder.type);
+                typeReference = Collections.unmodifiableList(builder.typeReference);
+                subtype = Collections.unmodifiableList(builder.subtype);
                 relationship = builder.relationship;
-                context = Collections.unmodifiableList(ValidationSupport.checkList(builder.context, "context", Context.class));
+                context = Collections.unmodifiableList(builder.context);
                 condition = builder.condition;
-                periodType = Collections.unmodifiableList(ValidationSupport.checkList(builder.periodType, "periodType", CodeableConcept.class));
-                period = Collections.unmodifiableList(ValidationSupport.checkList(builder.period, "period", Period.class));
-                usePeriod = Collections.unmodifiableList(ValidationSupport.checkList(builder.usePeriod, "usePeriod", Period.class));
+                periodType = Collections.unmodifiableList(builder.periodType);
+                period = Collections.unmodifiableList(builder.period);
+                usePeriod = Collections.unmodifiableList(builder.usePeriod);
                 text = builder.text;
-                linkId = Collections.unmodifiableList(ValidationSupport.checkList(builder.linkId, "linkId", String.class));
-                answer = Collections.unmodifiableList(ValidationSupport.checkList(builder.answer, "answer", Contract.Term.Offer.Answer.class));
-                securityLabelNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.securityLabelNumber, "securityLabelNumber", UnsignedInt.class));
-                valuedItem = Collections.unmodifiableList(ValidationSupport.checkList(builder.valuedItem, "valuedItem", ValuedItem.class));
-                ValidationSupport.requireValueOrChildren(this);
+                linkId = Collections.unmodifiableList(builder.linkId);
+                answer = Collections.unmodifiableList(builder.answer);
+                securityLabelNumber = Collections.unmodifiableList(builder.securityLabelNumber);
+                valuedItem = Collections.unmodifiableList(builder.valuedItem);
             }
 
             /**
@@ -5631,7 +5723,27 @@ public Builder valuedItem(Collection<ValuedItem> valuedItem) {
                  */
                 @Override
                 public Asset build() {
-                    return new Asset(this);
+                    Asset asset = new Asset(this);
+                    if (validating) {
+                        validate(asset);
+                    }
+                    return asset;
+                }
+
+                protected void validate(Asset asset) {
+                    super.validate(asset);
+                    ValidationSupport.checkList(asset.type, "type", CodeableConcept.class);
+                    ValidationSupport.checkList(asset.typeReference, "typeReference", Reference.class);
+                    ValidationSupport.checkList(asset.subtype, "subtype", CodeableConcept.class);
+                    ValidationSupport.checkList(asset.context, "context", Context.class);
+                    ValidationSupport.checkList(asset.periodType, "periodType", CodeableConcept.class);
+                    ValidationSupport.checkList(asset.period, "period", Period.class);
+                    ValidationSupport.checkList(asset.usePeriod, "usePeriod", Period.class);
+                    ValidationSupport.checkList(asset.linkId, "linkId", String.class);
+                    ValidationSupport.checkList(asset.answer, "answer", Contract.Term.Offer.Answer.class);
+                    ValidationSupport.checkList(asset.securityLabelNumber, "securityLabelNumber", UnsignedInt.class);
+                    ValidationSupport.checkList(asset.valuedItem, "valuedItem", ValuedItem.class);
+                    ValidationSupport.requireValueOrChildren(asset);
                 }
 
                 protected Builder from(Asset asset) {
@@ -5672,9 +5784,8 @@ public static class Context extends BackboneElement {
                 private Context(Builder builder) {
                     super(builder);
                     reference = builder.reference;
-                    code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
+                    code = Collections.unmodifiableList(builder.code);
                     text = builder.text;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -5961,7 +6072,17 @@ public Builder text(String text) {
                      */
                     @Override
                     public Context build() {
-                        return new Context(this);
+                        Context context = new Context(this);
+                        if (validating) {
+                            validate(context);
+                        }
+                        return context;
+                    }
+
+                    protected void validate(Context context) {
+                        super.validate(context);
+                        ValidationSupport.checkList(context.code, "code", CodeableConcept.class);
+                        ValidationSupport.requireValueOrChildren(context);
                     }
 
                     protected Builder from(Context context) {
@@ -5998,7 +6119,7 @@ public static class ValuedItem extends BackboneElement {
 
                 private ValuedItem(Builder builder) {
                     super(builder);
-                    entity = ValidationSupport.choiceElement(builder.entity, "entity", CodeableConcept.class, Reference.class);
+                    entity = builder.entity;
                     identifier = builder.identifier;
                     effectiveTime = builder.effectiveTime;
                     quantity = builder.quantity;
@@ -6010,11 +6131,8 @@ private ValuedItem(Builder builder) {
                     paymentDate = builder.paymentDate;
                     responsible = builder.responsible;
                     recipient = builder.recipient;
-                    linkId = Collections.unmodifiableList(ValidationSupport.checkList(builder.linkId, "linkId", String.class));
-                    securityLabelNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.securityLabelNumber, "securityLabelNumber", UnsignedInt.class));
-                    ValidationSupport.checkReferenceType(responsible, "responsible", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
-                    ValidationSupport.checkReferenceType(recipient, "recipient", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
-                    ValidationSupport.requireValueOrChildren(this);
+                    linkId = Collections.unmodifiableList(builder.linkId);
+                    securityLabelNumber = Collections.unmodifiableList(builder.securityLabelNumber);
                 }
 
                 /**
@@ -6677,7 +6795,21 @@ public Builder securityLabelNumber(Collection<UnsignedInt> securityLabelNumber)
                      */
                     @Override
                     public ValuedItem build() {
-                        return new ValuedItem(this);
+                        ValuedItem valuedItem = new ValuedItem(this);
+                        if (validating) {
+                            validate(valuedItem);
+                        }
+                        return valuedItem;
+                    }
+
+                    protected void validate(ValuedItem valuedItem) {
+                        super.validate(valuedItem);
+                        ValidationSupport.choiceElement(valuedItem.entity, "entity", CodeableConcept.class, Reference.class);
+                        ValidationSupport.checkList(valuedItem.linkId, "linkId", String.class);
+                        ValidationSupport.checkList(valuedItem.securityLabelNumber, "securityLabelNumber", UnsignedInt.class);
+                        ValidationSupport.checkReferenceType(valuedItem.responsible, "responsible", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
+                        ValidationSupport.checkReferenceType(valuedItem.recipient, "recipient", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
+                        ValidationSupport.requireValueOrChildren(valuedItem);
                     }
 
                     protected Builder from(ValuedItem valuedItem) {
@@ -6776,31 +6908,26 @@ public static class Action extends BackboneElement {
             private Action(Builder builder) {
                 super(builder);
                 doNotPerform = builder.doNotPerform;
-                type = ValidationSupport.requireNonNull(builder.type, "type");
-                subject = Collections.unmodifiableList(ValidationSupport.checkList(builder.subject, "subject", Subject.class));
-                intent = ValidationSupport.requireNonNull(builder.intent, "intent");
-                linkId = Collections.unmodifiableList(ValidationSupport.checkList(builder.linkId, "linkId", String.class));
-                status = ValidationSupport.requireNonNull(builder.status, "status");
+                type = builder.type;
+                subject = Collections.unmodifiableList(builder.subject);
+                intent = builder.intent;
+                linkId = Collections.unmodifiableList(builder.linkId);
+                status = builder.status;
                 context = builder.context;
-                contextLinkId = Collections.unmodifiableList(ValidationSupport.checkList(builder.contextLinkId, "contextLinkId", String.class));
-                occurrence = ValidationSupport.choiceElement(builder.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
-                requester = Collections.unmodifiableList(ValidationSupport.checkList(builder.requester, "requester", Reference.class));
-                requesterLinkId = Collections.unmodifiableList(ValidationSupport.checkList(builder.requesterLinkId, "requesterLinkId", String.class));
-                performerType = Collections.unmodifiableList(ValidationSupport.checkList(builder.performerType, "performerType", CodeableConcept.class));
+                contextLinkId = Collections.unmodifiableList(builder.contextLinkId);
+                occurrence = builder.occurrence;
+                requester = Collections.unmodifiableList(builder.requester);
+                requesterLinkId = Collections.unmodifiableList(builder.requesterLinkId);
+                performerType = Collections.unmodifiableList(builder.performerType);
                 performerRole = builder.performerRole;
                 performer = builder.performer;
-                performerLinkId = Collections.unmodifiableList(ValidationSupport.checkList(builder.performerLinkId, "performerLinkId", String.class));
-                reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-                reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-                reason = Collections.unmodifiableList(ValidationSupport.checkList(builder.reason, "reason", String.class));
-                reasonLinkId = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonLinkId, "reasonLinkId", String.class));
-                note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-                securityLabelNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.securityLabelNumber, "securityLabelNumber", UnsignedInt.class));
-                ValidationSupport.checkReferenceType(context, "context", "Encounter", "EpisodeOfCare");
-                ValidationSupport.checkReferenceType(requester, "requester", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole", "Device", "Group", "Organization");
-                ValidationSupport.checkReferenceType(performer, "performer", "RelatedPerson", "Patient", "Practitioner", "PractitionerRole", "CareTeam", "Device", "Substance", "Organization", "Location");
-                ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference", "Questionnaire", "QuestionnaireResponse");
-                ValidationSupport.requireValueOrChildren(this);
+                performerLinkId = Collections.unmodifiableList(builder.performerLinkId);
+                reasonCode = Collections.unmodifiableList(builder.reasonCode);
+                reasonReference = Collections.unmodifiableList(builder.reasonReference);
+                reason = Collections.unmodifiableList(builder.reason);
+                reasonLinkId = Collections.unmodifiableList(builder.reasonLinkId);
+                note = Collections.unmodifiableList(builder.note);
+                securityLabelNumber = Collections.unmodifiableList(builder.securityLabelNumber);
             }
 
             /**
@@ -7945,7 +8072,37 @@ public Builder securityLabelNumber(Collection<UnsignedInt> securityLabelNumber)
                  */
                 @Override
                 public Action build() {
-                    return new Action(this);
+                    Action action = new Action(this);
+                    if (validating) {
+                        validate(action);
+                    }
+                    return action;
+                }
+
+                protected void validate(Action action) {
+                    super.validate(action);
+                    ValidationSupport.requireNonNull(action.type, "type");
+                    ValidationSupport.checkList(action.subject, "subject", Subject.class);
+                    ValidationSupport.requireNonNull(action.intent, "intent");
+                    ValidationSupport.checkList(action.linkId, "linkId", String.class);
+                    ValidationSupport.requireNonNull(action.status, "status");
+                    ValidationSupport.checkList(action.contextLinkId, "contextLinkId", String.class);
+                    ValidationSupport.choiceElement(action.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
+                    ValidationSupport.checkList(action.requester, "requester", Reference.class);
+                    ValidationSupport.checkList(action.requesterLinkId, "requesterLinkId", String.class);
+                    ValidationSupport.checkList(action.performerType, "performerType", CodeableConcept.class);
+                    ValidationSupport.checkList(action.performerLinkId, "performerLinkId", String.class);
+                    ValidationSupport.checkList(action.reasonCode, "reasonCode", CodeableConcept.class);
+                    ValidationSupport.checkList(action.reasonReference, "reasonReference", Reference.class);
+                    ValidationSupport.checkList(action.reason, "reason", String.class);
+                    ValidationSupport.checkList(action.reasonLinkId, "reasonLinkId", String.class);
+                    ValidationSupport.checkList(action.note, "note", Annotation.class);
+                    ValidationSupport.checkList(action.securityLabelNumber, "securityLabelNumber", UnsignedInt.class);
+                    ValidationSupport.checkReferenceType(action.context, "context", "Encounter", "EpisodeOfCare");
+                    ValidationSupport.checkReferenceType(action.requester, "requester", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole", "Device", "Group", "Organization");
+                    ValidationSupport.checkReferenceType(action.performer, "performer", "RelatedPerson", "Patient", "Practitioner", "PractitionerRole", "CareTeam", "Device", "Substance", "Organization", "Location");
+                    ValidationSupport.checkReferenceType(action.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference", "Questionnaire", "QuestionnaireResponse");
+                    ValidationSupport.requireValueOrChildren(action);
                 }
 
                 protected Builder from(Action action) {
@@ -7992,10 +8149,8 @@ public static class Subject extends BackboneElement {
 
                 private Subject(Builder builder) {
                     super(builder);
-                    reference = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.reference, "reference", Reference.class));
+                    reference = Collections.unmodifiableList(builder.reference);
                     role = builder.role;
-                    ValidationSupport.checkReferenceType(reference, "reference", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole", "Device", "Group", "Organization");
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -8282,7 +8437,18 @@ public Builder role(CodeableConcept role) {
                      */
                     @Override
                     public Subject build() {
-                        return new Subject(this);
+                        Subject subject = new Subject(this);
+                        if (validating) {
+                            validate(subject);
+                        }
+                        return subject;
+                    }
+
+                    protected void validate(Subject subject) {
+                        super.validate(subject);
+                        ValidationSupport.checkNonEmptyList(subject.reference, "reference", Reference.class);
+                        ValidationSupport.checkReferenceType(subject.reference, "reference", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole", "Device", "Group", "Organization");
+                        ValidationSupport.requireValueOrChildren(subject);
                     }
 
                     protected Builder from(Subject subject) {
@@ -8318,11 +8484,9 @@ public static class Signer extends BackboneElement {
 
         private Signer(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            party = ValidationSupport.requireNonNull(builder.party, "party");
-            signature = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.signature, "signature", Signature.class));
-            ValidationSupport.checkReferenceType(party, "party", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            party = builder.party;
+            signature = Collections.unmodifiableList(builder.signature);
         }
 
         /**
@@ -8631,7 +8795,20 @@ public Builder signature(Collection<Signature> signature) {
              */
             @Override
             public Signer build() {
-                return new Signer(this);
+                Signer signer = new Signer(this);
+                if (validating) {
+                    validate(signer);
+                }
+                return signer;
+            }
+
+            protected void validate(Signer signer) {
+                super.validate(signer);
+                ValidationSupport.requireNonNull(signer.type, "type");
+                ValidationSupport.requireNonNull(signer.party, "party");
+                ValidationSupport.checkNonEmptyList(signer.signature, "signature", Signature.class);
+                ValidationSupport.checkReferenceType(signer.party, "party", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(signer);
             }
 
             protected Builder from(Signer signer) {
@@ -8658,9 +8835,7 @@ public static class Friendly extends BackboneElement {
 
         private Friendly(Builder builder) {
             super(builder);
-            content = ValidationSupport.requireChoiceElement(builder.content, "content", Attachment.class, Reference.class);
-            ValidationSupport.checkReferenceType(content, "content", "Composition", "DocumentReference", "QuestionnaireResponse");
-            ValidationSupport.requireValueOrChildren(this);
+            content = builder.content;
         }
 
         /**
@@ -8889,7 +9064,18 @@ public Builder content(Element content) {
              */
             @Override
             public Friendly build() {
-                return new Friendly(this);
+                Friendly friendly = new Friendly(this);
+                if (validating) {
+                    validate(friendly);
+                }
+                return friendly;
+            }
+
+            protected void validate(Friendly friendly) {
+                super.validate(friendly);
+                ValidationSupport.requireChoiceElement(friendly.content, "content", Attachment.class, Reference.class);
+                ValidationSupport.checkReferenceType(friendly.content, "content", "Composition", "DocumentReference", "QuestionnaireResponse");
+                ValidationSupport.requireValueOrChildren(friendly);
             }
 
             protected Builder from(Friendly friendly) {
@@ -8911,9 +9097,7 @@ public static class Legal extends BackboneElement {
 
         private Legal(Builder builder) {
             super(builder);
-            content = ValidationSupport.requireChoiceElement(builder.content, "content", Attachment.class, Reference.class);
-            ValidationSupport.checkReferenceType(content, "content", "Composition", "DocumentReference", "QuestionnaireResponse");
-            ValidationSupport.requireValueOrChildren(this);
+            content = builder.content;
         }
 
         /**
@@ -9140,7 +9324,18 @@ public Builder content(Element content) {
              */
             @Override
             public Legal build() {
-                return new Legal(this);
+                Legal legal = new Legal(this);
+                if (validating) {
+                    validate(legal);
+                }
+                return legal;
+            }
+
+            protected void validate(Legal legal) {
+                super.validate(legal);
+                ValidationSupport.requireChoiceElement(legal.content, "content", Attachment.class, Reference.class);
+                ValidationSupport.checkReferenceType(legal.content, "content", "Composition", "DocumentReference", "QuestionnaireResponse");
+                ValidationSupport.requireValueOrChildren(legal);
             }
 
             protected Builder from(Legal legal) {
@@ -9162,9 +9357,7 @@ public static class Rule extends BackboneElement {
 
         private Rule(Builder builder) {
             super(builder);
-            content = ValidationSupport.requireChoiceElement(builder.content, "content", Attachment.class, Reference.class);
-            ValidationSupport.checkReferenceType(content, "content", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            content = builder.content;
         }
 
         /**
@@ -9389,7 +9582,18 @@ public Builder content(Element content) {
              */
             @Override
             public Rule build() {
-                return new Rule(this);
+                Rule rule = new Rule(this);
+                if (validating) {
+                    validate(rule);
+                }
+                return rule;
+            }
+
+            protected void validate(Rule rule) {
+                super.validate(rule);
+                ValidationSupport.requireChoiceElement(rule.content, "content", Attachment.class, Reference.class);
+                ValidationSupport.checkReferenceType(rule.content, "content", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(rule);
             }
 
             protected Builder from(Rule rule) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Coverage.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Coverage.java
index 0b44c8d4556..af3cfe6e0a7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Coverage.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Coverage.java
@@ -145,28 +145,23 @@ public class Coverage extends DomainResource {
 
     private Coverage(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         type = builder.type;
         policyHolder = builder.policyHolder;
         subscriber = builder.subscriber;
         subscriberId = builder.subscriberId;
-        beneficiary = ValidationSupport.requireNonNull(builder.beneficiary, "beneficiary");
+        beneficiary = builder.beneficiary;
         dependent = builder.dependent;
         relationship = builder.relationship;
         period = builder.period;
-        payor = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.payor, "payor", Reference.class));
-        clazz = Collections.unmodifiableList(ValidationSupport.checkList(builder.clazz, "class", Class.class));
+        payor = Collections.unmodifiableList(builder.payor);
+        clazz = Collections.unmodifiableList(builder.clazz);
         order = builder.order;
         network = builder.network;
-        costToBeneficiary = Collections.unmodifiableList(ValidationSupport.checkList(builder.costToBeneficiary, "costToBeneficiary", CostToBeneficiary.class));
+        costToBeneficiary = Collections.unmodifiableList(builder.costToBeneficiary);
         subrogation = builder.subrogation;
-        contract = Collections.unmodifiableList(ValidationSupport.checkList(builder.contract, "contract", Reference.class));
-        ValidationSupport.checkReferenceType(policyHolder, "policyHolder", "Patient", "RelatedPerson", "Organization");
-        ValidationSupport.checkReferenceType(subscriber, "subscriber", "Patient", "RelatedPerson");
-        ValidationSupport.checkReferenceType(beneficiary, "beneficiary", "Patient");
-        ValidationSupport.checkReferenceType(payor, "payor", "Organization", "Patient", "RelatedPerson");
-        ValidationSupport.checkReferenceType(contract, "contract", "Contract");
+        contract = Collections.unmodifiableList(builder.contract);
     }
 
     /**
@@ -1124,7 +1119,27 @@ public Builder contract(Collection<Reference> contract) {
          */
         @Override
         public Coverage build() {
-            return new Coverage(this);
+            Coverage coverage = new Coverage(this);
+            if (validating) {
+                validate(coverage);
+            }
+            return coverage;
+        }
+
+        protected void validate(Coverage coverage) {
+            super.validate(coverage);
+            ValidationSupport.checkList(coverage.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(coverage.status, "status");
+            ValidationSupport.requireNonNull(coverage.beneficiary, "beneficiary");
+            ValidationSupport.checkNonEmptyList(coverage.payor, "payor", Reference.class);
+            ValidationSupport.checkList(coverage.clazz, "class", Class.class);
+            ValidationSupport.checkList(coverage.costToBeneficiary, "costToBeneficiary", CostToBeneficiary.class);
+            ValidationSupport.checkList(coverage.contract, "contract", Reference.class);
+            ValidationSupport.checkReferenceType(coverage.policyHolder, "policyHolder", "Patient", "RelatedPerson", "Organization");
+            ValidationSupport.checkReferenceType(coverage.subscriber, "subscriber", "Patient", "RelatedPerson");
+            ValidationSupport.checkReferenceType(coverage.beneficiary, "beneficiary", "Patient");
+            ValidationSupport.checkReferenceType(coverage.payor, "payor", "Organization", "Patient", "RelatedPerson");
+            ValidationSupport.checkReferenceType(coverage.contract, "contract", "Contract");
         }
 
         protected Builder from(Coverage coverage) {
@@ -1171,10 +1186,9 @@ public static class Class extends BackboneElement {
 
         private Class(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            value = ValidationSupport.requireNonNull(builder.value, "value");
+            type = builder.type;
+            value = builder.value;
             name = builder.name;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1451,7 +1465,18 @@ public Builder name(String name) {
              */
             @Override
             public Class build() {
-                return new Class(this);
+                Class _class = new Class(this);
+                if (validating) {
+                    validate(_class);
+                }
+                return _class;
+            }
+
+            protected void validate(Class _class) {
+                super.validate(_class);
+                ValidationSupport.requireNonNull(_class.type, "type");
+                ValidationSupport.requireNonNull(_class.value, "value");
+                ValidationSupport.requireValueOrChildren(_class);
             }
 
             protected Builder from(Class _class) {
@@ -1486,9 +1511,8 @@ public static class CostToBeneficiary extends BackboneElement {
         private CostToBeneficiary(Builder builder) {
             super(builder);
             type = builder.type;
-            value = ValidationSupport.requireChoiceElement(builder.value, "value", SimpleQuantity.class, Money.class);
-            exception = Collections.unmodifiableList(ValidationSupport.checkList(builder.exception, "exception", Exception.class));
-            ValidationSupport.requireValueOrChildren(this);
+            value = builder.value;
+            exception = Collections.unmodifiableList(builder.exception);
         }
 
         /**
@@ -1786,7 +1810,18 @@ public Builder exception(Collection<Exception> exception) {
              */
             @Override
             public CostToBeneficiary build() {
-                return new CostToBeneficiary(this);
+                CostToBeneficiary costToBeneficiary = new CostToBeneficiary(this);
+                if (validating) {
+                    validate(costToBeneficiary);
+                }
+                return costToBeneficiary;
+            }
+
+            protected void validate(CostToBeneficiary costToBeneficiary) {
+                super.validate(costToBeneficiary);
+                ValidationSupport.requireChoiceElement(costToBeneficiary.value, "value", SimpleQuantity.class, Money.class);
+                ValidationSupport.checkList(costToBeneficiary.exception, "exception", Exception.class);
+                ValidationSupport.requireValueOrChildren(costToBeneficiary);
             }
 
             protected Builder from(CostToBeneficiary costToBeneficiary) {
@@ -1816,9 +1851,8 @@ public static class Exception extends BackboneElement {
 
             private Exception(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
+                type = builder.type;
                 period = builder.period;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2061,7 +2095,17 @@ public Builder period(Period period) {
                  */
                 @Override
                 public Exception build() {
-                    return new Exception(this);
+                    Exception exception = new Exception(this);
+                    if (validating) {
+                        validate(exception);
+                    }
+                    return exception;
+                }
+
+                protected void validate(Exception exception) {
+                    super.validate(exception);
+                    ValidationSupport.requireNonNull(exception.type, "type");
+                    ValidationSupport.requireValueOrChildren(exception);
                 }
 
                 protected Builder from(Exception exception) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CoverageEligibilityRequest.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CoverageEligibilityRequest.java
index 8451e6b4b09..fd09452c3a1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CoverageEligibilityRequest.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CoverageEligibilityRequest.java
@@ -109,25 +109,20 @@ public class CoverageEligibilityRequest extends DomainResource {
 
     private CoverageEligibilityRequest(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         priority = builder.priority;
-        purpose = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.purpose, "purpose", EligibilityRequestPurpose.class));
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
-        serviced = ValidationSupport.choiceElement(builder.serviced, "serviced", Date.class, Period.class);
-        created = ValidationSupport.requireNonNull(builder.created, "created");
+        purpose = Collections.unmodifiableList(builder.purpose);
+        patient = builder.patient;
+        serviced = builder.serviced;
+        created = builder.created;
         enterer = builder.enterer;
         provider = builder.provider;
-        insurer = ValidationSupport.requireNonNull(builder.insurer, "insurer");
+        insurer = builder.insurer;
         facility = builder.facility;
-        supportingInfo = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInfo, "supportingInfo", SupportingInfo.class));
-        insurance = Collections.unmodifiableList(ValidationSupport.checkList(builder.insurance, "insurance", Insurance.class));
-        item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", Item.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(enterer, "enterer", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(insurer, "insurer", "Organization");
-        ValidationSupport.checkReferenceType(facility, "facility", "Location");
+        supportingInfo = Collections.unmodifiableList(builder.supportingInfo);
+        insurance = Collections.unmodifiableList(builder.insurance);
+        item = Collections.unmodifiableList(builder.item);
     }
 
     /**
@@ -988,7 +983,30 @@ public Builder item(Collection<Item> item) {
          */
         @Override
         public CoverageEligibilityRequest build() {
-            return new CoverageEligibilityRequest(this);
+            CoverageEligibilityRequest coverageEligibilityRequest = new CoverageEligibilityRequest(this);
+            if (validating) {
+                validate(coverageEligibilityRequest);
+            }
+            return coverageEligibilityRequest;
+        }
+
+        protected void validate(CoverageEligibilityRequest coverageEligibilityRequest) {
+            super.validate(coverageEligibilityRequest);
+            ValidationSupport.checkList(coverageEligibilityRequest.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(coverageEligibilityRequest.status, "status");
+            ValidationSupport.checkNonEmptyList(coverageEligibilityRequest.purpose, "purpose", EligibilityRequestPurpose.class);
+            ValidationSupport.requireNonNull(coverageEligibilityRequest.patient, "patient");
+            ValidationSupport.choiceElement(coverageEligibilityRequest.serviced, "serviced", Date.class, Period.class);
+            ValidationSupport.requireNonNull(coverageEligibilityRequest.created, "created");
+            ValidationSupport.requireNonNull(coverageEligibilityRequest.insurer, "insurer");
+            ValidationSupport.checkList(coverageEligibilityRequest.supportingInfo, "supportingInfo", SupportingInfo.class);
+            ValidationSupport.checkList(coverageEligibilityRequest.insurance, "insurance", Insurance.class);
+            ValidationSupport.checkList(coverageEligibilityRequest.item, "item", Item.class);
+            ValidationSupport.checkReferenceType(coverageEligibilityRequest.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(coverageEligibilityRequest.enterer, "enterer", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(coverageEligibilityRequest.provider, "provider", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(coverageEligibilityRequest.insurer, "insurer", "Organization");
+            ValidationSupport.checkReferenceType(coverageEligibilityRequest.facility, "facility", "Location");
         }
 
         protected Builder from(CoverageEligibilityRequest coverageEligibilityRequest) {
@@ -1024,10 +1042,9 @@ public static class SupportingInfo extends BackboneElement {
 
         private SupportingInfo(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            information = ValidationSupport.requireNonNull(builder.information, "information");
+            sequence = builder.sequence;
+            information = builder.information;
             appliesToAll = builder.appliesToAll;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1304,7 +1321,18 @@ public Builder appliesToAll(Boolean appliesToAll) {
              */
             @Override
             public SupportingInfo build() {
-                return new SupportingInfo(this);
+                SupportingInfo supportingInfo = new SupportingInfo(this);
+                if (validating) {
+                    validate(supportingInfo);
+                }
+                return supportingInfo;
+            }
+
+            protected void validate(SupportingInfo supportingInfo) {
+                super.validate(supportingInfo);
+                ValidationSupport.requireNonNull(supportingInfo.sequence, "sequence");
+                ValidationSupport.requireNonNull(supportingInfo.information, "information");
+                ValidationSupport.requireValueOrChildren(supportingInfo);
             }
 
             protected Builder from(SupportingInfo supportingInfo) {
@@ -1330,10 +1358,8 @@ public static class Insurance extends BackboneElement {
         private Insurance(Builder builder) {
             super(builder);
             focal = builder.focal;
-            coverage = ValidationSupport.requireNonNull(builder.coverage, "coverage");
+            coverage = builder.coverage;
             businessArrangement = builder.businessArrangement;
-            ValidationSupport.checkReferenceType(coverage, "coverage", "Coverage");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1612,7 +1638,18 @@ public Builder businessArrangement(String businessArrangement) {
              */
             @Override
             public Insurance build() {
-                return new Insurance(this);
+                Insurance insurance = new Insurance(this);
+                if (validating) {
+                    validate(insurance);
+                }
+                return insurance;
+            }
+
+            protected void validate(Insurance insurance) {
+                super.validate(insurance);
+                ValidationSupport.requireNonNull(insurance.coverage, "coverage");
+                ValidationSupport.checkReferenceType(insurance.coverage, "coverage", "Coverage");
+                ValidationSupport.requireValueOrChildren(insurance);
             }
 
             protected Builder from(Insurance insurance) {
@@ -1663,19 +1700,16 @@ public static class Item extends BackboneElement {
 
         private Item(Builder builder) {
             super(builder);
-            supportingInfoSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInfoSequence, "supportingInfoSequence", PositiveInt.class));
+            supportingInfoSequence = Collections.unmodifiableList(builder.supportingInfoSequence);
             category = builder.category;
             productOrService = builder.productOrService;
-            modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
+            modifier = Collections.unmodifiableList(builder.modifier);
             provider = builder.provider;
             quantity = builder.quantity;
             unitPrice = builder.unitPrice;
             facility = builder.facility;
-            diagnosis = Collections.unmodifiableList(ValidationSupport.checkList(builder.diagnosis, "diagnosis", Diagnosis.class));
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Reference.class));
-            ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole");
-            ValidationSupport.checkReferenceType(facility, "facility", "Location", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
+            diagnosis = Collections.unmodifiableList(builder.diagnosis);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -2235,7 +2269,22 @@ public Builder detail(Collection<Reference> detail) {
              */
             @Override
             public Item build() {
-                return new Item(this);
+                Item item = new Item(this);
+                if (validating) {
+                    validate(item);
+                }
+                return item;
+            }
+
+            protected void validate(Item item) {
+                super.validate(item);
+                ValidationSupport.checkList(item.supportingInfoSequence, "supportingInfoSequence", PositiveInt.class);
+                ValidationSupport.checkList(item.modifier, "modifier", CodeableConcept.class);
+                ValidationSupport.checkList(item.diagnosis, "diagnosis", Diagnosis.class);
+                ValidationSupport.checkList(item.detail, "detail", Reference.class);
+                ValidationSupport.checkReferenceType(item.provider, "provider", "Practitioner", "PractitionerRole");
+                ValidationSupport.checkReferenceType(item.facility, "facility", "Location", "Organization");
+                ValidationSupport.requireValueOrChildren(item);
             }
 
             protected Builder from(Item item) {
@@ -2270,9 +2319,7 @@ public static class Diagnosis extends BackboneElement {
 
             private Diagnosis(Builder builder) {
                 super(builder);
-                diagnosis = ValidationSupport.choiceElement(builder.diagnosis, "diagnosis", CodeableConcept.class, Reference.class);
-                ValidationSupport.checkReferenceType(diagnosis, "diagnosis", "Condition");
-                ValidationSupport.requireValueOrChildren(this);
+                diagnosis = builder.diagnosis;
             }
 
             /**
@@ -2490,7 +2537,18 @@ public Builder diagnosis(Element diagnosis) {
                  */
                 @Override
                 public Diagnosis build() {
-                    return new Diagnosis(this);
+                    Diagnosis diagnosis = new Diagnosis(this);
+                    if (validating) {
+                        validate(diagnosis);
+                    }
+                    return diagnosis;
+                }
+
+                protected void validate(Diagnosis diagnosis) {
+                    super.validate(diagnosis);
+                    ValidationSupport.choiceElement(diagnosis.diagnosis, "diagnosis", CodeableConcept.class, Reference.class);
+                    ValidationSupport.checkReferenceType(diagnosis.diagnosis, "diagnosis", "Condition");
+                    ValidationSupport.requireValueOrChildren(diagnosis);
                 }
 
                 protected Builder from(Diagnosis diagnosis) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CoverageEligibilityResponse.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CoverageEligibilityResponse.java
index 4b902d26a49..cdd1d5ad211 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/CoverageEligibilityResponse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/CoverageEligibilityResponse.java
@@ -125,25 +125,21 @@ public class CoverageEligibilityResponse extends DomainResource {
 
     private CoverageEligibilityResponse(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        purpose = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.purpose, "purpose", EligibilityResponsePurpose.class));
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
-        serviced = ValidationSupport.choiceElement(builder.serviced, "serviced", Date.class, Period.class);
-        created = ValidationSupport.requireNonNull(builder.created, "created");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        purpose = Collections.unmodifiableList(builder.purpose);
+        patient = builder.patient;
+        serviced = builder.serviced;
+        created = builder.created;
         requestor = builder.requestor;
-        request = ValidationSupport.requireNonNull(builder.request, "request");
-        outcome = ValidationSupport.requireNonNull(builder.outcome, "outcome");
+        request = builder.request;
+        outcome = builder.outcome;
         disposition = builder.disposition;
-        insurer = ValidationSupport.requireNonNull(builder.insurer, "insurer");
-        insurance = Collections.unmodifiableList(ValidationSupport.checkList(builder.insurance, "insurance", Insurance.class));
+        insurer = builder.insurer;
+        insurance = Collections.unmodifiableList(builder.insurance);
         preAuthRef = builder.preAuthRef;
         form = builder.form;
-        error = Collections.unmodifiableList(ValidationSupport.checkList(builder.error, "error", Error.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(requestor, "requestor", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(request, "request", "CoverageEligibilityRequest");
-        ValidationSupport.checkReferenceType(insurer, "insurer", "Organization");
+        error = Collections.unmodifiableList(builder.error);
     }
 
     /**
@@ -1009,7 +1005,30 @@ public Builder error(Collection<Error> error) {
          */
         @Override
         public CoverageEligibilityResponse build() {
-            return new CoverageEligibilityResponse(this);
+            CoverageEligibilityResponse coverageEligibilityResponse = new CoverageEligibilityResponse(this);
+            if (validating) {
+                validate(coverageEligibilityResponse);
+            }
+            return coverageEligibilityResponse;
+        }
+
+        protected void validate(CoverageEligibilityResponse coverageEligibilityResponse) {
+            super.validate(coverageEligibilityResponse);
+            ValidationSupport.checkList(coverageEligibilityResponse.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(coverageEligibilityResponse.status, "status");
+            ValidationSupport.checkNonEmptyList(coverageEligibilityResponse.purpose, "purpose", EligibilityResponsePurpose.class);
+            ValidationSupport.requireNonNull(coverageEligibilityResponse.patient, "patient");
+            ValidationSupport.choiceElement(coverageEligibilityResponse.serviced, "serviced", Date.class, Period.class);
+            ValidationSupport.requireNonNull(coverageEligibilityResponse.created, "created");
+            ValidationSupport.requireNonNull(coverageEligibilityResponse.request, "request");
+            ValidationSupport.requireNonNull(coverageEligibilityResponse.outcome, "outcome");
+            ValidationSupport.requireNonNull(coverageEligibilityResponse.insurer, "insurer");
+            ValidationSupport.checkList(coverageEligibilityResponse.insurance, "insurance", Insurance.class);
+            ValidationSupport.checkList(coverageEligibilityResponse.error, "error", Error.class);
+            ValidationSupport.checkReferenceType(coverageEligibilityResponse.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(coverageEligibilityResponse.requestor, "requestor", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(coverageEligibilityResponse.request, "request", "CoverageEligibilityRequest");
+            ValidationSupport.checkReferenceType(coverageEligibilityResponse.insurer, "insurer", "Organization");
         }
 
         protected Builder from(CoverageEligibilityResponse coverageEligibilityResponse) {
@@ -1047,12 +1066,10 @@ public static class Insurance extends BackboneElement {
 
         private Insurance(Builder builder) {
             super(builder);
-            coverage = ValidationSupport.requireNonNull(builder.coverage, "coverage");
+            coverage = builder.coverage;
             inforce = builder.inforce;
             benefitPeriod = builder.benefitPeriod;
-            item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", Item.class));
-            ValidationSupport.checkReferenceType(coverage, "coverage", "Coverage");
-            ValidationSupport.requireValueOrChildren(this);
+            item = Collections.unmodifiableList(builder.item);
         }
 
         /**
@@ -1382,7 +1399,19 @@ public Builder item(Collection<Item> item) {
              */
             @Override
             public Insurance build() {
-                return new Insurance(this);
+                Insurance insurance = new Insurance(this);
+                if (validating) {
+                    validate(insurance);
+                }
+                return insurance;
+            }
+
+            protected void validate(Insurance insurance) {
+                super.validate(insurance);
+                ValidationSupport.requireNonNull(insurance.coverage, "coverage");
+                ValidationSupport.checkList(insurance.item, "item", Item.class);
+                ValidationSupport.checkReferenceType(insurance.coverage, "coverage", "Coverage");
+                ValidationSupport.requireValueOrChildren(insurance);
             }
 
             protected Builder from(Insurance insurance) {
@@ -1461,7 +1490,7 @@ private Item(Builder builder) {
                 super(builder);
                 category = builder.category;
                 productOrService = builder.productOrService;
-                modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
+                modifier = Collections.unmodifiableList(builder.modifier);
                 provider = builder.provider;
                 excluded = builder.excluded;
                 name = builder.name;
@@ -1469,12 +1498,10 @@ private Item(Builder builder) {
                 network = builder.network;
                 unit = builder.unit;
                 term = builder.term;
-                benefit = Collections.unmodifiableList(ValidationSupport.checkList(builder.benefit, "benefit", Benefit.class));
+                benefit = Collections.unmodifiableList(builder.benefit);
                 authorizationRequired = builder.authorizationRequired;
-                authorizationSupporting = Collections.unmodifiableList(ValidationSupport.checkList(builder.authorizationSupporting, "authorizationSupporting", CodeableConcept.class));
+                authorizationSupporting = Collections.unmodifiableList(builder.authorizationSupporting);
                 authorizationUrl = builder.authorizationUrl;
-                ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole");
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2126,7 +2153,20 @@ public Builder authorizationUrl(Uri authorizationUrl) {
                  */
                 @Override
                 public Item build() {
-                    return new Item(this);
+                    Item item = new Item(this);
+                    if (validating) {
+                        validate(item);
+                    }
+                    return item;
+                }
+
+                protected void validate(Item item) {
+                    super.validate(item);
+                    ValidationSupport.checkList(item.modifier, "modifier", CodeableConcept.class);
+                    ValidationSupport.checkList(item.benefit, "benefit", Benefit.class);
+                    ValidationSupport.checkList(item.authorizationSupporting, "authorizationSupporting", CodeableConcept.class);
+                    ValidationSupport.checkReferenceType(item.provider, "provider", "Practitioner", "PractitionerRole");
+                    ValidationSupport.requireValueOrChildren(item);
                 }
 
                 protected Builder from(Item item) {
@@ -2168,10 +2208,9 @@ public static class Benefit extends BackboneElement {
 
                 private Benefit(Builder builder) {
                     super(builder);
-                    type = ValidationSupport.requireNonNull(builder.type, "type");
-                    allowed = ValidationSupport.choiceElement(builder.allowed, "allowed", UnsignedInt.class, String.class, Money.class);
-                    used = ValidationSupport.choiceElement(builder.used, "used", UnsignedInt.class, String.class, Money.class);
-                    ValidationSupport.requireValueOrChildren(this);
+                    type = builder.type;
+                    allowed = builder.allowed;
+                    used = builder.used;
                 }
 
                 /**
@@ -2457,7 +2496,19 @@ public Builder used(Element used) {
                      */
                     @Override
                     public Benefit build() {
-                        return new Benefit(this);
+                        Benefit benefit = new Benefit(this);
+                        if (validating) {
+                            validate(benefit);
+                        }
+                        return benefit;
+                    }
+
+                    protected void validate(Benefit benefit) {
+                        super.validate(benefit);
+                        ValidationSupport.requireNonNull(benefit.type, "type");
+                        ValidationSupport.choiceElement(benefit.allowed, "allowed", UnsignedInt.class, String.class, Money.class);
+                        ValidationSupport.choiceElement(benefit.used, "used", UnsignedInt.class, String.class, Money.class);
+                        ValidationSupport.requireValueOrChildren(benefit);
                     }
 
                     protected Builder from(Benefit benefit) {
@@ -2487,8 +2538,7 @@ public static class Error extends BackboneElement {
 
         private Error(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            ValidationSupport.requireValueOrChildren(this);
+            code = builder.code;
         }
 
         /**
@@ -2702,7 +2752,17 @@ public Builder code(CodeableConcept code) {
              */
             @Override
             public Error build() {
-                return new Error(this);
+                Error error = new Error(this);
+                if (validating) {
+                    validate(error);
+                }
+                return error;
+            }
+
+            protected void validate(Error error) {
+                super.validate(error);
+                ValidationSupport.requireNonNull(error.code, "code");
+                ValidationSupport.requireValueOrChildren(error);
             }
 
             protected Builder from(Error error) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DetectedIssue.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DetectedIssue.java
index 9c77f1b1e8c..296bd390039 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DetectedIssue.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DetectedIssue.java
@@ -114,20 +114,18 @@ public class DetectedIssue extends DomainResource {
 
     private DetectedIssue(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         code = builder.code;
         severity = builder.severity;
         patient = builder.patient;
-        identified = ValidationSupport.choiceElement(builder.identified, "identified", DateTime.class, Period.class);
+        identified = builder.identified;
         author = builder.author;
-        implicated = Collections.unmodifiableList(ValidationSupport.checkList(builder.implicated, "implicated", Reference.class));
-        evidence = Collections.unmodifiableList(ValidationSupport.checkList(builder.evidence, "evidence", Evidence.class));
+        implicated = Collections.unmodifiableList(builder.implicated);
+        evidence = Collections.unmodifiableList(builder.evidence);
         detail = builder.detail;
         reference = builder.reference;
-        mitigation = Collections.unmodifiableList(ValidationSupport.checkList(builder.mitigation, "mitigation", Mitigation.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole", "Device");
+        mitigation = Collections.unmodifiableList(builder.mitigation);
     }
 
     /**
@@ -879,7 +877,23 @@ public Builder mitigation(Collection<Mitigation> mitigation) {
          */
         @Override
         public DetectedIssue build() {
-            return new DetectedIssue(this);
+            DetectedIssue detectedIssue = new DetectedIssue(this);
+            if (validating) {
+                validate(detectedIssue);
+            }
+            return detectedIssue;
+        }
+
+        protected void validate(DetectedIssue detectedIssue) {
+            super.validate(detectedIssue);
+            ValidationSupport.checkList(detectedIssue.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(detectedIssue.status, "status");
+            ValidationSupport.choiceElement(detectedIssue.identified, "identified", DateTime.class, Period.class);
+            ValidationSupport.checkList(detectedIssue.implicated, "implicated", Reference.class);
+            ValidationSupport.checkList(detectedIssue.evidence, "evidence", Evidence.class);
+            ValidationSupport.checkList(detectedIssue.mitigation, "mitigation", Mitigation.class);
+            ValidationSupport.checkReferenceType(detectedIssue.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(detectedIssue.author, "author", "Practitioner", "PractitionerRole", "Device");
         }
 
         protected Builder from(DetectedIssue detectedIssue) {
@@ -916,9 +930,8 @@ public static class Evidence extends BackboneElement {
 
         private Evidence(Builder builder) {
             super(builder);
-            code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Reference.class));
-            ValidationSupport.requireValueOrChildren(this);
+            code = Collections.unmodifiableList(builder.code);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -1194,7 +1207,18 @@ public Builder detail(Collection<Reference> detail) {
              */
             @Override
             public Evidence build() {
-                return new Evidence(this);
+                Evidence evidence = new Evidence(this);
+                if (validating) {
+                    validate(evidence);
+                }
+                return evidence;
+            }
+
+            protected void validate(Evidence evidence) {
+                super.validate(evidence);
+                ValidationSupport.checkList(evidence.code, "code", CodeableConcept.class);
+                ValidationSupport.checkList(evidence.detail, "detail", Reference.class);
+                ValidationSupport.requireValueOrChildren(evidence);
             }
 
             protected Builder from(Evidence evidence) {
@@ -1226,11 +1250,9 @@ public static class Mitigation extends BackboneElement {
 
         private Mitigation(Builder builder) {
             super(builder);
-            action = ValidationSupport.requireNonNull(builder.action, "action");
+            action = builder.action;
             date = builder.date;
             author = builder.author;
-            ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1510,7 +1532,18 @@ public Builder author(Reference author) {
              */
             @Override
             public Mitigation build() {
-                return new Mitigation(this);
+                Mitigation mitigation = new Mitigation(this);
+                if (validating) {
+                    validate(mitigation);
+                }
+                return mitigation;
+            }
+
+            protected void validate(Mitigation mitigation) {
+                super.validate(mitigation);
+                ValidationSupport.requireNonNull(mitigation.action, "action");
+                ValidationSupport.checkReferenceType(mitigation.author, "author", "Practitioner", "PractitionerRole");
+                ValidationSupport.requireValueOrChildren(mitigation);
             }
 
             protected Builder from(Mitigation mitigation) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Device.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Device.java
index 4e771377d86..e4cd5e8362a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Device.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Device.java
@@ -118,37 +118,32 @@ public class Device extends DomainResource {
 
     private Device(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         definition = builder.definition;
-        udiCarrier = Collections.unmodifiableList(ValidationSupport.checkList(builder.udiCarrier, "udiCarrier", UdiCarrier.class));
+        udiCarrier = Collections.unmodifiableList(builder.udiCarrier);
         status = builder.status;
-        statusReason = Collections.unmodifiableList(ValidationSupport.checkList(builder.statusReason, "statusReason", CodeableConcept.class));
+        statusReason = Collections.unmodifiableList(builder.statusReason);
         distinctIdentifier = builder.distinctIdentifier;
         manufacturer = builder.manufacturer;
         manufactureDate = builder.manufactureDate;
         expirationDate = builder.expirationDate;
         lotNumber = builder.lotNumber;
         serialNumber = builder.serialNumber;
-        deviceName = Collections.unmodifiableList(ValidationSupport.checkList(builder.deviceName, "deviceName", DeviceName.class));
+        deviceName = Collections.unmodifiableList(builder.deviceName);
         modelNumber = builder.modelNumber;
         partNumber = builder.partNumber;
         type = builder.type;
-        specialization = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialization, "specialization", Specialization.class));
-        version = Collections.unmodifiableList(ValidationSupport.checkList(builder.version, "version", Version.class));
-        property = Collections.unmodifiableList(ValidationSupport.checkList(builder.property, "property", Property.class));
+        specialization = Collections.unmodifiableList(builder.specialization);
+        version = Collections.unmodifiableList(builder.version);
+        property = Collections.unmodifiableList(builder.property);
         patient = builder.patient;
         owner = builder.owner;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactPoint.class));
+        contact = Collections.unmodifiableList(builder.contact);
         location = builder.location;
         url = builder.url;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        safety = Collections.unmodifiableList(ValidationSupport.checkList(builder.safety, "safety", CodeableConcept.class));
+        note = Collections.unmodifiableList(builder.note);
+        safety = Collections.unmodifiableList(builder.safety);
         parent = builder.parent;
-        ValidationSupport.checkReferenceType(definition, "definition", "DeviceDefinition");
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(owner, "owner", "Organization");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(parent, "parent", "Device");
     }
 
     /**
@@ -1434,7 +1429,30 @@ public Builder parent(Reference parent) {
          */
         @Override
         public Device build() {
-            return new Device(this);
+            Device device = new Device(this);
+            if (validating) {
+                validate(device);
+            }
+            return device;
+        }
+
+        protected void validate(Device device) {
+            super.validate(device);
+            ValidationSupport.checkList(device.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(device.udiCarrier, "udiCarrier", UdiCarrier.class);
+            ValidationSupport.checkList(device.statusReason, "statusReason", CodeableConcept.class);
+            ValidationSupport.checkList(device.deviceName, "deviceName", DeviceName.class);
+            ValidationSupport.checkList(device.specialization, "specialization", Specialization.class);
+            ValidationSupport.checkList(device.version, "version", Version.class);
+            ValidationSupport.checkList(device.property, "property", Property.class);
+            ValidationSupport.checkList(device.contact, "contact", ContactPoint.class);
+            ValidationSupport.checkList(device.note, "note", Annotation.class);
+            ValidationSupport.checkList(device.safety, "safety", CodeableConcept.class);
+            ValidationSupport.checkReferenceType(device.definition, "definition", "DeviceDefinition");
+            ValidationSupport.checkReferenceType(device.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(device.owner, "owner", "Organization");
+            ValidationSupport.checkReferenceType(device.location, "location", "Location");
+            ValidationSupport.checkReferenceType(device.parent, "parent", "Device");
         }
 
         protected Builder from(Device device) {
@@ -1499,7 +1517,6 @@ private UdiCarrier(Builder builder) {
             carrierAIDC = builder.carrierAIDC;
             carrierHRF = builder.carrierHRF;
             entryType = builder.entryType;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1879,7 +1896,16 @@ public Builder entryType(UDIEntryType entryType) {
              */
             @Override
             public UdiCarrier build() {
-                return new UdiCarrier(this);
+                UdiCarrier udiCarrier = new UdiCarrier(this);
+                if (validating) {
+                    validate(udiCarrier);
+                }
+                return udiCarrier;
+            }
+
+            protected void validate(UdiCarrier udiCarrier) {
+                super.validate(udiCarrier);
+                ValidationSupport.requireValueOrChildren(udiCarrier);
             }
 
             protected Builder from(UdiCarrier udiCarrier) {
@@ -1914,9 +1940,8 @@ public static class DeviceName extends BackboneElement {
 
         private DeviceName(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            ValidationSupport.requireValueOrChildren(this);
+            name = builder.name;
+            type = builder.type;
         }
 
         /**
@@ -2164,7 +2189,18 @@ public Builder type(DeviceNameType type) {
              */
             @Override
             public DeviceName build() {
-                return new DeviceName(this);
+                DeviceName deviceName = new DeviceName(this);
+                if (validating) {
+                    validate(deviceName);
+                }
+                return deviceName;
+            }
+
+            protected void validate(DeviceName deviceName) {
+                super.validate(deviceName);
+                ValidationSupport.requireNonNull(deviceName.name, "name");
+                ValidationSupport.requireNonNull(deviceName.type, "type");
+                ValidationSupport.requireValueOrChildren(deviceName);
             }
 
             protected Builder from(DeviceName deviceName) {
@@ -2187,9 +2223,8 @@ public static class Specialization extends BackboneElement {
 
         private Specialization(Builder builder) {
             super(builder);
-            systemType = ValidationSupport.requireNonNull(builder.systemType, "systemType");
+            systemType = builder.systemType;
             version = builder.version;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2432,7 +2467,17 @@ public Builder version(String version) {
              */
             @Override
             public Specialization build() {
-                return new Specialization(this);
+                Specialization specialization = new Specialization(this);
+                if (validating) {
+                    validate(specialization);
+                }
+                return specialization;
+            }
+
+            protected void validate(Specialization specialization) {
+                super.validate(specialization);
+                ValidationSupport.requireNonNull(specialization.systemType, "systemType");
+                ValidationSupport.requireValueOrChildren(specialization);
             }
 
             protected Builder from(Specialization specialization) {
@@ -2457,8 +2502,7 @@ private Version(Builder builder) {
             super(builder);
             type = builder.type;
             component = builder.component;
-            value = ValidationSupport.requireNonNull(builder.value, "value");
-            ValidationSupport.requireValueOrChildren(this);
+            value = builder.value;
         }
 
         /**
@@ -2730,7 +2774,17 @@ public Builder value(String value) {
              */
             @Override
             public Version build() {
-                return new Version(this);
+                Version version = new Version(this);
+                if (validating) {
+                    validate(version);
+                }
+                return version;
+            }
+
+            protected void validate(Version version) {
+                super.validate(version);
+                ValidationSupport.requireNonNull(version.value, "value");
+                ValidationSupport.requireValueOrChildren(version);
             }
 
             protected Builder from(Version version) {
@@ -2754,10 +2808,9 @@ public static class Property extends BackboneElement {
 
         private Property(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            valueQuantity = Collections.unmodifiableList(ValidationSupport.checkList(builder.valueQuantity, "valueQuantity", Quantity.class));
-            valueCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.valueCode, "valueCode", CodeableConcept.class));
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            valueQuantity = Collections.unmodifiableList(builder.valueQuantity);
+            valueCode = Collections.unmodifiableList(builder.valueCode);
         }
 
         /**
@@ -3069,7 +3122,19 @@ public Builder valueCode(Collection<CodeableConcept> valueCode) {
              */
             @Override
             public Property build() {
-                return new Property(this);
+                Property property = new Property(this);
+                if (validating) {
+                    validate(property);
+                }
+                return property;
+            }
+
+            protected void validate(Property property) {
+                super.validate(property);
+                ValidationSupport.requireNonNull(property.type, "type");
+                ValidationSupport.checkList(property.valueQuantity, "valueQuantity", Quantity.class);
+                ValidationSupport.checkList(property.valueCode, "valueCode", CodeableConcept.class);
+                ValidationSupport.requireValueOrChildren(property);
             }
 
             protected Builder from(Property property) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceDefinition.java
index 1948497a812..bf1efe95b89 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceDefinition.java
@@ -96,31 +96,28 @@ public class DeviceDefinition extends DomainResource {
 
     private DeviceDefinition(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        udiDeviceIdentifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.udiDeviceIdentifier, "udiDeviceIdentifier", UdiDeviceIdentifier.class));
-        manufacturer = ValidationSupport.choiceElement(builder.manufacturer, "manufacturer", String.class, Reference.class);
-        deviceName = Collections.unmodifiableList(ValidationSupport.checkList(builder.deviceName, "deviceName", DeviceName.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        udiDeviceIdentifier = Collections.unmodifiableList(builder.udiDeviceIdentifier);
+        manufacturer = builder.manufacturer;
+        deviceName = Collections.unmodifiableList(builder.deviceName);
         modelNumber = builder.modelNumber;
         type = builder.type;
-        specialization = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialization, "specialization", Specialization.class));
-        version = Collections.unmodifiableList(ValidationSupport.checkList(builder.version, "version", String.class));
-        safety = Collections.unmodifiableList(ValidationSupport.checkList(builder.safety, "safety", CodeableConcept.class));
-        shelfLifeStorage = Collections.unmodifiableList(ValidationSupport.checkList(builder.shelfLifeStorage, "shelfLifeStorage", ProductShelfLife.class));
+        specialization = Collections.unmodifiableList(builder.specialization);
+        version = Collections.unmodifiableList(builder.version);
+        safety = Collections.unmodifiableList(builder.safety);
+        shelfLifeStorage = Collections.unmodifiableList(builder.shelfLifeStorage);
         physicalCharacteristics = builder.physicalCharacteristics;
-        languageCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.languageCode, "languageCode", CodeableConcept.class));
-        capability = Collections.unmodifiableList(ValidationSupport.checkList(builder.capability, "capability", Capability.class));
-        property = Collections.unmodifiableList(ValidationSupport.checkList(builder.property, "property", Property.class));
+        languageCode = Collections.unmodifiableList(builder.languageCode);
+        capability = Collections.unmodifiableList(builder.capability);
+        property = Collections.unmodifiableList(builder.property);
         owner = builder.owner;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactPoint.class));
+        contact = Collections.unmodifiableList(builder.contact);
         url = builder.url;
         onlineInformation = builder.onlineInformation;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
+        note = Collections.unmodifiableList(builder.note);
         quantity = builder.quantity;
         parentDevice = builder.parentDevice;
-        material = Collections.unmodifiableList(ValidationSupport.checkList(builder.material, "material", Material.class));
-        ValidationSupport.checkReferenceType(manufacturer, "manufacturer", "Organization");
-        ValidationSupport.checkReferenceType(owner, "owner", "Organization");
-        ValidationSupport.checkReferenceType(parentDevice, "parentDevice", "DeviceDefinition");
+        material = Collections.unmodifiableList(builder.material);
     }
 
     /**
@@ -1344,7 +1341,32 @@ public Builder material(Collection<Material> material) {
          */
         @Override
         public DeviceDefinition build() {
-            return new DeviceDefinition(this);
+            DeviceDefinition deviceDefinition = new DeviceDefinition(this);
+            if (validating) {
+                validate(deviceDefinition);
+            }
+            return deviceDefinition;
+        }
+
+        protected void validate(DeviceDefinition deviceDefinition) {
+            super.validate(deviceDefinition);
+            ValidationSupport.checkList(deviceDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(deviceDefinition.udiDeviceIdentifier, "udiDeviceIdentifier", UdiDeviceIdentifier.class);
+            ValidationSupport.choiceElement(deviceDefinition.manufacturer, "manufacturer", String.class, Reference.class);
+            ValidationSupport.checkList(deviceDefinition.deviceName, "deviceName", DeviceName.class);
+            ValidationSupport.checkList(deviceDefinition.specialization, "specialization", Specialization.class);
+            ValidationSupport.checkList(deviceDefinition.version, "version", String.class);
+            ValidationSupport.checkList(deviceDefinition.safety, "safety", CodeableConcept.class);
+            ValidationSupport.checkList(deviceDefinition.shelfLifeStorage, "shelfLifeStorage", ProductShelfLife.class);
+            ValidationSupport.checkList(deviceDefinition.languageCode, "languageCode", CodeableConcept.class);
+            ValidationSupport.checkList(deviceDefinition.capability, "capability", Capability.class);
+            ValidationSupport.checkList(deviceDefinition.property, "property", Property.class);
+            ValidationSupport.checkList(deviceDefinition.contact, "contact", ContactPoint.class);
+            ValidationSupport.checkList(deviceDefinition.note, "note", Annotation.class);
+            ValidationSupport.checkList(deviceDefinition.material, "material", Material.class);
+            ValidationSupport.checkReferenceType(deviceDefinition.manufacturer, "manufacturer", "Organization");
+            ValidationSupport.checkReferenceType(deviceDefinition.owner, "owner", "Organization");
+            ValidationSupport.checkReferenceType(deviceDefinition.parentDevice, "parentDevice", "DeviceDefinition");
         }
 
         protected Builder from(DeviceDefinition deviceDefinition) {
@@ -1390,10 +1412,9 @@ public static class UdiDeviceIdentifier extends BackboneElement {
 
         private UdiDeviceIdentifier(Builder builder) {
             super(builder);
-            deviceIdentifier = ValidationSupport.requireNonNull(builder.deviceIdentifier, "deviceIdentifier");
-            issuer = ValidationSupport.requireNonNull(builder.issuer, "issuer");
-            jurisdiction = ValidationSupport.requireNonNull(builder.jurisdiction, "jurisdiction");
-            ValidationSupport.requireValueOrChildren(this);
+            deviceIdentifier = builder.deviceIdentifier;
+            issuer = builder.issuer;
+            jurisdiction = builder.jurisdiction;
         }
 
         /**
@@ -1674,7 +1695,19 @@ public Builder jurisdiction(Uri jurisdiction) {
              */
             @Override
             public UdiDeviceIdentifier build() {
-                return new UdiDeviceIdentifier(this);
+                UdiDeviceIdentifier udiDeviceIdentifier = new UdiDeviceIdentifier(this);
+                if (validating) {
+                    validate(udiDeviceIdentifier);
+                }
+                return udiDeviceIdentifier;
+            }
+
+            protected void validate(UdiDeviceIdentifier udiDeviceIdentifier) {
+                super.validate(udiDeviceIdentifier);
+                ValidationSupport.requireNonNull(udiDeviceIdentifier.deviceIdentifier, "deviceIdentifier");
+                ValidationSupport.requireNonNull(udiDeviceIdentifier.issuer, "issuer");
+                ValidationSupport.requireNonNull(udiDeviceIdentifier.jurisdiction, "jurisdiction");
+                ValidationSupport.requireValueOrChildren(udiDeviceIdentifier);
             }
 
             protected Builder from(UdiDeviceIdentifier udiDeviceIdentifier) {
@@ -1704,9 +1737,8 @@ public static class DeviceName extends BackboneElement {
 
         private DeviceName(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            ValidationSupport.requireValueOrChildren(this);
+            name = builder.name;
+            type = builder.type;
         }
 
         /**
@@ -1954,7 +1986,18 @@ public Builder type(DeviceNameType type) {
              */
             @Override
             public DeviceName build() {
-                return new DeviceName(this);
+                DeviceName deviceName = new DeviceName(this);
+                if (validating) {
+                    validate(deviceName);
+                }
+                return deviceName;
+            }
+
+            protected void validate(DeviceName deviceName) {
+                super.validate(deviceName);
+                ValidationSupport.requireNonNull(deviceName.name, "name");
+                ValidationSupport.requireNonNull(deviceName.type, "type");
+                ValidationSupport.requireValueOrChildren(deviceName);
             }
 
             protected Builder from(DeviceName deviceName) {
@@ -1977,9 +2020,8 @@ public static class Specialization extends BackboneElement {
 
         private Specialization(Builder builder) {
             super(builder);
-            systemType = ValidationSupport.requireNonNull(builder.systemType, "systemType");
+            systemType = builder.systemType;
             version = builder.version;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2222,7 +2264,17 @@ public Builder version(String version) {
              */
             @Override
             public Specialization build() {
-                return new Specialization(this);
+                Specialization specialization = new Specialization(this);
+                if (validating) {
+                    validate(specialization);
+                }
+                return specialization;
+            }
+
+            protected void validate(Specialization specialization) {
+                super.validate(specialization);
+                ValidationSupport.requireNonNull(specialization.systemType, "systemType");
+                ValidationSupport.requireValueOrChildren(specialization);
             }
 
             protected Builder from(Specialization specialization) {
@@ -2244,9 +2296,8 @@ public static class Capability extends BackboneElement {
 
         private Capability(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            description = Collections.unmodifiableList(ValidationSupport.checkList(builder.description, "description", CodeableConcept.class));
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            description = Collections.unmodifiableList(builder.description);
         }
 
         /**
@@ -2509,7 +2560,18 @@ public Builder description(Collection<CodeableConcept> description) {
              */
             @Override
             public Capability build() {
-                return new Capability(this);
+                Capability capability = new Capability(this);
+                if (validating) {
+                    validate(capability);
+                }
+                return capability;
+            }
+
+            protected void validate(Capability capability) {
+                super.validate(capability);
+                ValidationSupport.requireNonNull(capability.type, "type");
+                ValidationSupport.checkList(capability.description, "description", CodeableConcept.class);
+                ValidationSupport.requireValueOrChildren(capability);
             }
 
             protected Builder from(Capability capability) {
@@ -2532,10 +2594,9 @@ public static class Property extends BackboneElement {
 
         private Property(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            valueQuantity = Collections.unmodifiableList(ValidationSupport.checkList(builder.valueQuantity, "valueQuantity", Quantity.class));
-            valueCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.valueCode, "valueCode", CodeableConcept.class));
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            valueQuantity = Collections.unmodifiableList(builder.valueQuantity);
+            valueCode = Collections.unmodifiableList(builder.valueCode);
         }
 
         /**
@@ -2847,7 +2908,19 @@ public Builder valueCode(Collection<CodeableConcept> valueCode) {
              */
             @Override
             public Property build() {
-                return new Property(this);
+                Property property = new Property(this);
+                if (validating) {
+                    validate(property);
+                }
+                return property;
+            }
+
+            protected void validate(Property property) {
+                super.validate(property);
+                ValidationSupport.requireNonNull(property.type, "type");
+                ValidationSupport.checkList(property.valueQuantity, "valueQuantity", Quantity.class);
+                ValidationSupport.checkList(property.valueCode, "valueCode", CodeableConcept.class);
+                ValidationSupport.requireValueOrChildren(property);
             }
 
             protected Builder from(Property property) {
@@ -2871,10 +2944,9 @@ public static class Material extends BackboneElement {
 
         private Material(Builder builder) {
             super(builder);
-            substance = ValidationSupport.requireNonNull(builder.substance, "substance");
+            substance = builder.substance;
             alternate = builder.alternate;
             allergenicIndicator = builder.allergenicIndicator;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3146,7 +3218,17 @@ public Builder allergenicIndicator(Boolean allergenicIndicator) {
              */
             @Override
             public Material build() {
-                return new Material(this);
+                Material material = new Material(this);
+                if (validating) {
+                    validate(material);
+                }
+                return material;
+            }
+
+            protected void validate(Material material) {
+                super.validate(material);
+                ValidationSupport.requireNonNull(material.substance, "substance");
+                ValidationSupport.requireValueOrChildren(material);
             }
 
             protected Builder from(Material material) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceMetric.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceMetric.java
index 63eb4ad5ff1..9e886f6ddeb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceMetric.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceMetric.java
@@ -125,18 +125,16 @@ public class DeviceMetric extends DomainResource {
 
     private DeviceMetric(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        type = builder.type;
         unit = builder.unit;
         source = builder.source;
         parent = builder.parent;
         operationalStatus = builder.operationalStatus;
         color = builder.color;
-        category = ValidationSupport.requireNonNull(builder.category, "category");
+        category = builder.category;
         measurementPeriod = builder.measurementPeriod;
-        calibration = Collections.unmodifiableList(ValidationSupport.checkList(builder.calibration, "calibration", Calibration.class));
-        ValidationSupport.checkReferenceType(source, "source", "Device");
-        ValidationSupport.checkReferenceType(parent, "parent", "Device");
+        calibration = Collections.unmodifiableList(builder.calibration);
     }
 
     /**
@@ -799,7 +797,21 @@ public Builder calibration(Collection<Calibration> calibration) {
          */
         @Override
         public DeviceMetric build() {
-            return new DeviceMetric(this);
+            DeviceMetric deviceMetric = new DeviceMetric(this);
+            if (validating) {
+                validate(deviceMetric);
+            }
+            return deviceMetric;
+        }
+
+        protected void validate(DeviceMetric deviceMetric) {
+            super.validate(deviceMetric);
+            ValidationSupport.checkList(deviceMetric.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(deviceMetric.type, "type");
+            ValidationSupport.requireNonNull(deviceMetric.category, "category");
+            ValidationSupport.checkList(deviceMetric.calibration, "calibration", Calibration.class);
+            ValidationSupport.checkReferenceType(deviceMetric.source, "source", "Device");
+            ValidationSupport.checkReferenceType(deviceMetric.parent, "parent", "Device");
         }
 
         protected Builder from(DeviceMetric deviceMetric) {
@@ -846,7 +858,6 @@ private Calibration(Builder builder) {
             type = builder.type;
             state = builder.state;
             time = builder.time;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1111,7 +1122,16 @@ public Builder time(Instant time) {
              */
             @Override
             public Calibration build() {
-                return new Calibration(this);
+                Calibration calibration = new Calibration(this);
+                if (validating) {
+                    validate(calibration);
+                }
+                return calibration;
+            }
+
+            protected void validate(Calibration calibration) {
+                super.validate(calibration);
+                ValidationSupport.requireValueOrChildren(calibration);
             }
 
             protected Builder from(Calibration calibration) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceRequest.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceRequest.java
index 8914b5765d5..0a28e98385c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceRequest.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceRequest.java
@@ -153,38 +153,30 @@ public class DeviceRequest extends DomainResource {
 
     private DeviceRequest(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-        instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        priorRequest = Collections.unmodifiableList(ValidationSupport.checkList(builder.priorRequest, "priorRequest", Reference.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+        instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        priorRequest = Collections.unmodifiableList(builder.priorRequest);
         groupIdentifier = builder.groupIdentifier;
         status = builder.status;
-        intent = ValidationSupport.requireNonNull(builder.intent, "intent");
+        intent = builder.intent;
         priority = builder.priority;
-        code = ValidationSupport.requireChoiceElement(builder.code, "code", Reference.class, CodeableConcept.class);
-        parameter = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameter, "parameter", Parameter.class));
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        code = builder.code;
+        parameter = Collections.unmodifiableList(builder.parameter);
+        subject = builder.subject;
         encounter = builder.encounter;
-        occurrence = ValidationSupport.choiceElement(builder.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
+        occurrence = builder.occurrence;
         authoredOn = builder.authoredOn;
         requester = builder.requester;
         performerType = builder.performerType;
         performer = builder.performer;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        insurance = Collections.unmodifiableList(ValidationSupport.checkList(builder.insurance, "insurance", Reference.class));
-        supportingInfo = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInfo, "supportingInfo", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        relevantHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.relevantHistory, "relevantHistory", Reference.class));
-        ValidationSupport.checkReferenceType(code, "code", "Device");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group", "Location", "Device");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(requester, "requester", "Device", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(performer, "performer", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "HealthcareService", "Patient", "Device", "RelatedPerson");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
-        ValidationSupport.checkReferenceType(insurance, "insurance", "Coverage", "ClaimResponse");
-        ValidationSupport.checkReferenceType(relevantHistory, "relevantHistory", "Provenance");
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        insurance = Collections.unmodifiableList(builder.insurance);
+        supportingInfo = Collections.unmodifiableList(builder.supportingInfo);
+        note = Collections.unmodifiableList(builder.note);
+        relevantHistory = Collections.unmodifiableList(builder.relevantHistory);
     }
 
     /**
@@ -1529,7 +1521,39 @@ public Builder relevantHistory(Collection<Reference> relevantHistory) {
          */
         @Override
         public DeviceRequest build() {
-            return new DeviceRequest(this);
+            DeviceRequest deviceRequest = new DeviceRequest(this);
+            if (validating) {
+                validate(deviceRequest);
+            }
+            return deviceRequest;
+        }
+
+        protected void validate(DeviceRequest deviceRequest) {
+            super.validate(deviceRequest);
+            ValidationSupport.checkList(deviceRequest.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(deviceRequest.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+            ValidationSupport.checkList(deviceRequest.instantiatesUri, "instantiatesUri", Uri.class);
+            ValidationSupport.checkList(deviceRequest.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(deviceRequest.priorRequest, "priorRequest", Reference.class);
+            ValidationSupport.requireNonNull(deviceRequest.intent, "intent");
+            ValidationSupport.requireChoiceElement(deviceRequest.code, "code", Reference.class, CodeableConcept.class);
+            ValidationSupport.checkList(deviceRequest.parameter, "parameter", Parameter.class);
+            ValidationSupport.requireNonNull(deviceRequest.subject, "subject");
+            ValidationSupport.choiceElement(deviceRequest.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
+            ValidationSupport.checkList(deviceRequest.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(deviceRequest.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(deviceRequest.insurance, "insurance", Reference.class);
+            ValidationSupport.checkList(deviceRequest.supportingInfo, "supportingInfo", Reference.class);
+            ValidationSupport.checkList(deviceRequest.note, "note", Annotation.class);
+            ValidationSupport.checkList(deviceRequest.relevantHistory, "relevantHistory", Reference.class);
+            ValidationSupport.checkReferenceType(deviceRequest.code, "code", "Device");
+            ValidationSupport.checkReferenceType(deviceRequest.subject, "subject", "Patient", "Group", "Location", "Device");
+            ValidationSupport.checkReferenceType(deviceRequest.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(deviceRequest.requester, "requester", "Device", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(deviceRequest.performer, "performer", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "HealthcareService", "Patient", "Device", "RelatedPerson");
+            ValidationSupport.checkReferenceType(deviceRequest.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
+            ValidationSupport.checkReferenceType(deviceRequest.insurance, "insurance", "Coverage", "ClaimResponse");
+            ValidationSupport.checkReferenceType(deviceRequest.relevantHistory, "relevantHistory", "Provenance");
         }
 
         protected Builder from(DeviceRequest deviceRequest) {
@@ -1578,8 +1602,7 @@ public static class Parameter extends BackboneElement {
         private Parameter(Builder builder) {
             super(builder);
             code = builder.code;
-            value = ValidationSupport.choiceElement(builder.value, "value", CodeableConcept.class, Quantity.class, Range.class, Boolean.class);
-            ValidationSupport.requireValueOrChildren(this);
+            value = builder.value;
         }
 
         /**
@@ -1823,7 +1846,17 @@ public Builder value(Element value) {
              */
             @Override
             public Parameter build() {
-                return new Parameter(this);
+                Parameter parameter = new Parameter(this);
+                if (validating) {
+                    validate(parameter);
+                }
+                return parameter;
+            }
+
+            protected void validate(Parameter parameter) {
+                super.validate(parameter);
+                ValidationSupport.choiceElement(parameter.value, "value", CodeableConcept.class, Quantity.class, Range.class, Boolean.class);
+                ValidationSupport.requireValueOrChildren(parameter);
             }
 
             protected Builder from(Parameter parameter) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceUseStatement.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceUseStatement.java
index f66ff8797a5..741bf9989d6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceUseStatement.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DeviceUseStatement.java
@@ -101,25 +101,19 @@ public class DeviceUseStatement extends DomainResource {
 
     private DeviceUseStatement(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
-        derivedFrom = Collections.unmodifiableList(ValidationSupport.checkList(builder.derivedFrom, "derivedFrom", Reference.class));
-        timing = ValidationSupport.choiceElement(builder.timing, "timing", Timing.class, Period.class, DateTime.class);
+        identifier = Collections.unmodifiableList(builder.identifier);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        status = builder.status;
+        subject = builder.subject;
+        derivedFrom = Collections.unmodifiableList(builder.derivedFrom);
+        timing = builder.timing;
         recordedOn = builder.recordedOn;
         source = builder.source;
-        device = ValidationSupport.requireNonNull(builder.device, "device");
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
+        device = builder.device;
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
         bodySite = builder.bodySite;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "ServiceRequest");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(derivedFrom, "derivedFrom", "ServiceRequest", "Procedure", "Claim", "Observation", "QuestionnaireResponse", "DocumentReference");
-        ValidationSupport.checkReferenceType(source, "source", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
-        ValidationSupport.checkReferenceType(device, "device", "Device");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference", "Media");
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -999,7 +993,31 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public DeviceUseStatement build() {
-            return new DeviceUseStatement(this);
+            DeviceUseStatement deviceUseStatement = new DeviceUseStatement(this);
+            if (validating) {
+                validate(deviceUseStatement);
+            }
+            return deviceUseStatement;
+        }
+
+        protected void validate(DeviceUseStatement deviceUseStatement) {
+            super.validate(deviceUseStatement);
+            ValidationSupport.checkList(deviceUseStatement.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(deviceUseStatement.basedOn, "basedOn", Reference.class);
+            ValidationSupport.requireNonNull(deviceUseStatement.status, "status");
+            ValidationSupport.requireNonNull(deviceUseStatement.subject, "subject");
+            ValidationSupport.checkList(deviceUseStatement.derivedFrom, "derivedFrom", Reference.class);
+            ValidationSupport.choiceElement(deviceUseStatement.timing, "timing", Timing.class, Period.class, DateTime.class);
+            ValidationSupport.requireNonNull(deviceUseStatement.device, "device");
+            ValidationSupport.checkList(deviceUseStatement.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(deviceUseStatement.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(deviceUseStatement.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(deviceUseStatement.basedOn, "basedOn", "ServiceRequest");
+            ValidationSupport.checkReferenceType(deviceUseStatement.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(deviceUseStatement.derivedFrom, "derivedFrom", "ServiceRequest", "Procedure", "Claim", "Observation", "QuestionnaireResponse", "DocumentReference");
+            ValidationSupport.checkReferenceType(deviceUseStatement.source, "source", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
+            ValidationSupport.checkReferenceType(deviceUseStatement.device, "device", "Device");
+            ValidationSupport.checkReferenceType(deviceUseStatement.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference", "Media");
         }
 
         protected Builder from(DeviceUseStatement deviceUseStatement) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DiagnosticReport.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DiagnosticReport.java
index 1c74cca1450..035283313f9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DiagnosticReport.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DiagnosticReport.java
@@ -131,32 +131,24 @@ public class DiagnosticReport extends DomainResource {
 
     private DiagnosticReport(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
-        code = ValidationSupport.requireNonNull(builder.code, "code");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        status = builder.status;
+        category = Collections.unmodifiableList(builder.category);
+        code = builder.code;
         subject = builder.subject;
         encounter = builder.encounter;
-        effective = ValidationSupport.choiceElement(builder.effective, "effective", DateTime.class, Period.class);
+        effective = builder.effective;
         issued = builder.issued;
-        performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Reference.class));
-        resultsInterpreter = Collections.unmodifiableList(ValidationSupport.checkList(builder.resultsInterpreter, "resultsInterpreter", Reference.class));
-        specimen = Collections.unmodifiableList(ValidationSupport.checkList(builder.specimen, "specimen", Reference.class));
-        result = Collections.unmodifiableList(ValidationSupport.checkList(builder.result, "result", Reference.class));
-        imagingStudy = Collections.unmodifiableList(ValidationSupport.checkList(builder.imagingStudy, "imagingStudy", Reference.class));
-        media = Collections.unmodifiableList(ValidationSupport.checkList(builder.media, "media", Media.class));
+        performer = Collections.unmodifiableList(builder.performer);
+        resultsInterpreter = Collections.unmodifiableList(builder.resultsInterpreter);
+        specimen = Collections.unmodifiableList(builder.specimen);
+        result = Collections.unmodifiableList(builder.result);
+        imagingStudy = Collections.unmodifiableList(builder.imagingStudy);
+        media = Collections.unmodifiableList(builder.media);
         conclusion = builder.conclusion;
-        conclusionCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.conclusionCode, "conclusionCode", CodeableConcept.class));
-        presentedForm = Collections.unmodifiableList(ValidationSupport.checkList(builder.presentedForm, "presentedForm", Attachment.class));
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "CarePlan", "ImmunizationRecommendation", "MedicationRequest", "NutritionOrder", "ServiceRequest");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group", "Device", "Location");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(performer, "performer", "Practitioner", "PractitionerRole", "Organization", "CareTeam");
-        ValidationSupport.checkReferenceType(resultsInterpreter, "resultsInterpreter", "Practitioner", "PractitionerRole", "Organization", "CareTeam");
-        ValidationSupport.checkReferenceType(specimen, "specimen", "Specimen");
-        ValidationSupport.checkReferenceType(result, "result", "Observation");
-        ValidationSupport.checkReferenceType(imagingStudy, "imagingStudy", "ImagingStudy");
+        conclusionCode = Collections.unmodifiableList(builder.conclusionCode);
+        presentedForm = Collections.unmodifiableList(builder.presentedForm);
     }
 
     /**
@@ -1318,7 +1310,37 @@ public Builder presentedForm(Collection<Attachment> presentedForm) {
          */
         @Override
         public DiagnosticReport build() {
-            return new DiagnosticReport(this);
+            DiagnosticReport diagnosticReport = new DiagnosticReport(this);
+            if (validating) {
+                validate(diagnosticReport);
+            }
+            return diagnosticReport;
+        }
+
+        protected void validate(DiagnosticReport diagnosticReport) {
+            super.validate(diagnosticReport);
+            ValidationSupport.checkList(diagnosticReport.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(diagnosticReport.basedOn, "basedOn", Reference.class);
+            ValidationSupport.requireNonNull(diagnosticReport.status, "status");
+            ValidationSupport.checkList(diagnosticReport.category, "category", CodeableConcept.class);
+            ValidationSupport.requireNonNull(diagnosticReport.code, "code");
+            ValidationSupport.choiceElement(diagnosticReport.effective, "effective", DateTime.class, Period.class);
+            ValidationSupport.checkList(diagnosticReport.performer, "performer", Reference.class);
+            ValidationSupport.checkList(diagnosticReport.resultsInterpreter, "resultsInterpreter", Reference.class);
+            ValidationSupport.checkList(diagnosticReport.specimen, "specimen", Reference.class);
+            ValidationSupport.checkList(diagnosticReport.result, "result", Reference.class);
+            ValidationSupport.checkList(diagnosticReport.imagingStudy, "imagingStudy", Reference.class);
+            ValidationSupport.checkList(diagnosticReport.media, "media", Media.class);
+            ValidationSupport.checkList(diagnosticReport.conclusionCode, "conclusionCode", CodeableConcept.class);
+            ValidationSupport.checkList(diagnosticReport.presentedForm, "presentedForm", Attachment.class);
+            ValidationSupport.checkReferenceType(diagnosticReport.basedOn, "basedOn", "CarePlan", "ImmunizationRecommendation", "MedicationRequest", "NutritionOrder", "ServiceRequest");
+            ValidationSupport.checkReferenceType(diagnosticReport.subject, "subject", "Patient", "Group", "Device", "Location");
+            ValidationSupport.checkReferenceType(diagnosticReport.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(diagnosticReport.performer, "performer", "Practitioner", "PractitionerRole", "Organization", "CareTeam");
+            ValidationSupport.checkReferenceType(diagnosticReport.resultsInterpreter, "resultsInterpreter", "Practitioner", "PractitionerRole", "Organization", "CareTeam");
+            ValidationSupport.checkReferenceType(diagnosticReport.specimen, "specimen", "Specimen");
+            ValidationSupport.checkReferenceType(diagnosticReport.result, "result", "Observation");
+            ValidationSupport.checkReferenceType(diagnosticReport.imagingStudy, "imagingStudy", "ImagingStudy");
         }
 
         protected Builder from(DiagnosticReport diagnosticReport) {
@@ -1359,9 +1381,7 @@ public static class Media extends BackboneElement {
         private Media(Builder builder) {
             super(builder);
             comment = builder.comment;
-            link = ValidationSupport.requireNonNull(builder.link, "link");
-            ValidationSupport.checkReferenceType(link, "link", "Media");
-            ValidationSupport.requireValueOrChildren(this);
+            link = builder.link;
         }
 
         /**
@@ -1611,7 +1631,18 @@ public Builder link(Reference link) {
              */
             @Override
             public Media build() {
-                return new Media(this);
+                Media media = new Media(this);
+                if (validating) {
+                    validate(media);
+                }
+                return media;
+            }
+
+            protected void validate(Media media) {
+                super.validate(media);
+                ValidationSupport.requireNonNull(media.link, "link");
+                ValidationSupport.checkReferenceType(media.link, "link", "Media");
+                ValidationSupport.requireValueOrChildren(media);
             }
 
             protected Builder from(Media media) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DocumentManifest.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DocumentManifest.java
index c4b3777bc89..5510e5d9f99 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DocumentManifest.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DocumentManifest.java
@@ -88,20 +88,17 @@ public class DocumentManifest extends DomainResource {
     private DocumentManifest(Builder builder) {
         super(builder);
         masterIdentifier = builder.masterIdentifier;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         type = builder.type;
         subject = builder.subject;
         created = builder.created;
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", Reference.class));
-        recipient = Collections.unmodifiableList(ValidationSupport.checkList(builder.recipient, "recipient", Reference.class));
+        author = Collections.unmodifiableList(builder.author);
+        recipient = Collections.unmodifiableList(builder.recipient);
         source = builder.source;
         description = builder.description;
-        content = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.content, "content", Reference.class));
-        related = Collections.unmodifiableList(ValidationSupport.checkList(builder.related, "related", Related.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Practitioner", "Group", "Device");
-        ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole", "Organization", "Device", "Patient", "RelatedPerson");
-        ValidationSupport.checkReferenceType(recipient, "recipient", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Organization");
+        content = Collections.unmodifiableList(builder.content);
+        related = Collections.unmodifiableList(builder.related);
     }
 
     /**
@@ -907,7 +904,24 @@ public Builder related(Collection<Related> related) {
          */
         @Override
         public DocumentManifest build() {
-            return new DocumentManifest(this);
+            DocumentManifest documentManifest = new DocumentManifest(this);
+            if (validating) {
+                validate(documentManifest);
+            }
+            return documentManifest;
+        }
+
+        protected void validate(DocumentManifest documentManifest) {
+            super.validate(documentManifest);
+            ValidationSupport.checkList(documentManifest.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(documentManifest.status, "status");
+            ValidationSupport.checkList(documentManifest.author, "author", Reference.class);
+            ValidationSupport.checkList(documentManifest.recipient, "recipient", Reference.class);
+            ValidationSupport.checkNonEmptyList(documentManifest.content, "content", Reference.class);
+            ValidationSupport.checkList(documentManifest.related, "related", Related.class);
+            ValidationSupport.checkReferenceType(documentManifest.subject, "subject", "Patient", "Practitioner", "Group", "Device");
+            ValidationSupport.checkReferenceType(documentManifest.author, "author", "Practitioner", "PractitionerRole", "Organization", "Device", "Patient", "RelatedPerson");
+            ValidationSupport.checkReferenceType(documentManifest.recipient, "recipient", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Organization");
         }
 
         protected Builder from(DocumentManifest documentManifest) {
@@ -939,7 +953,6 @@ private Related(Builder builder) {
             super(builder);
             identifier = builder.identifier;
             ref = builder.ref;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1175,7 +1188,16 @@ public Builder ref(Reference ref) {
              */
             @Override
             public Related build() {
-                return new Related(this);
+                Related related = new Related(this);
+                if (validating) {
+                    validate(related);
+                }
+                return related;
+            }
+
+            protected void validate(Related related) {
+                super.validate(related);
+                ValidationSupport.requireValueOrChildren(related);
             }
 
             protected Builder from(Related related) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DocumentReference.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DocumentReference.java
index 8f3c99b4c5b..e3baf4b5bb0 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DocumentReference.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DocumentReference.java
@@ -149,25 +149,21 @@ public class DocumentReference extends DomainResource {
     private DocumentReference(Builder builder) {
         super(builder);
         masterIdentifier = builder.masterIdentifier;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         docStatus = builder.docStatus;
         type = builder.type;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        category = Collections.unmodifiableList(builder.category);
         subject = builder.subject;
         date = builder.date;
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", Reference.class));
+        author = Collections.unmodifiableList(builder.author);
         authenticator = builder.authenticator;
         custodian = builder.custodian;
-        relatesTo = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatesTo, "relatesTo", RelatesTo.class));
+        relatesTo = Collections.unmodifiableList(builder.relatesTo);
         description = builder.description;
-        securityLabel = Collections.unmodifiableList(ValidationSupport.checkList(builder.securityLabel, "securityLabel", CodeableConcept.class));
-        content = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.content, "content", Content.class));
+        securityLabel = Collections.unmodifiableList(builder.securityLabel);
+        content = Collections.unmodifiableList(builder.content);
         context = builder.context;
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Practitioner", "Group", "Device");
-        ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole", "Organization", "Device", "Patient", "RelatedPerson");
-        ValidationSupport.checkReferenceType(authenticator, "authenticator", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(custodian, "custodian", "Organization");
     }
 
     /**
@@ -1108,7 +1104,26 @@ public Builder context(Context context) {
          */
         @Override
         public DocumentReference build() {
-            return new DocumentReference(this);
+            DocumentReference documentReference = new DocumentReference(this);
+            if (validating) {
+                validate(documentReference);
+            }
+            return documentReference;
+        }
+
+        protected void validate(DocumentReference documentReference) {
+            super.validate(documentReference);
+            ValidationSupport.checkList(documentReference.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(documentReference.status, "status");
+            ValidationSupport.checkList(documentReference.category, "category", CodeableConcept.class);
+            ValidationSupport.checkList(documentReference.author, "author", Reference.class);
+            ValidationSupport.checkList(documentReference.relatesTo, "relatesTo", RelatesTo.class);
+            ValidationSupport.checkList(documentReference.securityLabel, "securityLabel", CodeableConcept.class);
+            ValidationSupport.checkNonEmptyList(documentReference.content, "content", Content.class);
+            ValidationSupport.checkReferenceType(documentReference.subject, "subject", "Patient", "Practitioner", "Group", "Device");
+            ValidationSupport.checkReferenceType(documentReference.author, "author", "Practitioner", "PractitionerRole", "Organization", "Device", "Patient", "RelatedPerson");
+            ValidationSupport.checkReferenceType(documentReference.authenticator, "authenticator", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(documentReference.custodian, "custodian", "Organization");
         }
 
         protected Builder from(DocumentReference documentReference) {
@@ -1153,10 +1168,8 @@ public static class RelatesTo extends BackboneElement {
 
         private RelatesTo(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            target = ValidationSupport.requireNonNull(builder.target, "target");
-            ValidationSupport.checkReferenceType(target, "target", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            code = builder.code;
+            target = builder.target;
         }
 
         /**
@@ -1407,7 +1420,19 @@ public Builder target(Reference target) {
              */
             @Override
             public RelatesTo build() {
-                return new RelatesTo(this);
+                RelatesTo relatesTo = new RelatesTo(this);
+                if (validating) {
+                    validate(relatesTo);
+                }
+                return relatesTo;
+            }
+
+            protected void validate(RelatesTo relatesTo) {
+                super.validate(relatesTo);
+                ValidationSupport.requireNonNull(relatesTo.code, "code");
+                ValidationSupport.requireNonNull(relatesTo.target, "target");
+                ValidationSupport.checkReferenceType(relatesTo.target, "target", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(relatesTo);
             }
 
             protected Builder from(RelatesTo relatesTo) {
@@ -1437,9 +1462,8 @@ public static class Content extends BackboneElement {
 
         private Content(Builder builder) {
             super(builder);
-            attachment = ValidationSupport.requireNonNull(builder.attachment, "attachment");
+            attachment = builder.attachment;
             format = builder.format;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1684,7 +1708,17 @@ public Builder format(Coding format) {
              */
             @Override
             public Content build() {
-                return new Content(this);
+                Content content = new Content(this);
+                if (validating) {
+                    validate(content);
+                }
+                return content;
+            }
+
+            protected void validate(Content content) {
+                super.validate(content);
+                ValidationSupport.requireNonNull(content.attachment, "attachment");
+                ValidationSupport.requireValueOrChildren(content);
             }
 
             protected Builder from(Content content) {
@@ -1731,16 +1765,13 @@ public static class Context extends BackboneElement {
 
         private Context(Builder builder) {
             super(builder);
-            encounter = Collections.unmodifiableList(ValidationSupport.checkList(builder.encounter, "encounter", Reference.class));
-            event = Collections.unmodifiableList(ValidationSupport.checkList(builder.event, "event", CodeableConcept.class));
+            encounter = Collections.unmodifiableList(builder.encounter);
+            event = Collections.unmodifiableList(builder.event);
             period = builder.period;
             facilityType = builder.facilityType;
             practiceSetting = builder.practiceSetting;
             sourcePatientInfo = builder.sourcePatientInfo;
-            related = Collections.unmodifiableList(ValidationSupport.checkList(builder.related, "related", Reference.class));
-            ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter", "EpisodeOfCare");
-            ValidationSupport.checkReferenceType(sourcePatientInfo, "sourcePatientInfo", "Patient");
-            ValidationSupport.requireValueOrChildren(this);
+            related = Collections.unmodifiableList(builder.related);
         }
 
         /**
@@ -2208,7 +2239,21 @@ public Builder related(Collection<Reference> related) {
              */
             @Override
             public Context build() {
-                return new Context(this);
+                Context context = new Context(this);
+                if (validating) {
+                    validate(context);
+                }
+                return context;
+            }
+
+            protected void validate(Context context) {
+                super.validate(context);
+                ValidationSupport.checkList(context.encounter, "encounter", Reference.class);
+                ValidationSupport.checkList(context.event, "event", CodeableConcept.class);
+                ValidationSupport.checkList(context.related, "related", Reference.class);
+                ValidationSupport.checkReferenceType(context.encounter, "encounter", "Encounter", "EpisodeOfCare");
+                ValidationSupport.checkReferenceType(context.sourcePatientInfo, "sourcePatientInfo", "Patient");
+                ValidationSupport.requireValueOrChildren(context);
             }
 
             protected Builder from(Context context) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DomainResource.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DomainResource.java
index e79b43748a0..92168a7cf72 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/DomainResource.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/DomainResource.java
@@ -77,9 +77,9 @@ public abstract class DomainResource extends Resource {
     protected DomainResource(Builder builder) {
         super(builder);
         text = builder.text;
-        contained = Collections.unmodifiableList(ValidationSupport.checkList(builder.contained, "contained", Resource.class));
-        extension = Collections.unmodifiableList(ValidationSupport.checkList(builder.extension, "extension", Extension.class));
-        modifierExtension = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifierExtension, "modifierExtension", Extension.class));
+        contained = Collections.unmodifiableList(builder.contained);
+        extension = Collections.unmodifiableList(builder.extension);
+        modifierExtension = Collections.unmodifiableList(builder.modifierExtension);
     }
 
     /**
@@ -364,6 +364,13 @@ public Builder modifierExtension(Collection<Extension> modifierExtension) {
         @Override
         public abstract DomainResource build();
 
+        protected void validate(DomainResource domainResource) {
+            super.validate(domainResource);
+            ValidationSupport.checkList(domainResource.contained, "contained", Resource.class);
+            ValidationSupport.checkList(domainResource.extension, "extension", Extension.class);
+            ValidationSupport.checkList(domainResource.modifierExtension, "modifierExtension", Extension.class);
+        }
+
         protected Builder from(DomainResource domainResource) {
             super.from(domainResource);
             text = domainResource.text;
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EffectEvidenceSynthesis.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EffectEvidenceSynthesis.java
index 7e6d8a98aa2..3cee9617d12 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EffectEvidenceSynthesis.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EffectEvidenceSynthesis.java
@@ -240,42 +240,38 @@ public class EffectEvidenceSynthesis extends DomainResource {
     private EffectEvidenceSynthesis(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        note = Collections.unmodifiableList(builder.note);
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
         synthesisType = builder.synthesisType;
         studyType = builder.studyType;
-        population = ValidationSupport.requireNonNull(builder.population, "population");
-        exposure = ValidationSupport.requireNonNull(builder.exposure, "exposure");
-        exposureAlternative = ValidationSupport.requireNonNull(builder.exposureAlternative, "exposureAlternative");
-        outcome = ValidationSupport.requireNonNull(builder.outcome, "outcome");
+        population = builder.population;
+        exposure = builder.exposure;
+        exposureAlternative = builder.exposureAlternative;
+        outcome = builder.outcome;
         sampleSize = builder.sampleSize;
-        resultsByExposure = Collections.unmodifiableList(ValidationSupport.checkList(builder.resultsByExposure, "resultsByExposure", ResultsByExposure.class));
-        effectEstimate = Collections.unmodifiableList(ValidationSupport.checkList(builder.effectEstimate, "effectEstimate", EffectEstimate.class));
-        certainty = Collections.unmodifiableList(ValidationSupport.checkList(builder.certainty, "certainty", Certainty.class));
-        ValidationSupport.checkReferenceType(population, "population", "EvidenceVariable");
-        ValidationSupport.checkReferenceType(exposure, "exposure", "EvidenceVariable");
-        ValidationSupport.checkReferenceType(exposureAlternative, "exposureAlternative", "EvidenceVariable");
-        ValidationSupport.checkReferenceType(outcome, "outcome", "EvidenceVariable");
+        resultsByExposure = Collections.unmodifiableList(builder.resultsByExposure);
+        effectEstimate = Collections.unmodifiableList(builder.effectEstimate);
+        certainty = Collections.unmodifiableList(builder.certainty);
     }
 
     /**
@@ -1877,7 +1873,38 @@ public Builder certainty(Collection<Certainty> certainty) {
          */
         @Override
         public EffectEvidenceSynthesis build() {
-            return new EffectEvidenceSynthesis(this);
+            EffectEvidenceSynthesis effectEvidenceSynthesis = new EffectEvidenceSynthesis(this);
+            if (validating) {
+                validate(effectEvidenceSynthesis);
+            }
+            return effectEvidenceSynthesis;
+        }
+
+        protected void validate(EffectEvidenceSynthesis effectEvidenceSynthesis) {
+            super.validate(effectEvidenceSynthesis);
+            ValidationSupport.checkList(effectEvidenceSynthesis.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(effectEvidenceSynthesis.status, "status");
+            ValidationSupport.checkList(effectEvidenceSynthesis.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.note, "note", Annotation.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.requireNonNull(effectEvidenceSynthesis.population, "population");
+            ValidationSupport.requireNonNull(effectEvidenceSynthesis.exposure, "exposure");
+            ValidationSupport.requireNonNull(effectEvidenceSynthesis.exposureAlternative, "exposureAlternative");
+            ValidationSupport.requireNonNull(effectEvidenceSynthesis.outcome, "outcome");
+            ValidationSupport.checkList(effectEvidenceSynthesis.resultsByExposure, "resultsByExposure", ResultsByExposure.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.effectEstimate, "effectEstimate", EffectEstimate.class);
+            ValidationSupport.checkList(effectEvidenceSynthesis.certainty, "certainty", Certainty.class);
+            ValidationSupport.checkReferenceType(effectEvidenceSynthesis.population, "population", "EvidenceVariable");
+            ValidationSupport.checkReferenceType(effectEvidenceSynthesis.exposure, "exposure", "EvidenceVariable");
+            ValidationSupport.checkReferenceType(effectEvidenceSynthesis.exposureAlternative, "exposureAlternative", "EvidenceVariable");
+            ValidationSupport.checkReferenceType(effectEvidenceSynthesis.outcome, "outcome", "EvidenceVariable");
         }
 
         protected Builder from(EffectEvidenceSynthesis effectEvidenceSynthesis) {
@@ -1932,7 +1959,6 @@ private SampleSize(Builder builder) {
             description = builder.description;
             numberOfStudies = builder.numberOfStudies;
             numberOfParticipants = builder.numberOfParticipants;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2197,7 +2223,16 @@ public Builder numberOfParticipants(Integer numberOfParticipants) {
              */
             @Override
             public SampleSize build() {
-                return new SampleSize(this);
+                SampleSize sampleSize = new SampleSize(this);
+                if (validating) {
+                    validate(sampleSize);
+                }
+                return sampleSize;
+            }
+
+            protected void validate(SampleSize sampleSize) {
+                super.validate(sampleSize);
+                ValidationSupport.requireValueOrChildren(sampleSize);
             }
 
             protected Builder from(SampleSize sampleSize) {
@@ -2238,9 +2273,7 @@ private ResultsByExposure(Builder builder) {
             description = builder.description;
             exposureState = builder.exposureState;
             variantState = builder.variantState;
-            riskEvidenceSynthesis = ValidationSupport.requireNonNull(builder.riskEvidenceSynthesis, "riskEvidenceSynthesis");
-            ValidationSupport.checkReferenceType(riskEvidenceSynthesis, "riskEvidenceSynthesis", "RiskEvidenceSynthesis");
-            ValidationSupport.requireValueOrChildren(this);
+            riskEvidenceSynthesis = builder.riskEvidenceSynthesis;
         }
 
         /**
@@ -2546,7 +2579,18 @@ public Builder riskEvidenceSynthesis(Reference riskEvidenceSynthesis) {
              */
             @Override
             public ResultsByExposure build() {
-                return new ResultsByExposure(this);
+                ResultsByExposure resultsByExposure = new ResultsByExposure(this);
+                if (validating) {
+                    validate(resultsByExposure);
+                }
+                return resultsByExposure;
+            }
+
+            protected void validate(ResultsByExposure resultsByExposure) {
+                super.validate(resultsByExposure);
+                ValidationSupport.requireNonNull(resultsByExposure.riskEvidenceSynthesis, "riskEvidenceSynthesis");
+                ValidationSupport.checkReferenceType(resultsByExposure.riskEvidenceSynthesis, "riskEvidenceSynthesis", "RiskEvidenceSynthesis");
+                ValidationSupport.requireValueOrChildren(resultsByExposure);
             }
 
             protected Builder from(ResultsByExposure resultsByExposure) {
@@ -2596,9 +2640,7 @@ private EffectEstimate(Builder builder) {
             variantState = builder.variantState;
             value = builder.value;
             unitOfMeasure = builder.unitOfMeasure;
-            precisionEstimate = Collections.unmodifiableList(ValidationSupport.checkList(builder.precisionEstimate, "precisionEstimate", PrecisionEstimate.class));
-            ValidationSupport.checkValueSetBinding(unitOfMeasure, "unitOfMeasure", "http://hl7.org/fhir/ValueSet/ucum-units", "http://unitsofmeasure.org");
-            ValidationSupport.requireValueOrChildren(this);
+            precisionEstimate = Collections.unmodifiableList(builder.precisionEstimate);
         }
 
         /**
@@ -2970,7 +3012,18 @@ public Builder precisionEstimate(Collection<PrecisionEstimate> precisionEstimate
              */
             @Override
             public EffectEstimate build() {
-                return new EffectEstimate(this);
+                EffectEstimate effectEstimate = new EffectEstimate(this);
+                if (validating) {
+                    validate(effectEstimate);
+                }
+                return effectEstimate;
+            }
+
+            protected void validate(EffectEstimate effectEstimate) {
+                super.validate(effectEstimate);
+                ValidationSupport.checkList(effectEstimate.precisionEstimate, "precisionEstimate", PrecisionEstimate.class);
+                ValidationSupport.checkValueSetBinding(effectEstimate.unitOfMeasure, "unitOfMeasure", "http://hl7.org/fhir/ValueSet/ucum-units", "http://unitsofmeasure.org");
+                ValidationSupport.requireValueOrChildren(effectEstimate);
             }
 
             protected Builder from(EffectEstimate effectEstimate) {
@@ -3006,7 +3059,6 @@ private PrecisionEstimate(Builder builder) {
                 level = builder.level;
                 from = builder.from;
                 to = builder.to;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -3300,7 +3352,16 @@ public Builder to(Decimal to) {
                  */
                 @Override
                 public PrecisionEstimate build() {
-                    return new PrecisionEstimate(this);
+                    PrecisionEstimate precisionEstimate = new PrecisionEstimate(this);
+                    if (validating) {
+                        validate(precisionEstimate);
+                    }
+                    return precisionEstimate;
+                }
+
+                protected void validate(PrecisionEstimate precisionEstimate) {
+                    super.validate(precisionEstimate);
+                    ValidationSupport.requireValueOrChildren(precisionEstimate);
                 }
 
                 protected Builder from(PrecisionEstimate precisionEstimate) {
@@ -3331,10 +3392,9 @@ public static class Certainty extends BackboneElement {
 
         private Certainty(Builder builder) {
             super(builder);
-            rating = Collections.unmodifiableList(ValidationSupport.checkList(builder.rating, "rating", CodeableConcept.class));
-            note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-            certaintySubcomponent = Collections.unmodifiableList(ValidationSupport.checkList(builder.certaintySubcomponent, "certaintySubcomponent", CertaintySubcomponent.class));
-            ValidationSupport.requireValueOrChildren(this);
+            rating = Collections.unmodifiableList(builder.rating);
+            note = Collections.unmodifiableList(builder.note);
+            certaintySubcomponent = Collections.unmodifiableList(builder.certaintySubcomponent);
         }
 
         /**
@@ -3659,7 +3719,19 @@ public Builder certaintySubcomponent(Collection<CertaintySubcomponent> certainty
              */
             @Override
             public Certainty build() {
-                return new Certainty(this);
+                Certainty certainty = new Certainty(this);
+                if (validating) {
+                    validate(certainty);
+                }
+                return certainty;
+            }
+
+            protected void validate(Certainty certainty) {
+                super.validate(certainty);
+                ValidationSupport.checkList(certainty.rating, "rating", CodeableConcept.class);
+                ValidationSupport.checkList(certainty.note, "note", Annotation.class);
+                ValidationSupport.checkList(certainty.certaintySubcomponent, "certaintySubcomponent", CertaintySubcomponent.class);
+                ValidationSupport.requireValueOrChildren(certainty);
             }
 
             protected Builder from(Certainty certainty) {
@@ -3694,9 +3766,8 @@ public static class CertaintySubcomponent extends BackboneElement {
             private CertaintySubcomponent(Builder builder) {
                 super(builder);
                 type = builder.type;
-                rating = Collections.unmodifiableList(ValidationSupport.checkList(builder.rating, "rating", CodeableConcept.class));
-                note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-                ValidationSupport.requireValueOrChildren(this);
+                rating = Collections.unmodifiableList(builder.rating);
+                note = Collections.unmodifiableList(builder.note);
             }
 
             /**
@@ -4001,7 +4072,18 @@ public Builder note(Collection<Annotation> note) {
                  */
                 @Override
                 public CertaintySubcomponent build() {
-                    return new CertaintySubcomponent(this);
+                    CertaintySubcomponent certaintySubcomponent = new CertaintySubcomponent(this);
+                    if (validating) {
+                        validate(certaintySubcomponent);
+                    }
+                    return certaintySubcomponent;
+                }
+
+                protected void validate(CertaintySubcomponent certaintySubcomponent) {
+                    super.validate(certaintySubcomponent);
+                    ValidationSupport.checkList(certaintySubcomponent.rating, "rating", CodeableConcept.class);
+                    ValidationSupport.checkList(certaintySubcomponent.note, "note", Annotation.class);
+                    ValidationSupport.requireValueOrChildren(certaintySubcomponent);
                 }
 
                 protected Builder from(CertaintySubcomponent certaintySubcomponent) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Encounter.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Encounter.java
index 3d471bf8feb..763bc37577a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Encounter.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Encounter.java
@@ -200,37 +200,29 @@ public class Encounter extends DomainResource {
 
     private Encounter(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        statusHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.statusHistory, "statusHistory", StatusHistory.class));
-        clazz = ValidationSupport.requireNonNull(builder.clazz, "class");
-        classHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.classHistory, "classHistory", ClassHistory.class));
-        type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        statusHistory = Collections.unmodifiableList(builder.statusHistory);
+        clazz = builder.clazz;
+        classHistory = Collections.unmodifiableList(builder.classHistory);
+        type = Collections.unmodifiableList(builder.type);
         serviceType = builder.serviceType;
         priority = builder.priority;
         subject = builder.subject;
-        episodeOfCare = Collections.unmodifiableList(ValidationSupport.checkList(builder.episodeOfCare, "episodeOfCare", Reference.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        participant = Collections.unmodifiableList(ValidationSupport.checkList(builder.participant, "participant", Participant.class));
-        appointment = Collections.unmodifiableList(ValidationSupport.checkList(builder.appointment, "appointment", Reference.class));
+        episodeOfCare = Collections.unmodifiableList(builder.episodeOfCare);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        participant = Collections.unmodifiableList(builder.participant);
+        appointment = Collections.unmodifiableList(builder.appointment);
         period = builder.period;
         length = builder.length;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        diagnosis = Collections.unmodifiableList(ValidationSupport.checkList(builder.diagnosis, "diagnosis", Diagnosis.class));
-        account = Collections.unmodifiableList(ValidationSupport.checkList(builder.account, "account", Reference.class));
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        diagnosis = Collections.unmodifiableList(builder.diagnosis);
+        account = Collections.unmodifiableList(builder.account);
         hospitalization = builder.hospitalization;
-        location = Collections.unmodifiableList(ValidationSupport.checkList(builder.location, "location", Location.class));
+        location = Collections.unmodifiableList(builder.location);
         serviceProvider = builder.serviceProvider;
         partOf = builder.partOf;
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(episodeOfCare, "episodeOfCare", "EpisodeOfCare");
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "ServiceRequest");
-        ValidationSupport.checkReferenceType(appointment, "appointment", "Appointment");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Procedure", "Observation", "ImmunizationRecommendation");
-        ValidationSupport.checkReferenceType(account, "account", "Account");
-        ValidationSupport.checkReferenceType(serviceProvider, "serviceProvider", "Organization");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "Encounter");
     }
 
     /**
@@ -1568,7 +1560,38 @@ public Builder partOf(Reference partOf) {
          */
         @Override
         public Encounter build() {
-            return new Encounter(this);
+            Encounter encounter = new Encounter(this);
+            if (validating) {
+                validate(encounter);
+            }
+            return encounter;
+        }
+
+        protected void validate(Encounter encounter) {
+            super.validate(encounter);
+            ValidationSupport.checkList(encounter.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(encounter.status, "status");
+            ValidationSupport.checkList(encounter.statusHistory, "statusHistory", StatusHistory.class);
+            ValidationSupport.requireNonNull(encounter.clazz, "class");
+            ValidationSupport.checkList(encounter.classHistory, "classHistory", ClassHistory.class);
+            ValidationSupport.checkList(encounter.type, "type", CodeableConcept.class);
+            ValidationSupport.checkList(encounter.episodeOfCare, "episodeOfCare", Reference.class);
+            ValidationSupport.checkList(encounter.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(encounter.participant, "participant", Participant.class);
+            ValidationSupport.checkList(encounter.appointment, "appointment", Reference.class);
+            ValidationSupport.checkList(encounter.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(encounter.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(encounter.diagnosis, "diagnosis", Diagnosis.class);
+            ValidationSupport.checkList(encounter.account, "account", Reference.class);
+            ValidationSupport.checkList(encounter.location, "location", Location.class);
+            ValidationSupport.checkReferenceType(encounter.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(encounter.episodeOfCare, "episodeOfCare", "EpisodeOfCare");
+            ValidationSupport.checkReferenceType(encounter.basedOn, "basedOn", "ServiceRequest");
+            ValidationSupport.checkReferenceType(encounter.appointment, "appointment", "Appointment");
+            ValidationSupport.checkReferenceType(encounter.reasonReference, "reasonReference", "Condition", "Procedure", "Observation", "ImmunizationRecommendation");
+            ValidationSupport.checkReferenceType(encounter.account, "account", "Account");
+            ValidationSupport.checkReferenceType(encounter.serviceProvider, "serviceProvider", "Organization");
+            ValidationSupport.checkReferenceType(encounter.partOf, "partOf", "Encounter");
         }
 
         protected Builder from(Encounter encounter) {
@@ -1618,9 +1641,8 @@ public static class StatusHistory extends BackboneElement {
 
         private StatusHistory(Builder builder) {
             super(builder);
-            status = ValidationSupport.requireNonNull(builder.status, "status");
-            period = ValidationSupport.requireNonNull(builder.period, "period");
-            ValidationSupport.requireValueOrChildren(this);
+            status = builder.status;
+            period = builder.period;
         }
 
         /**
@@ -1866,7 +1888,18 @@ public Builder period(Period period) {
              */
             @Override
             public StatusHistory build() {
-                return new StatusHistory(this);
+                StatusHistory statusHistory = new StatusHistory(this);
+                if (validating) {
+                    validate(statusHistory);
+                }
+                return statusHistory;
+            }
+
+            protected void validate(StatusHistory statusHistory) {
+                super.validate(statusHistory);
+                ValidationSupport.requireNonNull(statusHistory.status, "status");
+                ValidationSupport.requireNonNull(statusHistory.period, "period");
+                ValidationSupport.requireValueOrChildren(statusHistory);
             }
 
             protected Builder from(StatusHistory statusHistory) {
@@ -1899,9 +1932,8 @@ public static class ClassHistory extends BackboneElement {
 
         private ClassHistory(Builder builder) {
             super(builder);
-            clazz = ValidationSupport.requireNonNull(builder.clazz, "class");
-            period = ValidationSupport.requireNonNull(builder.period, "period");
-            ValidationSupport.requireValueOrChildren(this);
+            clazz = builder.clazz;
+            period = builder.period;
         }
 
         /**
@@ -2147,7 +2179,18 @@ public Builder period(Period period) {
              */
             @Override
             public ClassHistory build() {
-                return new ClassHistory(this);
+                ClassHistory classHistory = new ClassHistory(this);
+                if (validating) {
+                    validate(classHistory);
+                }
+                return classHistory;
+            }
+
+            protected void validate(ClassHistory classHistory) {
+                super.validate(classHistory);
+                ValidationSupport.requireNonNull(classHistory.clazz, "class");
+                ValidationSupport.requireNonNull(classHistory.period, "period");
+                ValidationSupport.requireValueOrChildren(classHistory);
             }
 
             protected Builder from(ClassHistory classHistory) {
@@ -2178,11 +2221,9 @@ public static class Participant extends BackboneElement {
 
         private Participant(Builder builder) {
             super(builder);
-            type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+            type = Collections.unmodifiableList(builder.type);
             period = builder.period;
             individual = builder.individual;
-            ValidationSupport.checkReferenceType(individual, "individual", "Practitioner", "PractitionerRole", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2476,7 +2517,18 @@ public Builder individual(Reference individual) {
              */
             @Override
             public Participant build() {
-                return new Participant(this);
+                Participant participant = new Participant(this);
+                if (validating) {
+                    validate(participant);
+                }
+                return participant;
+            }
+
+            protected void validate(Participant participant) {
+                super.validate(participant);
+                ValidationSupport.checkList(participant.type, "type", CodeableConcept.class);
+                ValidationSupport.checkReferenceType(participant.individual, "individual", "Practitioner", "PractitionerRole", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(participant);
             }
 
             protected Builder from(Participant participant) {
@@ -2508,11 +2560,9 @@ public static class Diagnosis extends BackboneElement {
 
         private Diagnosis(Builder builder) {
             super(builder);
-            condition = ValidationSupport.requireNonNull(builder.condition, "condition");
+            condition = builder.condition;
             use = builder.use;
             rank = builder.rank;
-            ValidationSupport.checkReferenceType(condition, "condition", "Condition", "Procedure");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2794,7 +2844,18 @@ public Builder rank(PositiveInt rank) {
              */
             @Override
             public Diagnosis build() {
-                return new Diagnosis(this);
+                Diagnosis diagnosis = new Diagnosis(this);
+                if (validating) {
+                    validate(diagnosis);
+                }
+                return diagnosis;
+            }
+
+            protected void validate(Diagnosis diagnosis) {
+                super.validate(diagnosis);
+                ValidationSupport.requireNonNull(diagnosis.condition, "condition");
+                ValidationSupport.checkReferenceType(diagnosis.condition, "condition", "Condition", "Procedure");
+                ValidationSupport.requireValueOrChildren(diagnosis);
             }
 
             protected Builder from(Diagnosis diagnosis) {
@@ -2865,14 +2926,11 @@ private Hospitalization(Builder builder) {
             origin = builder.origin;
             admitSource = builder.admitSource;
             reAdmission = builder.reAdmission;
-            dietPreference = Collections.unmodifiableList(ValidationSupport.checkList(builder.dietPreference, "dietPreference", CodeableConcept.class));
-            specialCourtesy = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialCourtesy, "specialCourtesy", CodeableConcept.class));
-            specialArrangement = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialArrangement, "specialArrangement", CodeableConcept.class));
+            dietPreference = Collections.unmodifiableList(builder.dietPreference);
+            specialCourtesy = Collections.unmodifiableList(builder.specialCourtesy);
+            specialArrangement = Collections.unmodifiableList(builder.specialArrangement);
             destination = builder.destination;
             dischargeDisposition = builder.dischargeDisposition;
-            ValidationSupport.checkReferenceType(origin, "origin", "Location", "Organization");
-            ValidationSupport.checkReferenceType(destination, "destination", "Location", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3387,7 +3445,21 @@ public Builder dischargeDisposition(CodeableConcept dischargeDisposition) {
              */
             @Override
             public Hospitalization build() {
-                return new Hospitalization(this);
+                Hospitalization hospitalization = new Hospitalization(this);
+                if (validating) {
+                    validate(hospitalization);
+                }
+                return hospitalization;
+            }
+
+            protected void validate(Hospitalization hospitalization) {
+                super.validate(hospitalization);
+                ValidationSupport.checkList(hospitalization.dietPreference, "dietPreference", CodeableConcept.class);
+                ValidationSupport.checkList(hospitalization.specialCourtesy, "specialCourtesy", CodeableConcept.class);
+                ValidationSupport.checkList(hospitalization.specialArrangement, "specialArrangement", CodeableConcept.class);
+                ValidationSupport.checkReferenceType(hospitalization.origin, "origin", "Location", "Organization");
+                ValidationSupport.checkReferenceType(hospitalization.destination, "destination", "Location", "Organization");
+                ValidationSupport.requireValueOrChildren(hospitalization);
             }
 
             protected Builder from(Hospitalization hospitalization) {
@@ -3431,12 +3503,10 @@ public static class Location extends BackboneElement {
 
         private Location(Builder builder) {
             super(builder);
-            location = ValidationSupport.requireNonNull(builder.location, "location");
+            location = builder.location;
             status = builder.status;
             physicalType = builder.physicalType;
             period = builder.period;
-            ValidationSupport.checkReferenceType(location, "location", "Location");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3746,7 +3816,18 @@ public Builder period(Period period) {
              */
             @Override
             public Location build() {
-                return new Location(this);
+                Location location = new Location(this);
+                if (validating) {
+                    validate(location);
+                }
+                return location;
+            }
+
+            protected void validate(Location location) {
+                super.validate(location);
+                ValidationSupport.requireNonNull(location.location, "location");
+                ValidationSupport.checkReferenceType(location.location, "location", "Location");
+                ValidationSupport.requireValueOrChildren(location);
             }
 
             protected Builder from(Location location) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Endpoint.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Endpoint.java
index a0136b3eb26..bfca402e1d6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Endpoint.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Endpoint.java
@@ -109,18 +109,17 @@ public class Endpoint extends DomainResource {
 
     private Endpoint(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        connectionType = ValidationSupport.requireNonNull(builder.connectionType, "connectionType");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        connectionType = builder.connectionType;
         name = builder.name;
         managingOrganization = builder.managingOrganization;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactPoint.class));
+        contact = Collections.unmodifiableList(builder.contact);
         period = builder.period;
-        payloadType = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.payloadType, "payloadType", CodeableConcept.class));
-        payloadMimeType = Collections.unmodifiableList(ValidationSupport.checkList(builder.payloadMimeType, "payloadMimeType", Code.class));
-        address = ValidationSupport.requireNonNull(builder.address, "address");
-        header = Collections.unmodifiableList(ValidationSupport.checkList(builder.header, "header", String.class));
-        ValidationSupport.checkReferenceType(managingOrganization, "managingOrganization", "Organization");
+        payloadType = Collections.unmodifiableList(builder.payloadType);
+        payloadMimeType = Collections.unmodifiableList(builder.payloadMimeType);
+        address = builder.address;
+        header = Collections.unmodifiableList(builder.header);
     }
 
     /**
@@ -862,7 +861,24 @@ public Builder header(Collection<String> header) {
          */
         @Override
         public Endpoint build() {
-            return new Endpoint(this);
+            Endpoint endpoint = new Endpoint(this);
+            if (validating) {
+                validate(endpoint);
+            }
+            return endpoint;
+        }
+
+        protected void validate(Endpoint endpoint) {
+            super.validate(endpoint);
+            ValidationSupport.checkList(endpoint.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(endpoint.status, "status");
+            ValidationSupport.requireNonNull(endpoint.connectionType, "connectionType");
+            ValidationSupport.checkList(endpoint.contact, "contact", ContactPoint.class);
+            ValidationSupport.checkNonEmptyList(endpoint.payloadType, "payloadType", CodeableConcept.class);
+            ValidationSupport.checkList(endpoint.payloadMimeType, "payloadMimeType", Code.class);
+            ValidationSupport.requireNonNull(endpoint.address, "address");
+            ValidationSupport.checkList(endpoint.header, "header", String.class);
+            ValidationSupport.checkReferenceType(endpoint.managingOrganization, "managingOrganization", "Organization");
         }
 
         protected Builder from(Endpoint endpoint) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EnrollmentRequest.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EnrollmentRequest.java
index cffb67909e2..e9396ef35ca 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EnrollmentRequest.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EnrollmentRequest.java
@@ -64,17 +64,13 @@ public class EnrollmentRequest extends DomainResource {
 
     private EnrollmentRequest(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         status = builder.status;
         created = builder.created;
         insurer = builder.insurer;
         provider = builder.provider;
         candidate = builder.candidate;
         coverage = builder.coverage;
-        ValidationSupport.checkReferenceType(insurer, "insurer", "Organization");
-        ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(candidate, "candidate", "Patient");
-        ValidationSupport.checkReferenceType(coverage, "coverage", "Coverage");
     }
 
     /**
@@ -607,7 +603,20 @@ public Builder coverage(Reference coverage) {
          */
         @Override
         public EnrollmentRequest build() {
-            return new EnrollmentRequest(this);
+            EnrollmentRequest enrollmentRequest = new EnrollmentRequest(this);
+            if (validating) {
+                validate(enrollmentRequest);
+            }
+            return enrollmentRequest;
+        }
+
+        protected void validate(EnrollmentRequest enrollmentRequest) {
+            super.validate(enrollmentRequest);
+            ValidationSupport.checkList(enrollmentRequest.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkReferenceType(enrollmentRequest.insurer, "insurer", "Organization");
+            ValidationSupport.checkReferenceType(enrollmentRequest.provider, "provider", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(enrollmentRequest.candidate, "candidate", "Patient");
+            ValidationSupport.checkReferenceType(enrollmentRequest.coverage, "coverage", "Coverage");
         }
 
         protected Builder from(EnrollmentRequest enrollmentRequest) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EnrollmentResponse.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EnrollmentResponse.java
index 86bc768f759..d972e4e59c7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EnrollmentResponse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EnrollmentResponse.java
@@ -72,7 +72,7 @@ public class EnrollmentResponse extends DomainResource {
 
     private EnrollmentResponse(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         status = builder.status;
         request = builder.request;
         outcome = builder.outcome;
@@ -80,9 +80,6 @@ private EnrollmentResponse(Builder builder) {
         created = builder.created;
         organization = builder.organization;
         requestProvider = builder.requestProvider;
-        ValidationSupport.checkReferenceType(request, "request", "EnrollmentRequest");
-        ValidationSupport.checkReferenceType(organization, "organization", "Organization");
-        ValidationSupport.checkReferenceType(requestProvider, "requestProvider", "Practitioner", "PractitionerRole", "Organization");
     }
 
     /**
@@ -639,7 +636,19 @@ public Builder requestProvider(Reference requestProvider) {
          */
         @Override
         public EnrollmentResponse build() {
-            return new EnrollmentResponse(this);
+            EnrollmentResponse enrollmentResponse = new EnrollmentResponse(this);
+            if (validating) {
+                validate(enrollmentResponse);
+            }
+            return enrollmentResponse;
+        }
+
+        protected void validate(EnrollmentResponse enrollmentResponse) {
+            super.validate(enrollmentResponse);
+            ValidationSupport.checkList(enrollmentResponse.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkReferenceType(enrollmentResponse.request, "request", "EnrollmentRequest");
+            ValidationSupport.checkReferenceType(enrollmentResponse.organization, "organization", "Organization");
+            ValidationSupport.checkReferenceType(enrollmentResponse.requestProvider, "requestProvider", "Practitioner", "PractitionerRole", "Organization");
         }
 
         protected Builder from(EnrollmentResponse enrollmentResponse) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EpisodeOfCare.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EpisodeOfCare.java
index 87b21a68eb2..6db70b2dd8d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EpisodeOfCare.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EpisodeOfCare.java
@@ -98,24 +98,18 @@ public class EpisodeOfCare extends DomainResource {
 
     private EpisodeOfCare(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        statusHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.statusHistory, "statusHistory", StatusHistory.class));
-        type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
-        diagnosis = Collections.unmodifiableList(ValidationSupport.checkList(builder.diagnosis, "diagnosis", Diagnosis.class));
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        statusHistory = Collections.unmodifiableList(builder.statusHistory);
+        type = Collections.unmodifiableList(builder.type);
+        diagnosis = Collections.unmodifiableList(builder.diagnosis);
+        patient = builder.patient;
         managingOrganization = builder.managingOrganization;
         period = builder.period;
-        referralRequest = Collections.unmodifiableList(ValidationSupport.checkList(builder.referralRequest, "referralRequest", Reference.class));
+        referralRequest = Collections.unmodifiableList(builder.referralRequest);
         careManager = builder.careManager;
-        team = Collections.unmodifiableList(ValidationSupport.checkList(builder.team, "team", Reference.class));
-        account = Collections.unmodifiableList(ValidationSupport.checkList(builder.account, "account", Reference.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(managingOrganization, "managingOrganization", "Organization");
-        ValidationSupport.checkReferenceType(referralRequest, "referralRequest", "ServiceRequest");
-        ValidationSupport.checkReferenceType(careManager, "careManager", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(team, "team", "CareTeam");
-        ValidationSupport.checkReferenceType(account, "account", "Account");
+        team = Collections.unmodifiableList(builder.team);
+        account = Collections.unmodifiableList(builder.account);
     }
 
     /**
@@ -953,7 +947,30 @@ public Builder account(Collection<Reference> account) {
          */
         @Override
         public EpisodeOfCare build() {
-            return new EpisodeOfCare(this);
+            EpisodeOfCare episodeOfCare = new EpisodeOfCare(this);
+            if (validating) {
+                validate(episodeOfCare);
+            }
+            return episodeOfCare;
+        }
+
+        protected void validate(EpisodeOfCare episodeOfCare) {
+            super.validate(episodeOfCare);
+            ValidationSupport.checkList(episodeOfCare.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(episodeOfCare.status, "status");
+            ValidationSupport.checkList(episodeOfCare.statusHistory, "statusHistory", StatusHistory.class);
+            ValidationSupport.checkList(episodeOfCare.type, "type", CodeableConcept.class);
+            ValidationSupport.checkList(episodeOfCare.diagnosis, "diagnosis", Diagnosis.class);
+            ValidationSupport.requireNonNull(episodeOfCare.patient, "patient");
+            ValidationSupport.checkList(episodeOfCare.referralRequest, "referralRequest", Reference.class);
+            ValidationSupport.checkList(episodeOfCare.team, "team", Reference.class);
+            ValidationSupport.checkList(episodeOfCare.account, "account", Reference.class);
+            ValidationSupport.checkReferenceType(episodeOfCare.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(episodeOfCare.managingOrganization, "managingOrganization", "Organization");
+            ValidationSupport.checkReferenceType(episodeOfCare.referralRequest, "referralRequest", "ServiceRequest");
+            ValidationSupport.checkReferenceType(episodeOfCare.careManager, "careManager", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(episodeOfCare.team, "team", "CareTeam");
+            ValidationSupport.checkReferenceType(episodeOfCare.account, "account", "Account");
         }
 
         protected Builder from(EpisodeOfCare episodeOfCare) {
@@ -992,9 +1009,8 @@ public static class StatusHistory extends BackboneElement {
 
         private StatusHistory(Builder builder) {
             super(builder);
-            status = ValidationSupport.requireNonNull(builder.status, "status");
-            period = ValidationSupport.requireNonNull(builder.period, "period");
-            ValidationSupport.requireValueOrChildren(this);
+            status = builder.status;
+            period = builder.period;
         }
 
         /**
@@ -1240,7 +1256,18 @@ public Builder period(Period period) {
              */
             @Override
             public StatusHistory build() {
-                return new StatusHistory(this);
+                StatusHistory statusHistory = new StatusHistory(this);
+                if (validating) {
+                    validate(statusHistory);
+                }
+                return statusHistory;
+            }
+
+            protected void validate(StatusHistory statusHistory) {
+                super.validate(statusHistory);
+                ValidationSupport.requireNonNull(statusHistory.status, "status");
+                ValidationSupport.requireNonNull(statusHistory.period, "period");
+                ValidationSupport.requireValueOrChildren(statusHistory);
             }
 
             protected Builder from(StatusHistory statusHistory) {
@@ -1273,11 +1300,9 @@ public static class Diagnosis extends BackboneElement {
 
         private Diagnosis(Builder builder) {
             super(builder);
-            condition = ValidationSupport.requireNonNull(builder.condition, "condition");
+            condition = builder.condition;
             role = builder.role;
             rank = builder.rank;
-            ValidationSupport.checkReferenceType(condition, "condition", "Condition");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1554,7 +1579,18 @@ public Builder rank(PositiveInt rank) {
              */
             @Override
             public Diagnosis build() {
-                return new Diagnosis(this);
+                Diagnosis diagnosis = new Diagnosis(this);
+                if (validating) {
+                    validate(diagnosis);
+                }
+                return diagnosis;
+            }
+
+            protected void validate(Diagnosis diagnosis) {
+                super.validate(diagnosis);
+                ValidationSupport.requireNonNull(diagnosis.condition, "condition");
+                ValidationSupport.checkReferenceType(diagnosis.condition, "condition", "Condition");
+                ValidationSupport.requireValueOrChildren(diagnosis);
             }
 
             protected Builder from(Diagnosis diagnosis) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EventDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EventDefinition.java
index 3553d34f925..02c54278575 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EventDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EventDefinition.java
@@ -156,34 +156,33 @@ public class EventDefinition extends DomainResource {
     private EventDefinition(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
         subtitle = builder.subtitle;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
-        subject = ValidationSupport.choiceElement(builder.subject, "subject", CodeableConcept.class, Reference.class);
+        subject = builder.subject;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         usage = builder.usage;
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
-        trigger = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.trigger, "trigger", TriggerDefinition.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Group");
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
+        trigger = Collections.unmodifiableList(builder.trigger);
     }
 
     /**
@@ -1567,7 +1566,29 @@ public Builder trigger(Collection<TriggerDefinition> trigger) {
          */
         @Override
         public EventDefinition build() {
-            return new EventDefinition(this);
+            EventDefinition eventDefinition = new EventDefinition(this);
+            if (validating) {
+                validate(eventDefinition);
+            }
+            return eventDefinition;
+        }
+
+        protected void validate(EventDefinition eventDefinition) {
+            super.validate(eventDefinition);
+            ValidationSupport.checkList(eventDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(eventDefinition.status, "status");
+            ValidationSupport.choiceElement(eventDefinition.subject, "subject", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(eventDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(eventDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(eventDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(eventDefinition.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(eventDefinition.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(eventDefinition.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(eventDefinition.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(eventDefinition.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(eventDefinition.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.checkNonEmptyList(eventDefinition.trigger, "trigger", TriggerDefinition.class);
+            ValidationSupport.checkReferenceType(eventDefinition.subject, "subject", "Group");
         }
 
         protected Builder from(EventDefinition eventDefinition) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Evidence.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Evidence.java
index a3e3366028d..2e75bcc85d5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Evidence.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Evidence.java
@@ -141,36 +141,33 @@ public class Evidence extends DomainResource {
     private Evidence(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
         shortTitle = builder.shortTitle;
         subtitle = builder.subtitle;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        note = Collections.unmodifiableList(builder.note);
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
-        exposureBackground = ValidationSupport.requireNonNull(builder.exposureBackground, "exposureBackground");
-        exposureVariant = Collections.unmodifiableList(ValidationSupport.checkList(builder.exposureVariant, "exposureVariant", Reference.class));
-        outcome = Collections.unmodifiableList(ValidationSupport.checkList(builder.outcome, "outcome", Reference.class));
-        ValidationSupport.checkReferenceType(exposureBackground, "exposureBackground", "EvidenceVariable");
-        ValidationSupport.checkReferenceType(exposureVariant, "exposureVariant", "EvidenceVariable");
-        ValidationSupport.checkReferenceType(outcome, "outcome", "EvidenceVariable");
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
+        exposureBackground = builder.exposureBackground;
+        exposureVariant = Collections.unmodifiableList(builder.exposureVariant);
+        outcome = Collections.unmodifiableList(builder.outcome);
     }
 
     /**
@@ -1609,7 +1606,33 @@ public Builder outcome(Collection<Reference> outcome) {
          */
         @Override
         public Evidence build() {
-            return new Evidence(this);
+            Evidence evidence = new Evidence(this);
+            if (validating) {
+                validate(evidence);
+            }
+            return evidence;
+        }
+
+        protected void validate(Evidence evidence) {
+            super.validate(evidence);
+            ValidationSupport.checkList(evidence.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(evidence.status, "status");
+            ValidationSupport.checkList(evidence.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(evidence.note, "note", Annotation.class);
+            ValidationSupport.checkList(evidence.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(evidence.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(evidence.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(evidence.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(evidence.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(evidence.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(evidence.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(evidence.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.requireNonNull(evidence.exposureBackground, "exposureBackground");
+            ValidationSupport.checkList(evidence.exposureVariant, "exposureVariant", Reference.class);
+            ValidationSupport.checkList(evidence.outcome, "outcome", Reference.class);
+            ValidationSupport.checkReferenceType(evidence.exposureBackground, "exposureBackground", "EvidenceVariable");
+            ValidationSupport.checkReferenceType(evidence.exposureVariant, "exposureVariant", "EvidenceVariable");
+            ValidationSupport.checkReferenceType(evidence.outcome, "outcome", "EvidenceVariable");
         }
 
         protected Builder from(Evidence evidence) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EvidenceVariable.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EvidenceVariable.java
index 26ed8acbccf..7d450af59e4 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/EvidenceVariable.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/EvidenceVariable.java
@@ -154,32 +154,32 @@ public class EvidenceVariable extends DomainResource {
     private EvidenceVariable(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
         shortTitle = builder.shortTitle;
         subtitle = builder.subtitle;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        note = Collections.unmodifiableList(builder.note);
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
         type = builder.type;
-        characteristic = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.characteristic, "characteristic", Characteristic.class));
+        characteristic = Collections.unmodifiableList(builder.characteristic);
     }
 
     /**
@@ -1551,7 +1551,28 @@ public Builder characteristic(Collection<Characteristic> characteristic) {
          */
         @Override
         public EvidenceVariable build() {
-            return new EvidenceVariable(this);
+            EvidenceVariable evidenceVariable = new EvidenceVariable(this);
+            if (validating) {
+                validate(evidenceVariable);
+            }
+            return evidenceVariable;
+        }
+
+        protected void validate(EvidenceVariable evidenceVariable) {
+            super.validate(evidenceVariable);
+            ValidationSupport.checkList(evidenceVariable.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(evidenceVariable.status, "status");
+            ValidationSupport.checkList(evidenceVariable.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(evidenceVariable.note, "note", Annotation.class);
+            ValidationSupport.checkList(evidenceVariable.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(evidenceVariable.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(evidenceVariable.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(evidenceVariable.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(evidenceVariable.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(evidenceVariable.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(evidenceVariable.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(evidenceVariable.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.checkNonEmptyList(evidenceVariable.characteristic, "characteristic", Characteristic.class);
         }
 
         protected Builder from(EvidenceVariable evidenceVariable) {
@@ -1614,14 +1635,12 @@ public static class Characteristic extends BackboneElement {
         private Characteristic(Builder builder) {
             super(builder);
             description = builder.description;
-            definition = ValidationSupport.requireChoiceElement(builder.definition, "definition", Reference.class, Canonical.class, CodeableConcept.class, Expression.class, DataRequirement.class, TriggerDefinition.class);
-            usageContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.usageContext, "usageContext", UsageContext.class));
+            definition = builder.definition;
+            usageContext = Collections.unmodifiableList(builder.usageContext);
             exclude = builder.exclude;
-            participantEffective = ValidationSupport.choiceElement(builder.participantEffective, "participantEffective", DateTime.class, Period.class, Duration.class, Timing.class);
+            participantEffective = builder.participantEffective;
             timeFromStart = builder.timeFromStart;
             groupMeasure = builder.groupMeasure;
-            ValidationSupport.checkReferenceType(definition, "definition", "Group", "ActivityDefinition");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2059,7 +2078,20 @@ public Builder groupMeasure(GroupMeasure groupMeasure) {
              */
             @Override
             public Characteristic build() {
-                return new Characteristic(this);
+                Characteristic characteristic = new Characteristic(this);
+                if (validating) {
+                    validate(characteristic);
+                }
+                return characteristic;
+            }
+
+            protected void validate(Characteristic characteristic) {
+                super.validate(characteristic);
+                ValidationSupport.requireChoiceElement(characteristic.definition, "definition", Reference.class, Canonical.class, CodeableConcept.class, Expression.class, DataRequirement.class, TriggerDefinition.class);
+                ValidationSupport.checkList(characteristic.usageContext, "usageContext", UsageContext.class);
+                ValidationSupport.choiceElement(characteristic.participantEffective, "participantEffective", DateTime.class, Period.class, Duration.class, Timing.class);
+                ValidationSupport.checkReferenceType(characteristic.definition, "definition", "Group", "ActivityDefinition");
+                ValidationSupport.requireValueOrChildren(characteristic);
             }
 
             protected Builder from(Characteristic characteristic) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ExampleScenario.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ExampleScenario.java
index 0043ae328e8..d8a45fbfa39 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ExampleScenario.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ExampleScenario.java
@@ -113,22 +113,22 @@ public class ExampleScenario extends DomainResource {
     private ExampleScenario(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        contact = Collections.unmodifiableList(builder.contact);
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         copyright = builder.copyright;
         purpose = builder.purpose;
-        actor = Collections.unmodifiableList(ValidationSupport.checkList(builder.actor, "actor", Actor.class));
-        instance = Collections.unmodifiableList(ValidationSupport.checkList(builder.instance, "instance", Instance.class));
-        process = Collections.unmodifiableList(ValidationSupport.checkList(builder.process, "process", Process.class));
-        workflow = Collections.unmodifiableList(ValidationSupport.checkList(builder.workflow, "workflow", Canonical.class));
+        actor = Collections.unmodifiableList(builder.actor);
+        instance = Collections.unmodifiableList(builder.instance);
+        process = Collections.unmodifiableList(builder.process);
+        workflow = Collections.unmodifiableList(builder.workflow);
     }
 
     /**
@@ -1109,7 +1109,24 @@ public Builder workflow(Collection<Canonical> workflow) {
          */
         @Override
         public ExampleScenario build() {
-            return new ExampleScenario(this);
+            ExampleScenario exampleScenario = new ExampleScenario(this);
+            if (validating) {
+                validate(exampleScenario);
+            }
+            return exampleScenario;
+        }
+
+        protected void validate(ExampleScenario exampleScenario) {
+            super.validate(exampleScenario);
+            ValidationSupport.checkList(exampleScenario.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(exampleScenario.status, "status");
+            ValidationSupport.checkList(exampleScenario.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(exampleScenario.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(exampleScenario.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(exampleScenario.actor, "actor", Actor.class);
+            ValidationSupport.checkList(exampleScenario.instance, "instance", Instance.class);
+            ValidationSupport.checkList(exampleScenario.process, "process", Process.class);
+            ValidationSupport.checkList(exampleScenario.workflow, "workflow", Canonical.class);
         }
 
         protected Builder from(ExampleScenario exampleScenario) {
@@ -1154,11 +1171,10 @@ public static class Actor extends BackboneElement {
 
         private Actor(Builder builder) {
             super(builder);
-            actorId = ValidationSupport.requireNonNull(builder.actorId, "actorId");
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            actorId = builder.actorId;
+            type = builder.type;
             name = builder.name;
             description = builder.description;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1462,7 +1478,18 @@ public Builder description(Markdown description) {
              */
             @Override
             public Actor build() {
-                return new Actor(this);
+                Actor actor = new Actor(this);
+                if (validating) {
+                    validate(actor);
+                }
+                return actor;
+            }
+
+            protected void validate(Actor actor) {
+                super.validate(actor);
+                ValidationSupport.requireNonNull(actor.actorId, "actorId");
+                ValidationSupport.requireNonNull(actor.type, "type");
+                ValidationSupport.requireValueOrChildren(actor);
             }
 
             protected Builder from(Actor actor) {
@@ -1497,13 +1524,12 @@ public static class Instance extends BackboneElement {
 
         private Instance(Builder builder) {
             super(builder);
-            resourceId = ValidationSupport.requireNonNull(builder.resourceId, "resourceId");
-            resourceType = ValidationSupport.requireNonNull(builder.resourceType, "resourceType");
+            resourceId = builder.resourceId;
+            resourceType = builder.resourceType;
             name = builder.name;
             description = builder.description;
-            version = Collections.unmodifiableList(ValidationSupport.checkList(builder.version, "version", Version.class));
-            containedInstance = Collections.unmodifiableList(ValidationSupport.checkList(builder.containedInstance, "containedInstance", ContainedInstance.class));
-            ValidationSupport.requireValueOrChildren(this);
+            version = Collections.unmodifiableList(builder.version);
+            containedInstance = Collections.unmodifiableList(builder.containedInstance);
         }
 
         /**
@@ -1905,7 +1931,20 @@ public Builder containedInstance(Collection<ContainedInstance> containedInstance
              */
             @Override
             public Instance build() {
-                return new Instance(this);
+                Instance instance = new Instance(this);
+                if (validating) {
+                    validate(instance);
+                }
+                return instance;
+            }
+
+            protected void validate(Instance instance) {
+                super.validate(instance);
+                ValidationSupport.requireNonNull(instance.resourceId, "resourceId");
+                ValidationSupport.requireNonNull(instance.resourceType, "resourceType");
+                ValidationSupport.checkList(instance.version, "version", Version.class);
+                ValidationSupport.checkList(instance.containedInstance, "containedInstance", ContainedInstance.class);
+                ValidationSupport.requireValueOrChildren(instance);
             }
 
             protected Builder from(Instance instance) {
@@ -1931,9 +1970,8 @@ public static class Version extends BackboneElement {
 
             private Version(Builder builder) {
                 super(builder);
-                versionId = ValidationSupport.requireNonNull(builder.versionId, "versionId");
-                description = ValidationSupport.requireNonNull(builder.description, "description");
-                ValidationSupport.requireValueOrChildren(this);
+                versionId = builder.versionId;
+                description = builder.description;
             }
 
             /**
@@ -2179,7 +2217,18 @@ public Builder description(Markdown description) {
                  */
                 @Override
                 public Version build() {
-                    return new Version(this);
+                    Version version = new Version(this);
+                    if (validating) {
+                        validate(version);
+                    }
+                    return version;
+                }
+
+                protected void validate(Version version) {
+                    super.validate(version);
+                    ValidationSupport.requireNonNull(version.versionId, "versionId");
+                    ValidationSupport.requireNonNull(version.description, "description");
+                    ValidationSupport.requireValueOrChildren(version);
                 }
 
                 protected Builder from(Version version) {
@@ -2201,9 +2250,8 @@ public static class ContainedInstance extends BackboneElement {
 
             private ContainedInstance(Builder builder) {
                 super(builder);
-                resourceId = ValidationSupport.requireNonNull(builder.resourceId, "resourceId");
+                resourceId = builder.resourceId;
                 versionId = builder.versionId;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2446,7 +2494,17 @@ public Builder versionId(String versionId) {
                  */
                 @Override
                 public ContainedInstance build() {
-                    return new ContainedInstance(this);
+                    ContainedInstance containedInstance = new ContainedInstance(this);
+                    if (validating) {
+                        validate(containedInstance);
+                    }
+                    return containedInstance;
+                }
+
+                protected void validate(ContainedInstance containedInstance) {
+                    super.validate(containedInstance);
+                    ValidationSupport.requireNonNull(containedInstance.resourceId, "resourceId");
+                    ValidationSupport.requireValueOrChildren(containedInstance);
                 }
 
                 protected Builder from(ContainedInstance containedInstance) {
@@ -2473,12 +2531,11 @@ public static class Process extends BackboneElement {
 
         private Process(Builder builder) {
             super(builder);
-            title = ValidationSupport.requireNonNull(builder.title, "title");
+            title = builder.title;
             description = builder.description;
             preConditions = builder.preConditions;
             postConditions = builder.postConditions;
-            step = Collections.unmodifiableList(ValidationSupport.checkList(builder.step, "step", Step.class));
-            ValidationSupport.requireValueOrChildren(this);
+            step = Collections.unmodifiableList(builder.step);
         }
 
         /**
@@ -2828,7 +2885,18 @@ public Builder step(Collection<Step> step) {
              */
             @Override
             public Process build() {
-                return new Process(this);
+                Process process = new Process(this);
+                if (validating) {
+                    validate(process);
+                }
+                return process;
+            }
+
+            protected void validate(Process process) {
+                super.validate(process);
+                ValidationSupport.requireNonNull(process.title, "title");
+                ValidationSupport.checkList(process.step, "step", Step.class);
+                ValidationSupport.requireValueOrChildren(process);
             }
 
             protected Builder from(Process process) {
@@ -2853,11 +2921,10 @@ public static class Step extends BackboneElement {
 
             private Step(Builder builder) {
                 super(builder);
-                process = Collections.unmodifiableList(ValidationSupport.checkList(builder.process, "process", ExampleScenario.Process.class));
+                process = Collections.unmodifiableList(builder.process);
                 pause = builder.pause;
                 operation = builder.operation;
-                alternative = Collections.unmodifiableList(ValidationSupport.checkList(builder.alternative, "alternative", Alternative.class));
-                ValidationSupport.requireValueOrChildren(this);
+                alternative = Collections.unmodifiableList(builder.alternative);
             }
 
             /**
@@ -3194,7 +3261,18 @@ public Builder alternative(Collection<Alternative> alternative) {
                  */
                 @Override
                 public Step build() {
-                    return new Step(this);
+                    Step step = new Step(this);
+                    if (validating) {
+                        validate(step);
+                    }
+                    return step;
+                }
+
+                protected void validate(Step step) {
+                    super.validate(step);
+                    ValidationSupport.checkList(step.process, "process", ExampleScenario.Process.class);
+                    ValidationSupport.checkList(step.alternative, "alternative", Alternative.class);
+                    ValidationSupport.requireValueOrChildren(step);
                 }
 
                 protected Builder from(Step step) {
@@ -3225,7 +3303,7 @@ public static class Operation extends BackboneElement {
 
                 private Operation(Builder builder) {
                     super(builder);
-                    number = ValidationSupport.requireNonNull(builder.number, "number");
+                    number = builder.number;
                     type = builder.type;
                     name = builder.name;
                     initiator = builder.initiator;
@@ -3235,7 +3313,6 @@ private Operation(Builder builder) {
                     receiverActive = builder.receiverActive;
                     request = builder.request;
                     response = builder.response;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -3710,7 +3787,17 @@ public Builder response(ExampleScenario.Instance.ContainedInstance response) {
                      */
                     @Override
                     public Operation build() {
-                        return new Operation(this);
+                        Operation operation = new Operation(this);
+                        if (validating) {
+                            validate(operation);
+                        }
+                        return operation;
+                    }
+
+                    protected void validate(Operation operation) {
+                        super.validate(operation);
+                        ValidationSupport.requireNonNull(operation.number, "number");
+                        ValidationSupport.requireValueOrChildren(operation);
                     }
 
                     protected Builder from(Operation operation) {
@@ -3742,10 +3829,9 @@ public static class Alternative extends BackboneElement {
 
                 private Alternative(Builder builder) {
                     super(builder);
-                    title = ValidationSupport.requireNonNull(builder.title, "title");
+                    title = builder.title;
                     description = builder.description;
-                    step = Collections.unmodifiableList(ValidationSupport.checkList(builder.step, "step", ExampleScenario.Process.Step.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    step = Collections.unmodifiableList(builder.step);
                 }
 
                 /**
@@ -4039,7 +4125,18 @@ public Builder step(Collection<ExampleScenario.Process.Step> step) {
                      */
                     @Override
                     public Alternative build() {
-                        return new Alternative(this);
+                        Alternative alternative = new Alternative(this);
+                        if (validating) {
+                            validate(alternative);
+                        }
+                        return alternative;
+                    }
+
+                    protected void validate(Alternative alternative) {
+                        super.validate(alternative);
+                        ValidationSupport.requireNonNull(alternative.title, "title");
+                        ValidationSupport.checkList(alternative.step, "step", ExampleScenario.Process.Step.class);
+                        ValidationSupport.requireValueOrChildren(alternative);
                     }
 
                     protected Builder from(Alternative alternative) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ExplanationOfBenefit.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ExplanationOfBenefit.java
index 45a29706491..5e1f2fdb522 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ExplanationOfBenefit.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ExplanationOfBenefit.java
@@ -220,21 +220,21 @@ public class ExplanationOfBenefit extends DomainResource {
 
     private ExplanationOfBenefit(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        type = builder.type;
         subType = builder.subType;
-        use = ValidationSupport.requireNonNull(builder.use, "use");
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
+        use = builder.use;
+        patient = builder.patient;
         billablePeriod = builder.billablePeriod;
-        created = ValidationSupport.requireNonNull(builder.created, "created");
+        created = builder.created;
         enterer = builder.enterer;
-        insurer = ValidationSupport.requireNonNull(builder.insurer, "insurer");
-        provider = ValidationSupport.requireNonNull(builder.provider, "provider");
+        insurer = builder.insurer;
+        provider = builder.provider;
         priority = builder.priority;
         fundsReserveRequested = builder.fundsReserveRequested;
         fundsReserve = builder.fundsReserve;
-        related = Collections.unmodifiableList(ValidationSupport.checkList(builder.related, "related", Related.class));
+        related = Collections.unmodifiableList(builder.related);
         prescription = builder.prescription;
         originalPrescription = builder.originalPrescription;
         payee = builder.payee;
@@ -242,37 +242,27 @@ private ExplanationOfBenefit(Builder builder) {
         facility = builder.facility;
         claim = builder.claim;
         claimResponse = builder.claimResponse;
-        outcome = ValidationSupport.requireNonNull(builder.outcome, "outcome");
+        outcome = builder.outcome;
         disposition = builder.disposition;
-        preAuthRef = Collections.unmodifiableList(ValidationSupport.checkList(builder.preAuthRef, "preAuthRef", String.class));
-        preAuthRefPeriod = Collections.unmodifiableList(ValidationSupport.checkList(builder.preAuthRefPeriod, "preAuthRefPeriod", Period.class));
-        careTeam = Collections.unmodifiableList(ValidationSupport.checkList(builder.careTeam, "careTeam", CareTeam.class));
-        supportingInfo = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInfo, "supportingInfo", SupportingInfo.class));
-        diagnosis = Collections.unmodifiableList(ValidationSupport.checkList(builder.diagnosis, "diagnosis", Diagnosis.class));
-        procedure = Collections.unmodifiableList(ValidationSupport.checkList(builder.procedure, "procedure", Procedure.class));
+        preAuthRef = Collections.unmodifiableList(builder.preAuthRef);
+        preAuthRefPeriod = Collections.unmodifiableList(builder.preAuthRefPeriod);
+        careTeam = Collections.unmodifiableList(builder.careTeam);
+        supportingInfo = Collections.unmodifiableList(builder.supportingInfo);
+        diagnosis = Collections.unmodifiableList(builder.diagnosis);
+        procedure = Collections.unmodifiableList(builder.procedure);
         precedence = builder.precedence;
-        insurance = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.insurance, "insurance", Insurance.class));
+        insurance = Collections.unmodifiableList(builder.insurance);
         accident = builder.accident;
-        item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", Item.class));
-        addItem = Collections.unmodifiableList(ValidationSupport.checkList(builder.addItem, "addItem", AddItem.class));
-        adjudication = Collections.unmodifiableList(ValidationSupport.checkList(builder.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class));
-        total = Collections.unmodifiableList(ValidationSupport.checkList(builder.total, "total", Total.class));
+        item = Collections.unmodifiableList(builder.item);
+        addItem = Collections.unmodifiableList(builder.addItem);
+        adjudication = Collections.unmodifiableList(builder.adjudication);
+        total = Collections.unmodifiableList(builder.total);
         payment = builder.payment;
         formCode = builder.formCode;
         form = builder.form;
-        processNote = Collections.unmodifiableList(ValidationSupport.checkList(builder.processNote, "processNote", ProcessNote.class));
+        processNote = Collections.unmodifiableList(builder.processNote);
         benefitPeriod = builder.benefitPeriod;
-        benefitBalance = Collections.unmodifiableList(ValidationSupport.checkList(builder.benefitBalance, "benefitBalance", BenefitBalance.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(enterer, "enterer", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(insurer, "insurer", "Organization");
-        ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(prescription, "prescription", "MedicationRequest", "VisionPrescription");
-        ValidationSupport.checkReferenceType(originalPrescription, "originalPrescription", "MedicationRequest");
-        ValidationSupport.checkReferenceType(referral, "referral", "ServiceRequest");
-        ValidationSupport.checkReferenceType(facility, "facility", "Location");
-        ValidationSupport.checkReferenceType(claim, "claim", "Claim");
-        ValidationSupport.checkReferenceType(claimResponse, "claimResponse", "ClaimResponse");
+        benefitBalance = Collections.unmodifiableList(builder.benefitBalance);
     }
 
     /**
@@ -2220,7 +2210,48 @@ public Builder benefitBalance(Collection<BenefitBalance> benefitBalance) {
          */
         @Override
         public ExplanationOfBenefit build() {
-            return new ExplanationOfBenefit(this);
+            ExplanationOfBenefit explanationOfBenefit = new ExplanationOfBenefit(this);
+            if (validating) {
+                validate(explanationOfBenefit);
+            }
+            return explanationOfBenefit;
+        }
+
+        protected void validate(ExplanationOfBenefit explanationOfBenefit) {
+            super.validate(explanationOfBenefit);
+            ValidationSupport.checkList(explanationOfBenefit.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(explanationOfBenefit.status, "status");
+            ValidationSupport.requireNonNull(explanationOfBenefit.type, "type");
+            ValidationSupport.requireNonNull(explanationOfBenefit.use, "use");
+            ValidationSupport.requireNonNull(explanationOfBenefit.patient, "patient");
+            ValidationSupport.requireNonNull(explanationOfBenefit.created, "created");
+            ValidationSupport.requireNonNull(explanationOfBenefit.insurer, "insurer");
+            ValidationSupport.requireNonNull(explanationOfBenefit.provider, "provider");
+            ValidationSupport.checkList(explanationOfBenefit.related, "related", Related.class);
+            ValidationSupport.requireNonNull(explanationOfBenefit.outcome, "outcome");
+            ValidationSupport.checkList(explanationOfBenefit.preAuthRef, "preAuthRef", String.class);
+            ValidationSupport.checkList(explanationOfBenefit.preAuthRefPeriod, "preAuthRefPeriod", Period.class);
+            ValidationSupport.checkList(explanationOfBenefit.careTeam, "careTeam", CareTeam.class);
+            ValidationSupport.checkList(explanationOfBenefit.supportingInfo, "supportingInfo", SupportingInfo.class);
+            ValidationSupport.checkList(explanationOfBenefit.diagnosis, "diagnosis", Diagnosis.class);
+            ValidationSupport.checkList(explanationOfBenefit.procedure, "procedure", Procedure.class);
+            ValidationSupport.checkNonEmptyList(explanationOfBenefit.insurance, "insurance", Insurance.class);
+            ValidationSupport.checkList(explanationOfBenefit.item, "item", Item.class);
+            ValidationSupport.checkList(explanationOfBenefit.addItem, "addItem", AddItem.class);
+            ValidationSupport.checkList(explanationOfBenefit.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class);
+            ValidationSupport.checkList(explanationOfBenefit.total, "total", Total.class);
+            ValidationSupport.checkList(explanationOfBenefit.processNote, "processNote", ProcessNote.class);
+            ValidationSupport.checkList(explanationOfBenefit.benefitBalance, "benefitBalance", BenefitBalance.class);
+            ValidationSupport.checkReferenceType(explanationOfBenefit.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(explanationOfBenefit.enterer, "enterer", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(explanationOfBenefit.insurer, "insurer", "Organization");
+            ValidationSupport.checkReferenceType(explanationOfBenefit.provider, "provider", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(explanationOfBenefit.prescription, "prescription", "MedicationRequest", "VisionPrescription");
+            ValidationSupport.checkReferenceType(explanationOfBenefit.originalPrescription, "originalPrescription", "MedicationRequest");
+            ValidationSupport.checkReferenceType(explanationOfBenefit.referral, "referral", "ServiceRequest");
+            ValidationSupport.checkReferenceType(explanationOfBenefit.facility, "facility", "Location");
+            ValidationSupport.checkReferenceType(explanationOfBenefit.claim, "claim", "Claim");
+            ValidationSupport.checkReferenceType(explanationOfBenefit.claimResponse, "claimResponse", "ClaimResponse");
         }
 
         protected Builder from(ExplanationOfBenefit explanationOfBenefit) {
@@ -2293,8 +2324,6 @@ private Related(Builder builder) {
             claim = builder.claim;
             relationship = builder.relationship;
             reference = builder.reference;
-            ValidationSupport.checkReferenceType(claim, "claim", "Claim");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2564,7 +2593,17 @@ public Builder reference(Identifier reference) {
              */
             @Override
             public Related build() {
-                return new Related(this);
+                Related related = new Related(this);
+                if (validating) {
+                    validate(related);
+                }
+                return related;
+            }
+
+            protected void validate(Related related) {
+                super.validate(related);
+                ValidationSupport.checkReferenceType(related.claim, "claim", "Claim");
+                ValidationSupport.requireValueOrChildren(related);
             }
 
             protected Builder from(Related related) {
@@ -2595,8 +2634,6 @@ private Payee(Builder builder) {
             super(builder);
             type = builder.type;
             party = builder.party;
-            ValidationSupport.checkReferenceType(party, "party", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2841,7 +2878,17 @@ public Builder party(Reference party) {
              */
             @Override
             public Payee build() {
-                return new Payee(this);
+                Payee payee = new Payee(this);
+                if (validating) {
+                    validate(payee);
+                }
+                return payee;
+            }
+
+            protected void validate(Payee payee) {
+                super.validate(payee);
+                ValidationSupport.checkReferenceType(payee.party, "party", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(payee);
             }
 
             protected Builder from(Payee payee) {
@@ -2880,13 +2927,11 @@ public static class CareTeam extends BackboneElement {
 
         private CareTeam(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            provider = ValidationSupport.requireNonNull(builder.provider, "provider");
+            sequence = builder.sequence;
+            provider = builder.provider;
             responsible = builder.responsible;
             role = builder.role;
             qualification = builder.qualification;
-            ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3226,7 +3271,19 @@ public Builder qualification(CodeableConcept qualification) {
              */
             @Override
             public CareTeam build() {
-                return new CareTeam(this);
+                CareTeam careTeam = new CareTeam(this);
+                if (validating) {
+                    validate(careTeam);
+                }
+                return careTeam;
+            }
+
+            protected void validate(CareTeam careTeam) {
+                super.validate(careTeam);
+                ValidationSupport.requireNonNull(careTeam.sequence, "sequence");
+                ValidationSupport.requireNonNull(careTeam.provider, "provider");
+                ValidationSupport.checkReferenceType(careTeam.provider, "provider", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.requireValueOrChildren(careTeam);
             }
 
             protected Builder from(CareTeam careTeam) {
@@ -3277,13 +3334,12 @@ public static class SupportingInfo extends BackboneElement {
 
         private SupportingInfo(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            category = ValidationSupport.requireNonNull(builder.category, "category");
+            sequence = builder.sequence;
+            category = builder.category;
             code = builder.code;
-            timing = ValidationSupport.choiceElement(builder.timing, "timing", Date.class, Period.class);
-            value = ValidationSupport.choiceElement(builder.value, "value", Boolean.class, String.class, Quantity.class, Attachment.class, Reference.class);
+            timing = builder.timing;
+            value = builder.value;
             reason = builder.reason;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3664,7 +3720,20 @@ public Builder reason(Coding reason) {
              */
             @Override
             public SupportingInfo build() {
-                return new SupportingInfo(this);
+                SupportingInfo supportingInfo = new SupportingInfo(this);
+                if (validating) {
+                    validate(supportingInfo);
+                }
+                return supportingInfo;
+            }
+
+            protected void validate(SupportingInfo supportingInfo) {
+                super.validate(supportingInfo);
+                ValidationSupport.requireNonNull(supportingInfo.sequence, "sequence");
+                ValidationSupport.requireNonNull(supportingInfo.category, "category");
+                ValidationSupport.choiceElement(supportingInfo.timing, "timing", Date.class, Period.class);
+                ValidationSupport.choiceElement(supportingInfo.value, "value", Boolean.class, String.class, Quantity.class, Attachment.class, Reference.class);
+                ValidationSupport.requireValueOrChildren(supportingInfo);
             }
 
             protected Builder from(SupportingInfo supportingInfo) {
@@ -3720,13 +3789,11 @@ public static class Diagnosis extends BackboneElement {
 
         private Diagnosis(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            diagnosis = ValidationSupport.requireChoiceElement(builder.diagnosis, "diagnosis", CodeableConcept.class, Reference.class);
-            type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+            sequence = builder.sequence;
+            diagnosis = builder.diagnosis;
+            type = Collections.unmodifiableList(builder.type);
             onAdmission = builder.onAdmission;
             packageCode = builder.packageCode;
-            ValidationSupport.checkReferenceType(diagnosis, "diagnosis", "Condition");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -4092,7 +4159,20 @@ public Builder packageCode(CodeableConcept packageCode) {
              */
             @Override
             public Diagnosis build() {
-                return new Diagnosis(this);
+                Diagnosis diagnosis = new Diagnosis(this);
+                if (validating) {
+                    validate(diagnosis);
+                }
+                return diagnosis;
+            }
+
+            protected void validate(Diagnosis diagnosis) {
+                super.validate(diagnosis);
+                ValidationSupport.requireNonNull(diagnosis.sequence, "sequence");
+                ValidationSupport.requireChoiceElement(diagnosis.diagnosis, "diagnosis", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkList(diagnosis.type, "type", CodeableConcept.class);
+                ValidationSupport.checkReferenceType(diagnosis.diagnosis, "diagnosis", "Condition");
+                ValidationSupport.requireValueOrChildren(diagnosis);
             }
 
             protected Builder from(Diagnosis diagnosis) {
@@ -4136,14 +4216,11 @@ public static class Procedure extends BackboneElement {
 
         private Procedure(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+            sequence = builder.sequence;
+            type = Collections.unmodifiableList(builder.type);
             date = builder.date;
-            procedure = ValidationSupport.requireChoiceElement(builder.procedure, "procedure", CodeableConcept.class, Reference.class);
-            udi = Collections.unmodifiableList(ValidationSupport.checkList(builder.udi, "udi", Reference.class));
-            ValidationSupport.checkReferenceType(procedure, "procedure", "Procedure");
-            ValidationSupport.checkReferenceType(udi, "udi", "Device");
-            ValidationSupport.requireValueOrChildren(this);
+            procedure = builder.procedure;
+            udi = Collections.unmodifiableList(builder.udi);
         }
 
         /**
@@ -4537,7 +4614,22 @@ public Builder udi(Collection<Reference> udi) {
              */
             @Override
             public Procedure build() {
-                return new Procedure(this);
+                Procedure procedure = new Procedure(this);
+                if (validating) {
+                    validate(procedure);
+                }
+                return procedure;
+            }
+
+            protected void validate(Procedure procedure) {
+                super.validate(procedure);
+                ValidationSupport.requireNonNull(procedure.sequence, "sequence");
+                ValidationSupport.checkList(procedure.type, "type", CodeableConcept.class);
+                ValidationSupport.requireChoiceElement(procedure.procedure, "procedure", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkList(procedure.udi, "udi", Reference.class);
+                ValidationSupport.checkReferenceType(procedure.procedure, "procedure", "Procedure");
+                ValidationSupport.checkReferenceType(procedure.udi, "udi", "Device");
+                ValidationSupport.requireValueOrChildren(procedure);
             }
 
             protected Builder from(Procedure procedure) {
@@ -4567,11 +4659,9 @@ public static class Insurance extends BackboneElement {
 
         private Insurance(Builder builder) {
             super(builder);
-            focal = ValidationSupport.requireNonNull(builder.focal, "focal");
-            coverage = ValidationSupport.requireNonNull(builder.coverage, "coverage");
-            preAuthRef = Collections.unmodifiableList(ValidationSupport.checkList(builder.preAuthRef, "preAuthRef", String.class));
-            ValidationSupport.checkReferenceType(coverage, "coverage", "Coverage");
-            ValidationSupport.requireValueOrChildren(this);
+            focal = builder.focal;
+            coverage = builder.coverage;
+            preAuthRef = Collections.unmodifiableList(builder.preAuthRef);
         }
 
         /**
@@ -4876,7 +4966,20 @@ public Builder preAuthRef(Collection<String> preAuthRef) {
              */
             @Override
             public Insurance build() {
-                return new Insurance(this);
+                Insurance insurance = new Insurance(this);
+                if (validating) {
+                    validate(insurance);
+                }
+                return insurance;
+            }
+
+            protected void validate(Insurance insurance) {
+                super.validate(insurance);
+                ValidationSupport.requireNonNull(insurance.focal, "focal");
+                ValidationSupport.requireNonNull(insurance.coverage, "coverage");
+                ValidationSupport.checkList(insurance.preAuthRef, "preAuthRef", String.class);
+                ValidationSupport.checkReferenceType(insurance.coverage, "coverage", "Coverage");
+                ValidationSupport.requireValueOrChildren(insurance);
             }
 
             protected Builder from(Insurance insurance) {
@@ -4909,9 +5012,7 @@ private Accident(Builder builder) {
             super(builder);
             date = builder.date;
             type = builder.type;
-            location = ValidationSupport.choiceElement(builder.location, "location", Address.class, Reference.class);
-            ValidationSupport.checkReferenceType(location, "location", "Location");
-            ValidationSupport.requireValueOrChildren(this);
+            location = builder.location;
         }
 
         /**
@@ -5189,7 +5290,18 @@ public Builder location(Element location) {
              */
             @Override
             public Accident build() {
-                return new Accident(this);
+                Accident accident = new Accident(this);
+                if (validating) {
+                    validate(accident);
+                }
+                return accident;
+            }
+
+            protected void validate(Accident accident) {
+                super.validate(accident);
+                ValidationSupport.choiceElement(accident.location, "location", Address.class, Reference.class);
+                ValidationSupport.checkReferenceType(accident.location, "location", "Location");
+                ValidationSupport.requireValueOrChildren(accident);
             }
 
             protected Builder from(Accident accident) {
@@ -5288,33 +5400,29 @@ public static class Item extends BackboneElement {
 
         private Item(Builder builder) {
             super(builder);
-            sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
-            careTeamSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.careTeamSequence, "careTeamSequence", PositiveInt.class));
-            diagnosisSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.diagnosisSequence, "diagnosisSequence", PositiveInt.class));
-            procedureSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.procedureSequence, "procedureSequence", PositiveInt.class));
-            informationSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.informationSequence, "informationSequence", PositiveInt.class));
+            sequence = builder.sequence;
+            careTeamSequence = Collections.unmodifiableList(builder.careTeamSequence);
+            diagnosisSequence = Collections.unmodifiableList(builder.diagnosisSequence);
+            procedureSequence = Collections.unmodifiableList(builder.procedureSequence);
+            informationSequence = Collections.unmodifiableList(builder.informationSequence);
             revenue = builder.revenue;
             category = builder.category;
-            productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-            modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
-            programCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.programCode, "programCode", CodeableConcept.class));
-            serviced = ValidationSupport.choiceElement(builder.serviced, "serviced", Date.class, Period.class);
-            location = ValidationSupport.choiceElement(builder.location, "location", CodeableConcept.class, Address.class, Reference.class);
+            productOrService = builder.productOrService;
+            modifier = Collections.unmodifiableList(builder.modifier);
+            programCode = Collections.unmodifiableList(builder.programCode);
+            serviced = builder.serviced;
+            location = builder.location;
             quantity = builder.quantity;
             unitPrice = builder.unitPrice;
             factor = builder.factor;
             net = builder.net;
-            udi = Collections.unmodifiableList(ValidationSupport.checkList(builder.udi, "udi", Reference.class));
+            udi = Collections.unmodifiableList(builder.udi);
             bodySite = builder.bodySite;
-            subSite = Collections.unmodifiableList(ValidationSupport.checkList(builder.subSite, "subSite", CodeableConcept.class));
-            encounter = Collections.unmodifiableList(ValidationSupport.checkList(builder.encounter, "encounter", Reference.class));
-            noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-            adjudication = Collections.unmodifiableList(ValidationSupport.checkList(builder.adjudication, "adjudication", Adjudication.class));
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Detail.class));
-            ValidationSupport.checkReferenceType(location, "location", "Location");
-            ValidationSupport.checkReferenceType(udi, "udi", "Device");
-            ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-            ValidationSupport.requireValueOrChildren(this);
+            subSite = Collections.unmodifiableList(builder.subSite);
+            encounter = Collections.unmodifiableList(builder.encounter);
+            noteNumber = Collections.unmodifiableList(builder.noteNumber);
+            adjudication = Collections.unmodifiableList(builder.adjudication);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -6456,7 +6564,35 @@ public Builder detail(Collection<Detail> detail) {
              */
             @Override
             public Item build() {
-                return new Item(this);
+                Item item = new Item(this);
+                if (validating) {
+                    validate(item);
+                }
+                return item;
+            }
+
+            protected void validate(Item item) {
+                super.validate(item);
+                ValidationSupport.requireNonNull(item.sequence, "sequence");
+                ValidationSupport.checkList(item.careTeamSequence, "careTeamSequence", PositiveInt.class);
+                ValidationSupport.checkList(item.diagnosisSequence, "diagnosisSequence", PositiveInt.class);
+                ValidationSupport.checkList(item.procedureSequence, "procedureSequence", PositiveInt.class);
+                ValidationSupport.checkList(item.informationSequence, "informationSequence", PositiveInt.class);
+                ValidationSupport.requireNonNull(item.productOrService, "productOrService");
+                ValidationSupport.checkList(item.modifier, "modifier", CodeableConcept.class);
+                ValidationSupport.checkList(item.programCode, "programCode", CodeableConcept.class);
+                ValidationSupport.choiceElement(item.serviced, "serviced", Date.class, Period.class);
+                ValidationSupport.choiceElement(item.location, "location", CodeableConcept.class, Address.class, Reference.class);
+                ValidationSupport.checkList(item.udi, "udi", Reference.class);
+                ValidationSupport.checkList(item.subSite, "subSite", CodeableConcept.class);
+                ValidationSupport.checkList(item.encounter, "encounter", Reference.class);
+                ValidationSupport.checkList(item.noteNumber, "noteNumber", PositiveInt.class);
+                ValidationSupport.checkList(item.adjudication, "adjudication", Adjudication.class);
+                ValidationSupport.checkList(item.detail, "detail", Detail.class);
+                ValidationSupport.checkReferenceType(item.location, "location", "Location");
+                ValidationSupport.checkReferenceType(item.udi, "udi", "Device");
+                ValidationSupport.checkReferenceType(item.encounter, "encounter", "Encounter");
+                ValidationSupport.requireValueOrChildren(item);
             }
 
             protected Builder from(Item item) {
@@ -6513,11 +6649,10 @@ public static class Adjudication extends BackboneElement {
 
             private Adjudication(Builder builder) {
                 super(builder);
-                category = ValidationSupport.requireNonNull(builder.category, "category");
+                category = builder.category;
                 reason = builder.reason;
                 amount = builder.amount;
                 value = builder.value;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -6822,7 +6957,17 @@ public Builder value(Decimal value) {
                  */
                 @Override
                 public Adjudication build() {
-                    return new Adjudication(this);
+                    Adjudication adjudication = new Adjudication(this);
+                    if (validating) {
+                        validate(adjudication);
+                    }
+                    return adjudication;
+                }
+
+                protected void validate(Adjudication adjudication) {
+                    super.validate(adjudication);
+                    ValidationSupport.requireNonNull(adjudication.category, "category");
+                    ValidationSupport.requireValueOrChildren(adjudication);
                 }
 
                 protected Builder from(Adjudication adjudication) {
@@ -6890,22 +7035,20 @@ public static class Detail extends BackboneElement {
 
             private Detail(Builder builder) {
                 super(builder);
-                sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
+                sequence = builder.sequence;
                 revenue = builder.revenue;
                 category = builder.category;
-                productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-                modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
-                programCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.programCode, "programCode", CodeableConcept.class));
+                productOrService = builder.productOrService;
+                modifier = Collections.unmodifiableList(builder.modifier);
+                programCode = Collections.unmodifiableList(builder.programCode);
                 quantity = builder.quantity;
                 unitPrice = builder.unitPrice;
                 factor = builder.factor;
                 net = builder.net;
-                udi = Collections.unmodifiableList(ValidationSupport.checkList(builder.udi, "udi", Reference.class));
-                noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-                adjudication = Collections.unmodifiableList(ValidationSupport.checkList(builder.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class));
-                subDetail = Collections.unmodifiableList(ValidationSupport.checkList(builder.subDetail, "subDetail", SubDetail.class));
-                ValidationSupport.checkReferenceType(udi, "udi", "Device");
-                ValidationSupport.requireValueOrChildren(this);
+                udi = Collections.unmodifiableList(builder.udi);
+                noteNumber = Collections.unmodifiableList(builder.noteNumber);
+                adjudication = Collections.unmodifiableList(builder.adjudication);
+                subDetail = Collections.unmodifiableList(builder.subDetail);
             }
 
             /**
@@ -7635,7 +7778,25 @@ public Builder subDetail(Collection<SubDetail> subDetail) {
                  */
                 @Override
                 public Detail build() {
-                    return new Detail(this);
+                    Detail detail = new Detail(this);
+                    if (validating) {
+                        validate(detail);
+                    }
+                    return detail;
+                }
+
+                protected void validate(Detail detail) {
+                    super.validate(detail);
+                    ValidationSupport.requireNonNull(detail.sequence, "sequence");
+                    ValidationSupport.requireNonNull(detail.productOrService, "productOrService");
+                    ValidationSupport.checkList(detail.modifier, "modifier", CodeableConcept.class);
+                    ValidationSupport.checkList(detail.programCode, "programCode", CodeableConcept.class);
+                    ValidationSupport.checkList(detail.udi, "udi", Reference.class);
+                    ValidationSupport.checkList(detail.noteNumber, "noteNumber", PositiveInt.class);
+                    ValidationSupport.checkList(detail.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class);
+                    ValidationSupport.checkList(detail.subDetail, "subDetail", SubDetail.class);
+                    ValidationSupport.checkReferenceType(detail.udi, "udi", "Device");
+                    ValidationSupport.requireValueOrChildren(detail);
                 }
 
                 protected Builder from(Detail detail) {
@@ -7711,21 +7872,19 @@ public static class SubDetail extends BackboneElement {
 
                 private SubDetail(Builder builder) {
                     super(builder);
-                    sequence = ValidationSupport.requireNonNull(builder.sequence, "sequence");
+                    sequence = builder.sequence;
                     revenue = builder.revenue;
                     category = builder.category;
-                    productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-                    modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
-                    programCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.programCode, "programCode", CodeableConcept.class));
+                    productOrService = builder.productOrService;
+                    modifier = Collections.unmodifiableList(builder.modifier);
+                    programCode = Collections.unmodifiableList(builder.programCode);
                     quantity = builder.quantity;
                     unitPrice = builder.unitPrice;
                     factor = builder.factor;
                     net = builder.net;
-                    udi = Collections.unmodifiableList(ValidationSupport.checkList(builder.udi, "udi", Reference.class));
-                    noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-                    adjudication = Collections.unmodifiableList(ValidationSupport.checkList(builder.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class));
-                    ValidationSupport.checkReferenceType(udi, "udi", "Device");
-                    ValidationSupport.requireValueOrChildren(this);
+                    udi = Collections.unmodifiableList(builder.udi);
+                    noteNumber = Collections.unmodifiableList(builder.noteNumber);
+                    adjudication = Collections.unmodifiableList(builder.adjudication);
                 }
 
                 /**
@@ -8406,7 +8565,24 @@ public Builder adjudication(Collection<ExplanationOfBenefit.Item.Adjudication> a
                      */
                     @Override
                     public SubDetail build() {
-                        return new SubDetail(this);
+                        SubDetail subDetail = new SubDetail(this);
+                        if (validating) {
+                            validate(subDetail);
+                        }
+                        return subDetail;
+                    }
+
+                    protected void validate(SubDetail subDetail) {
+                        super.validate(subDetail);
+                        ValidationSupport.requireNonNull(subDetail.sequence, "sequence");
+                        ValidationSupport.requireNonNull(subDetail.productOrService, "productOrService");
+                        ValidationSupport.checkList(subDetail.modifier, "modifier", CodeableConcept.class);
+                        ValidationSupport.checkList(subDetail.programCode, "programCode", CodeableConcept.class);
+                        ValidationSupport.checkList(subDetail.udi, "udi", Reference.class);
+                        ValidationSupport.checkList(subDetail.noteNumber, "noteNumber", PositiveInt.class);
+                        ValidationSupport.checkList(subDetail.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class);
+                        ValidationSupport.checkReferenceType(subDetail.udi, "udi", "Device");
+                        ValidationSupport.requireValueOrChildren(subDetail);
                     }
 
                     protected Builder from(SubDetail subDetail) {
@@ -8497,27 +8673,24 @@ public static class AddItem extends BackboneElement {
 
         private AddItem(Builder builder) {
             super(builder);
-            itemSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.itemSequence, "itemSequence", PositiveInt.class));
-            detailSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.detailSequence, "detailSequence", PositiveInt.class));
-            subDetailSequence = Collections.unmodifiableList(ValidationSupport.checkList(builder.subDetailSequence, "subDetailSequence", PositiveInt.class));
-            provider = Collections.unmodifiableList(ValidationSupport.checkList(builder.provider, "provider", Reference.class));
-            productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-            modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
-            programCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.programCode, "programCode", CodeableConcept.class));
-            serviced = ValidationSupport.choiceElement(builder.serviced, "serviced", Date.class, Period.class);
-            location = ValidationSupport.choiceElement(builder.location, "location", CodeableConcept.class, Address.class, Reference.class);
+            itemSequence = Collections.unmodifiableList(builder.itemSequence);
+            detailSequence = Collections.unmodifiableList(builder.detailSequence);
+            subDetailSequence = Collections.unmodifiableList(builder.subDetailSequence);
+            provider = Collections.unmodifiableList(builder.provider);
+            productOrService = builder.productOrService;
+            modifier = Collections.unmodifiableList(builder.modifier);
+            programCode = Collections.unmodifiableList(builder.programCode);
+            serviced = builder.serviced;
+            location = builder.location;
             quantity = builder.quantity;
             unitPrice = builder.unitPrice;
             factor = builder.factor;
             net = builder.net;
             bodySite = builder.bodySite;
-            subSite = Collections.unmodifiableList(ValidationSupport.checkList(builder.subSite, "subSite", CodeableConcept.class));
-            noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-            adjudication = Collections.unmodifiableList(ValidationSupport.checkList(builder.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class));
-            detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Detail.class));
-            ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.checkReferenceType(location, "location", "Location");
-            ValidationSupport.requireValueOrChildren(this);
+            subSite = Collections.unmodifiableList(builder.subSite);
+            noteNumber = Collections.unmodifiableList(builder.noteNumber);
+            adjudication = Collections.unmodifiableList(builder.adjudication);
+            detail = Collections.unmodifiableList(builder.detail);
         }
 
         /**
@@ -9465,7 +9638,31 @@ public Builder detail(Collection<Detail> detail) {
              */
             @Override
             public AddItem build() {
-                return new AddItem(this);
+                AddItem addItem = new AddItem(this);
+                if (validating) {
+                    validate(addItem);
+                }
+                return addItem;
+            }
+
+            protected void validate(AddItem addItem) {
+                super.validate(addItem);
+                ValidationSupport.checkList(addItem.itemSequence, "itemSequence", PositiveInt.class);
+                ValidationSupport.checkList(addItem.detailSequence, "detailSequence", PositiveInt.class);
+                ValidationSupport.checkList(addItem.subDetailSequence, "subDetailSequence", PositiveInt.class);
+                ValidationSupport.checkList(addItem.provider, "provider", Reference.class);
+                ValidationSupport.requireNonNull(addItem.productOrService, "productOrService");
+                ValidationSupport.checkList(addItem.modifier, "modifier", CodeableConcept.class);
+                ValidationSupport.checkList(addItem.programCode, "programCode", CodeableConcept.class);
+                ValidationSupport.choiceElement(addItem.serviced, "serviced", Date.class, Period.class);
+                ValidationSupport.choiceElement(addItem.location, "location", CodeableConcept.class, Address.class, Reference.class);
+                ValidationSupport.checkList(addItem.subSite, "subSite", CodeableConcept.class);
+                ValidationSupport.checkList(addItem.noteNumber, "noteNumber", PositiveInt.class);
+                ValidationSupport.checkList(addItem.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class);
+                ValidationSupport.checkList(addItem.detail, "detail", Detail.class);
+                ValidationSupport.checkReferenceType(addItem.provider, "provider", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.checkReferenceType(addItem.location, "location", "Location");
+                ValidationSupport.requireValueOrChildren(addItem);
             }
 
             protected Builder from(AddItem addItem) {
@@ -9521,16 +9718,15 @@ public static class Detail extends BackboneElement {
 
             private Detail(Builder builder) {
                 super(builder);
-                productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-                modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
+                productOrService = builder.productOrService;
+                modifier = Collections.unmodifiableList(builder.modifier);
                 quantity = builder.quantity;
                 unitPrice = builder.unitPrice;
                 factor = builder.factor;
                 net = builder.net;
-                noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-                adjudication = Collections.unmodifiableList(ValidationSupport.checkList(builder.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class));
-                subDetail = Collections.unmodifiableList(ValidationSupport.checkList(builder.subDetail, "subDetail", SubDetail.class));
-                ValidationSupport.requireValueOrChildren(this);
+                noteNumber = Collections.unmodifiableList(builder.noteNumber);
+                adjudication = Collections.unmodifiableList(builder.adjudication);
+                subDetail = Collections.unmodifiableList(builder.subDetail);
             }
 
             /**
@@ -10062,7 +10258,21 @@ public Builder subDetail(Collection<SubDetail> subDetail) {
                  */
                 @Override
                 public Detail build() {
-                    return new Detail(this);
+                    Detail detail = new Detail(this);
+                    if (validating) {
+                        validate(detail);
+                    }
+                    return detail;
+                }
+
+                protected void validate(Detail detail) {
+                    super.validate(detail);
+                    ValidationSupport.requireNonNull(detail.productOrService, "productOrService");
+                    ValidationSupport.checkList(detail.modifier, "modifier", CodeableConcept.class);
+                    ValidationSupport.checkList(detail.noteNumber, "noteNumber", PositiveInt.class);
+                    ValidationSupport.checkList(detail.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class);
+                    ValidationSupport.checkList(detail.subDetail, "subDetail", SubDetail.class);
+                    ValidationSupport.requireValueOrChildren(detail);
                 }
 
                 protected Builder from(Detail detail) {
@@ -10108,15 +10318,14 @@ public static class SubDetail extends BackboneElement {
 
                 private SubDetail(Builder builder) {
                     super(builder);
-                    productOrService = ValidationSupport.requireNonNull(builder.productOrService, "productOrService");
-                    modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", CodeableConcept.class));
+                    productOrService = builder.productOrService;
+                    modifier = Collections.unmodifiableList(builder.modifier);
                     quantity = builder.quantity;
                     unitPrice = builder.unitPrice;
                     factor = builder.factor;
                     net = builder.net;
-                    noteNumber = Collections.unmodifiableList(ValidationSupport.checkList(builder.noteNumber, "noteNumber", PositiveInt.class));
-                    adjudication = Collections.unmodifiableList(ValidationSupport.checkList(builder.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    noteNumber = Collections.unmodifiableList(builder.noteNumber);
+                    adjudication = Collections.unmodifiableList(builder.adjudication);
                 }
 
                 /**
@@ -10599,7 +10808,20 @@ public Builder adjudication(Collection<ExplanationOfBenefit.Item.Adjudication> a
                      */
                     @Override
                     public SubDetail build() {
-                        return new SubDetail(this);
+                        SubDetail subDetail = new SubDetail(this);
+                        if (validating) {
+                            validate(subDetail);
+                        }
+                        return subDetail;
+                    }
+
+                    protected void validate(SubDetail subDetail) {
+                        super.validate(subDetail);
+                        ValidationSupport.requireNonNull(subDetail.productOrService, "productOrService");
+                        ValidationSupport.checkList(subDetail.modifier, "modifier", CodeableConcept.class);
+                        ValidationSupport.checkList(subDetail.noteNumber, "noteNumber", PositiveInt.class);
+                        ValidationSupport.checkList(subDetail.adjudication, "adjudication", ExplanationOfBenefit.Item.Adjudication.class);
+                        ValidationSupport.requireValueOrChildren(subDetail);
                     }
 
                     protected Builder from(SubDetail subDetail) {
@@ -10638,9 +10860,8 @@ public static class Total extends BackboneElement {
 
         private Total(Builder builder) {
             super(builder);
-            category = ValidationSupport.requireNonNull(builder.category, "category");
-            amount = ValidationSupport.requireNonNull(builder.amount, "amount");
-            ValidationSupport.requireValueOrChildren(this);
+            category = builder.category;
+            amount = builder.amount;
         }
 
         /**
@@ -10890,7 +11111,18 @@ public Builder amount(Money amount) {
              */
             @Override
             public Total build() {
-                return new Total(this);
+                Total total = new Total(this);
+                if (validating) {
+                    validate(total);
+                }
+                return total;
+            }
+
+            protected void validate(Total total) {
+                super.validate(total);
+                ValidationSupport.requireNonNull(total.category, "category");
+                ValidationSupport.requireNonNull(total.amount, "amount");
+                ValidationSupport.requireValueOrChildren(total);
             }
 
             protected Builder from(Total total) {
@@ -10933,7 +11165,6 @@ private Payment(Builder builder) {
             date = builder.date;
             amount = builder.amount;
             identifier = builder.identifier;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -11287,7 +11518,16 @@ public Builder identifier(Identifier identifier) {
              */
             @Override
             public Payment build() {
-                return new Payment(this);
+                Payment payment = new Payment(this);
+                if (validating) {
+                    validate(payment);
+                }
+                return payment;
+            }
+
+            protected void validate(Payment payment) {
+                super.validate(payment);
+                ValidationSupport.requireValueOrChildren(payment);
             }
 
             protected Builder from(Payment payment) {
@@ -11331,8 +11571,6 @@ private ProcessNote(Builder builder) {
             type = builder.type;
             text = builder.text;
             language = builder.language;
-            ValidationSupport.checkValueSetBinding(language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -11626,7 +11864,17 @@ public Builder language(CodeableConcept language) {
              */
             @Override
             public ProcessNote build() {
-                return new ProcessNote(this);
+                ProcessNote processNote = new ProcessNote(this);
+                if (validating) {
+                    validate(processNote);
+                }
+                return processNote;
+            }
+
+            protected void validate(ProcessNote processNote) {
+                super.validate(processNote);
+                ValidationSupport.checkValueSetBinding(processNote.language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+                ValidationSupport.requireValueOrChildren(processNote);
             }
 
             protected Builder from(ProcessNote processNote) {
@@ -11680,15 +11928,14 @@ public static class BenefitBalance extends BackboneElement {
 
         private BenefitBalance(Builder builder) {
             super(builder);
-            category = ValidationSupport.requireNonNull(builder.category, "category");
+            category = builder.category;
             excluded = builder.excluded;
             name = builder.name;
             description = builder.description;
             network = builder.network;
             unit = builder.unit;
             term = builder.term;
-            financial = Collections.unmodifiableList(ValidationSupport.checkList(builder.financial, "financial", Financial.class));
-            ValidationSupport.requireValueOrChildren(this);
+            financial = Collections.unmodifiableList(builder.financial);
         }
 
         /**
@@ -12127,7 +12374,18 @@ public Builder financial(Collection<Financial> financial) {
              */
             @Override
             public BenefitBalance build() {
-                return new BenefitBalance(this);
+                BenefitBalance benefitBalance = new BenefitBalance(this);
+                if (validating) {
+                    validate(benefitBalance);
+                }
+                return benefitBalance;
+            }
+
+            protected void validate(BenefitBalance benefitBalance) {
+                super.validate(benefitBalance);
+                ValidationSupport.requireNonNull(benefitBalance.category, "category");
+                ValidationSupport.checkList(benefitBalance.financial, "financial", Financial.class);
+                ValidationSupport.requireValueOrChildren(benefitBalance);
             }
 
             protected Builder from(BenefitBalance benefitBalance) {
@@ -12163,10 +12421,9 @@ public static class Financial extends BackboneElement {
 
             private Financial(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
-                allowed = ValidationSupport.choiceElement(builder.allowed, "allowed", UnsignedInt.class, String.class, Money.class);
-                used = ValidationSupport.choiceElement(builder.used, "used", UnsignedInt.class, Money.class);
-                ValidationSupport.requireValueOrChildren(this);
+                type = builder.type;
+                allowed = builder.allowed;
+                used = builder.used;
             }
 
             /**
@@ -12451,7 +12708,19 @@ public Builder used(Element used) {
                  */
                 @Override
                 public Financial build() {
-                    return new Financial(this);
+                    Financial financial = new Financial(this);
+                    if (validating) {
+                        validate(financial);
+                    }
+                    return financial;
+                }
+
+                protected void validate(Financial financial) {
+                    super.validate(financial);
+                    ValidationSupport.requireNonNull(financial.type, "type");
+                    ValidationSupport.choiceElement(financial.allowed, "allowed", UnsignedInt.class, String.class, Money.class);
+                    ValidationSupport.choiceElement(financial.used, "used", UnsignedInt.class, Money.class);
+                    ValidationSupport.requireValueOrChildren(financial);
                 }
 
                 protected Builder from(Financial financial) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/FamilyMemberHistory.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/FamilyMemberHistory.java
index 3c4b491ffc9..014142c38be 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/FamilyMemberHistory.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/FamilyMemberHistory.java
@@ -153,26 +153,24 @@ public class FamilyMemberHistory extends DomainResource {
 
     private FamilyMemberHistory(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-        instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+        instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
+        status = builder.status;
         dataAbsentReason = builder.dataAbsentReason;
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
+        patient = builder.patient;
         date = builder.date;
         name = builder.name;
-        relationship = ValidationSupport.requireNonNull(builder.relationship, "relationship");
+        relationship = builder.relationship;
         sex = builder.sex;
-        born = ValidationSupport.choiceElement(builder.born, "born", Period.class, Date.class, String.class);
-        age = ValidationSupport.choiceElement(builder.age, "age", Age.class, Range.class, String.class);
+        born = builder.born;
+        age = builder.age;
         estimatedAge = builder.estimatedAge;
-        deceased = ValidationSupport.choiceElement(builder.deceased, "deceased", Boolean.class, Age.class, Range.class, Date.class, String.class);
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        condition = Collections.unmodifiableList(ValidationSupport.checkList(builder.condition, "condition", Condition.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "AllergyIntolerance", "QuestionnaireResponse", "DiagnosticReport", "DocumentReference");
+        deceased = builder.deceased;
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        note = Collections.unmodifiableList(builder.note);
+        condition = Collections.unmodifiableList(builder.condition);
     }
 
     /**
@@ -1206,7 +1204,30 @@ public Builder condition(Collection<Condition> condition) {
          */
         @Override
         public FamilyMemberHistory build() {
-            return new FamilyMemberHistory(this);
+            FamilyMemberHistory familyMemberHistory = new FamilyMemberHistory(this);
+            if (validating) {
+                validate(familyMemberHistory);
+            }
+            return familyMemberHistory;
+        }
+
+        protected void validate(FamilyMemberHistory familyMemberHistory) {
+            super.validate(familyMemberHistory);
+            ValidationSupport.checkList(familyMemberHistory.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(familyMemberHistory.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+            ValidationSupport.checkList(familyMemberHistory.instantiatesUri, "instantiatesUri", Uri.class);
+            ValidationSupport.requireNonNull(familyMemberHistory.status, "status");
+            ValidationSupport.requireNonNull(familyMemberHistory.patient, "patient");
+            ValidationSupport.requireNonNull(familyMemberHistory.relationship, "relationship");
+            ValidationSupport.choiceElement(familyMemberHistory.born, "born", Period.class, Date.class, String.class);
+            ValidationSupport.choiceElement(familyMemberHistory.age, "age", Age.class, Range.class, String.class);
+            ValidationSupport.choiceElement(familyMemberHistory.deceased, "deceased", Boolean.class, Age.class, Range.class, Date.class, String.class);
+            ValidationSupport.checkList(familyMemberHistory.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(familyMemberHistory.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(familyMemberHistory.note, "note", Annotation.class);
+            ValidationSupport.checkList(familyMemberHistory.condition, "condition", Condition.class);
+            ValidationSupport.checkReferenceType(familyMemberHistory.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(familyMemberHistory.reasonReference, "reasonReference", "Condition", "Observation", "AllergyIntolerance", "QuestionnaireResponse", "DiagnosticReport", "DocumentReference");
         }
 
         protected Builder from(FamilyMemberHistory familyMemberHistory) {
@@ -1261,12 +1282,11 @@ public static class Condition extends BackboneElement {
 
         private Condition(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            code = builder.code;
             outcome = builder.outcome;
             contributedToDeath = builder.contributedToDeath;
-            onset = ValidationSupport.choiceElement(builder.onset, "onset", Age.class, Range.class, Period.class, String.class);
-            note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-            ValidationSupport.requireValueOrChildren(this);
+            onset = builder.onset;
+            note = Collections.unmodifiableList(builder.note);
         }
 
         /**
@@ -1632,7 +1652,19 @@ public Builder note(Collection<Annotation> note) {
              */
             @Override
             public Condition build() {
-                return new Condition(this);
+                Condition condition = new Condition(this);
+                if (validating) {
+                    validate(condition);
+                }
+                return condition;
+            }
+
+            protected void validate(Condition condition) {
+                super.validate(condition);
+                ValidationSupport.requireNonNull(condition.code, "code");
+                ValidationSupport.choiceElement(condition.onset, "onset", Age.class, Range.class, Period.class, String.class);
+                ValidationSupport.checkList(condition.note, "note", Annotation.class);
+                ValidationSupport.requireValueOrChildren(condition);
             }
 
             protected Builder from(Condition condition) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Flag.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Flag.java
index 726ed938b7a..8b06dc80f35 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Flag.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Flag.java
@@ -88,17 +88,14 @@ public class Flag extends DomainResource {
 
     private Flag(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
-        code = ValidationSupport.requireNonNull(builder.code, "code");
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        category = Collections.unmodifiableList(builder.category);
+        code = builder.code;
+        subject = builder.subject;
         period = builder.period;
         encounter = builder.encounter;
         author = builder.author;
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Location", "Group", "Organization", "Practitioner", "PlanDefinition", "Medication", "Procedure");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(author, "author", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole");
     }
 
     /**
@@ -705,7 +702,23 @@ public Builder author(Reference author) {
          */
         @Override
         public Flag build() {
-            return new Flag(this);
+            Flag flag = new Flag(this);
+            if (validating) {
+                validate(flag);
+            }
+            return flag;
+        }
+
+        protected void validate(Flag flag) {
+            super.validate(flag);
+            ValidationSupport.checkList(flag.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(flag.status, "status");
+            ValidationSupport.checkList(flag.category, "category", CodeableConcept.class);
+            ValidationSupport.requireNonNull(flag.code, "code");
+            ValidationSupport.requireNonNull(flag.subject, "subject");
+            ValidationSupport.checkReferenceType(flag.subject, "subject", "Patient", "Location", "Group", "Organization", "Practitioner", "PlanDefinition", "Medication", "Procedure");
+            ValidationSupport.checkReferenceType(flag.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(flag.author, "author", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole");
         }
 
         protected Builder from(Flag flag) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Goal.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Goal.java
index af5b599b893..4691bb8a663 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Goal.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Goal.java
@@ -159,26 +159,22 @@ public class Goal extends DomainResource {
 
     private Goal(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        lifecycleStatus = ValidationSupport.requireNonNull(builder.lifecycleStatus, "lifecycleStatus");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        lifecycleStatus = builder.lifecycleStatus;
         achievementStatus = builder.achievementStatus;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        category = Collections.unmodifiableList(builder.category);
         priority = builder.priority;
-        description = ValidationSupport.requireNonNull(builder.description, "description");
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
-        start = ValidationSupport.choiceElement(builder.start, "start", Date.class, CodeableConcept.class);
-        target = Collections.unmodifiableList(ValidationSupport.checkList(builder.target, "target", Target.class));
+        description = builder.description;
+        subject = builder.subject;
+        start = builder.start;
+        target = Collections.unmodifiableList(builder.target);
         statusDate = builder.statusDate;
         statusReason = builder.statusReason;
         expressedBy = builder.expressedBy;
-        addresses = Collections.unmodifiableList(ValidationSupport.checkList(builder.addresses, "addresses", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        outcomeCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.outcomeCode, "outcomeCode", CodeableConcept.class));
-        outcomeReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.outcomeReference, "outcomeReference", Reference.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group", "Organization");
-        ValidationSupport.checkReferenceType(expressedBy, "expressedBy", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
-        ValidationSupport.checkReferenceType(addresses, "addresses", "Condition", "Observation", "MedicationStatement", "NutritionOrder", "ServiceRequest", "RiskAssessment");
-        ValidationSupport.checkReferenceType(outcomeReference, "outcomeReference", "Observation");
+        addresses = Collections.unmodifiableList(builder.addresses);
+        note = Collections.unmodifiableList(builder.note);
+        outcomeCode = Collections.unmodifiableList(builder.outcomeCode);
+        outcomeReference = Collections.unmodifiableList(builder.outcomeReference);
     }
 
     /**
@@ -1139,7 +1135,30 @@ public Builder outcomeReference(Collection<Reference> outcomeReference) {
          */
         @Override
         public Goal build() {
-            return new Goal(this);
+            Goal goal = new Goal(this);
+            if (validating) {
+                validate(goal);
+            }
+            return goal;
+        }
+
+        protected void validate(Goal goal) {
+            super.validate(goal);
+            ValidationSupport.checkList(goal.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(goal.lifecycleStatus, "lifecycleStatus");
+            ValidationSupport.checkList(goal.category, "category", CodeableConcept.class);
+            ValidationSupport.requireNonNull(goal.description, "description");
+            ValidationSupport.requireNonNull(goal.subject, "subject");
+            ValidationSupport.choiceElement(goal.start, "start", Date.class, CodeableConcept.class);
+            ValidationSupport.checkList(goal.target, "target", Target.class);
+            ValidationSupport.checkList(goal.addresses, "addresses", Reference.class);
+            ValidationSupport.checkList(goal.note, "note", Annotation.class);
+            ValidationSupport.checkList(goal.outcomeCode, "outcomeCode", CodeableConcept.class);
+            ValidationSupport.checkList(goal.outcomeReference, "outcomeReference", Reference.class);
+            ValidationSupport.checkReferenceType(goal.subject, "subject", "Patient", "Group", "Organization");
+            ValidationSupport.checkReferenceType(goal.expressedBy, "expressedBy", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
+            ValidationSupport.checkReferenceType(goal.addresses, "addresses", "Condition", "Observation", "MedicationStatement", "NutritionOrder", "ServiceRequest", "RiskAssessment");
+            ValidationSupport.checkReferenceType(goal.outcomeReference, "outcomeReference", "Observation");
         }
 
         protected Builder from(Goal goal) {
@@ -1191,9 +1210,8 @@ public static class Target extends BackboneElement {
         private Target(Builder builder) {
             super(builder);
             measure = builder.measure;
-            detail = ValidationSupport.choiceElement(builder.detail, "detail", Quantity.class, Range.class, CodeableConcept.class, String.class, Boolean.class, Integer.class, Ratio.class);
-            due = ValidationSupport.choiceElement(builder.due, "due", Date.class, Duration.class);
-            ValidationSupport.requireValueOrChildren(this);
+            detail = builder.detail;
+            due = builder.due;
         }
 
         /**
@@ -1481,7 +1499,18 @@ public Builder due(Element due) {
              */
             @Override
             public Target build() {
-                return new Target(this);
+                Target target = new Target(this);
+                if (validating) {
+                    validate(target);
+                }
+                return target;
+            }
+
+            protected void validate(Target target) {
+                super.validate(target);
+                ValidationSupport.choiceElement(target.detail, "detail", Quantity.class, Range.class, CodeableConcept.class, String.class, Boolean.class, Integer.class, Ratio.class);
+                ValidationSupport.choiceElement(target.due, "due", Date.class, Duration.class);
+                ValidationSupport.requireValueOrChildren(target);
             }
 
             protected Builder from(Target target) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/GraphDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/GraphDefinition.java
index 12059ea8164..289af89c87a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/GraphDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/GraphDefinition.java
@@ -123,19 +123,19 @@ private GraphDefinition(Builder builder) {
         super(builder);
         url = builder.url;
         version = builder.version;
-        name = ValidationSupport.requireNonNull(builder.name, "name");
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        name = builder.name;
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
-        start = ValidationSupport.requireNonNull(builder.start, "start");
+        start = builder.start;
         profile = builder.profile;
-        link = Collections.unmodifiableList(ValidationSupport.checkList(builder.link, "link", Link.class));
+        link = Collections.unmodifiableList(builder.link);
     }
 
     /**
@@ -977,7 +977,22 @@ public Builder link(Collection<Link> link) {
          */
         @Override
         public GraphDefinition build() {
-            return new GraphDefinition(this);
+            GraphDefinition graphDefinition = new GraphDefinition(this);
+            if (validating) {
+                validate(graphDefinition);
+            }
+            return graphDefinition;
+        }
+
+        protected void validate(GraphDefinition graphDefinition) {
+            super.validate(graphDefinition);
+            ValidationSupport.requireNonNull(graphDefinition.name, "name");
+            ValidationSupport.requireNonNull(graphDefinition.status, "status");
+            ValidationSupport.checkList(graphDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(graphDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(graphDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.requireNonNull(graphDefinition.start, "start");
+            ValidationSupport.checkList(graphDefinition.link, "link", Link.class);
         }
 
         protected Builder from(GraphDefinition graphDefinition) {
@@ -1019,8 +1034,7 @@ private Link(Builder builder) {
             min = builder.min;
             max = builder.max;
             description = builder.description;
-            target = Collections.unmodifiableList(ValidationSupport.checkList(builder.target, "target", Target.class));
-            ValidationSupport.requireValueOrChildren(this);
+            target = Collections.unmodifiableList(builder.target);
         }
 
         /**
@@ -1392,7 +1406,17 @@ public Builder target(Collection<Target> target) {
              */
             @Override
             public Link build() {
-                return new Link(this);
+                Link link = new Link(this);
+                if (validating) {
+                    validate(link);
+                }
+                return link;
+            }
+
+            protected void validate(Link link) {
+                super.validate(link);
+                ValidationSupport.checkList(link.target, "target", Target.class);
+                ValidationSupport.requireValueOrChildren(link);
             }
 
             protected Builder from(Link link) {
@@ -1426,12 +1450,11 @@ public static class Target extends BackboneElement {
 
             private Target(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
+                type = builder.type;
                 params = builder.params;
                 profile = builder.profile;
-                compartment = Collections.unmodifiableList(ValidationSupport.checkList(builder.compartment, "compartment", Compartment.class));
-                link = Collections.unmodifiableList(ValidationSupport.checkList(builder.link, "link", GraphDefinition.Link.class));
-                ValidationSupport.requireValueOrChildren(this);
+                compartment = Collections.unmodifiableList(builder.compartment);
+                link = Collections.unmodifiableList(builder.link);
             }
 
             /**
@@ -1801,7 +1824,19 @@ public Builder link(Collection<GraphDefinition.Link> link) {
                  */
                 @Override
                 public Target build() {
-                    return new Target(this);
+                    Target target = new Target(this);
+                    if (validating) {
+                        validate(target);
+                    }
+                    return target;
+                }
+
+                protected void validate(Target target) {
+                    super.validate(target);
+                    ValidationSupport.requireNonNull(target.type, "type");
+                    ValidationSupport.checkList(target.compartment, "compartment", Compartment.class);
+                    ValidationSupport.checkList(target.link, "link", GraphDefinition.Link.class);
+                    ValidationSupport.requireValueOrChildren(target);
                 }
 
                 protected Builder from(Target target) {
@@ -1848,12 +1883,11 @@ public static class Compartment extends BackboneElement {
 
                 private Compartment(Builder builder) {
                     super(builder);
-                    use = ValidationSupport.requireNonNull(builder.use, "use");
-                    code = ValidationSupport.requireNonNull(builder.code, "code");
-                    rule = ValidationSupport.requireNonNull(builder.rule, "rule");
+                    use = builder.use;
+                    code = builder.code;
+                    rule = builder.rule;
                     expression = builder.expression;
                     description = builder.description;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -2191,7 +2225,19 @@ public Builder description(String description) {
                      */
                     @Override
                     public Compartment build() {
-                        return new Compartment(this);
+                        Compartment compartment = new Compartment(this);
+                        if (validating) {
+                            validate(compartment);
+                        }
+                        return compartment;
+                    }
+
+                    protected void validate(Compartment compartment) {
+                        super.validate(compartment);
+                        ValidationSupport.requireNonNull(compartment.use, "use");
+                        ValidationSupport.requireNonNull(compartment.code, "code");
+                        ValidationSupport.requireNonNull(compartment.rule, "rule");
+                        ValidationSupport.requireValueOrChildren(compartment);
                     }
 
                     protected Builder from(Compartment compartment) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Group.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Group.java
index 4eb21729197..7a7211bb5cd 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Group.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Group.java
@@ -98,17 +98,16 @@ public class Group extends DomainResource {
 
     private Group(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
-        type = ValidationSupport.requireNonNull(builder.type, "type");
-        actual = ValidationSupport.requireNonNull(builder.actual, "actual");
+        type = builder.type;
+        actual = builder.actual;
         code = builder.code;
         name = builder.name;
         quantity = builder.quantity;
         managingEntity = builder.managingEntity;
-        characteristic = Collections.unmodifiableList(ValidationSupport.checkList(builder.characteristic, "characteristic", Characteristic.class));
-        member = Collections.unmodifiableList(ValidationSupport.checkList(builder.member, "member", Member.class));
-        ValidationSupport.checkReferenceType(managingEntity, "managingEntity", "Organization", "RelatedPerson", "Practitioner", "PractitionerRole");
+        characteristic = Collections.unmodifiableList(builder.characteristic);
+        member = Collections.unmodifiableList(builder.member);
     }
 
     /**
@@ -766,7 +765,21 @@ public Builder member(Collection<Member> member) {
          */
         @Override
         public Group build() {
-            return new Group(this);
+            Group group = new Group(this);
+            if (validating) {
+                validate(group);
+            }
+            return group;
+        }
+
+        protected void validate(Group group) {
+            super.validate(group);
+            ValidationSupport.checkList(group.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(group.type, "type");
+            ValidationSupport.requireNonNull(group.actual, "actual");
+            ValidationSupport.checkList(group.characteristic, "characteristic", Characteristic.class);
+            ValidationSupport.checkList(group.member, "member", Member.class);
+            ValidationSupport.checkReferenceType(group.managingEntity, "managingEntity", "Organization", "RelatedPerson", "Practitioner", "PractitionerRole");
         }
 
         protected Builder from(Group group) {
@@ -810,11 +823,10 @@ public static class Characteristic extends BackboneElement {
 
         private Characteristic(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            value = ValidationSupport.requireChoiceElement(builder.value, "value", CodeableConcept.class, Boolean.class, Quantity.class, Range.class, Reference.class);
-            exclude = ValidationSupport.requireNonNull(builder.exclude, "exclude");
+            code = builder.code;
+            value = builder.value;
+            exclude = builder.exclude;
             period = builder.period;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1130,7 +1142,19 @@ public Builder period(Period period) {
              */
             @Override
             public Characteristic build() {
-                return new Characteristic(this);
+                Characteristic characteristic = new Characteristic(this);
+                if (validating) {
+                    validate(characteristic);
+                }
+                return characteristic;
+            }
+
+            protected void validate(Characteristic characteristic) {
+                super.validate(characteristic);
+                ValidationSupport.requireNonNull(characteristic.code, "code");
+                ValidationSupport.requireChoiceElement(characteristic.value, "value", CodeableConcept.class, Boolean.class, Quantity.class, Range.class, Reference.class);
+                ValidationSupport.requireNonNull(characteristic.exclude, "exclude");
+                ValidationSupport.requireValueOrChildren(characteristic);
             }
 
             protected Builder from(Characteristic characteristic) {
@@ -1156,11 +1180,9 @@ public static class Member extends BackboneElement {
 
         private Member(Builder builder) {
             super(builder);
-            entity = ValidationSupport.requireNonNull(builder.entity, "entity");
+            entity = builder.entity;
             period = builder.period;
             inactive = builder.inactive;
-            ValidationSupport.checkReferenceType(entity, "entity", "Patient", "Practitioner", "PractitionerRole", "Device", "Medication", "Substance", "Group");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1445,7 +1467,18 @@ public Builder inactive(Boolean inactive) {
              */
             @Override
             public Member build() {
-                return new Member(this);
+                Member member = new Member(this);
+                if (validating) {
+                    validate(member);
+                }
+                return member;
+            }
+
+            protected void validate(Member member) {
+                super.validate(member);
+                ValidationSupport.requireNonNull(member.entity, "entity");
+                ValidationSupport.checkReferenceType(member.entity, "entity", "Patient", "Practitioner", "PractitionerRole", "Device", "Medication", "Substance", "Group");
+                ValidationSupport.requireValueOrChildren(member);
             }
 
             protected Builder from(Member member) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/GuidanceResponse.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/GuidanceResponse.java
index 3cf4452c439..a4cd9aff1d0 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/GuidanceResponse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/GuidanceResponse.java
@@ -90,27 +90,20 @@ public class GuidanceResponse extends DomainResource {
     private GuidanceResponse(Builder builder) {
         super(builder);
         requestIdentifier = builder.requestIdentifier;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        module = ValidationSupport.requireChoiceElement(builder.module, "module", Uri.class, Canonical.class, CodeableConcept.class);
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        module = builder.module;
+        status = builder.status;
         subject = builder.subject;
         encounter = builder.encounter;
         occurrenceDateTime = builder.occurrenceDateTime;
         performer = builder.performer;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        evaluationMessage = Collections.unmodifiableList(ValidationSupport.checkList(builder.evaluationMessage, "evaluationMessage", Reference.class));
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        note = Collections.unmodifiableList(builder.note);
+        evaluationMessage = Collections.unmodifiableList(builder.evaluationMessage);
         outputParameters = builder.outputParameters;
         result = builder.result;
-        dataRequirement = Collections.unmodifiableList(ValidationSupport.checkList(builder.dataRequirement, "dataRequirement", DataRequirement.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(performer, "performer", "Device");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
-        ValidationSupport.checkReferenceType(evaluationMessage, "evaluationMessage", "OperationOutcome");
-        ValidationSupport.checkReferenceType(outputParameters, "outputParameters", "Parameters");
-        ValidationSupport.checkReferenceType(result, "result", "CarePlan", "RequestGroup");
+        dataRequirement = Collections.unmodifiableList(builder.dataRequirement);
     }
 
     /**
@@ -1054,7 +1047,30 @@ public Builder dataRequirement(Collection<DataRequirement> dataRequirement) {
          */
         @Override
         public GuidanceResponse build() {
-            return new GuidanceResponse(this);
+            GuidanceResponse guidanceResponse = new GuidanceResponse(this);
+            if (validating) {
+                validate(guidanceResponse);
+            }
+            return guidanceResponse;
+        }
+
+        protected void validate(GuidanceResponse guidanceResponse) {
+            super.validate(guidanceResponse);
+            ValidationSupport.checkList(guidanceResponse.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireChoiceElement(guidanceResponse.module, "module", Uri.class, Canonical.class, CodeableConcept.class);
+            ValidationSupport.requireNonNull(guidanceResponse.status, "status");
+            ValidationSupport.checkList(guidanceResponse.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(guidanceResponse.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(guidanceResponse.note, "note", Annotation.class);
+            ValidationSupport.checkList(guidanceResponse.evaluationMessage, "evaluationMessage", Reference.class);
+            ValidationSupport.checkList(guidanceResponse.dataRequirement, "dataRequirement", DataRequirement.class);
+            ValidationSupport.checkReferenceType(guidanceResponse.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(guidanceResponse.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(guidanceResponse.performer, "performer", "Device");
+            ValidationSupport.checkReferenceType(guidanceResponse.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
+            ValidationSupport.checkReferenceType(guidanceResponse.evaluationMessage, "evaluationMessage", "OperationOutcome");
+            ValidationSupport.checkReferenceType(guidanceResponse.outputParameters, "outputParameters", "Parameters");
+            ValidationSupport.checkReferenceType(guidanceResponse.result, "result", "CarePlan", "RequestGroup");
         }
 
         protected Builder from(GuidanceResponse guidanceResponse) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/HealthcareService.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/HealthcareService.java
index 9973c2b89c7..9eb294f7d69 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/HealthcareService.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/HealthcareService.java
@@ -158,35 +158,30 @@ public class HealthcareService extends DomainResource {
 
     private HealthcareService(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
         providedBy = builder.providedBy;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
-        type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
-        specialty = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialty, "specialty", CodeableConcept.class));
-        location = Collections.unmodifiableList(ValidationSupport.checkList(builder.location, "location", Reference.class));
+        category = Collections.unmodifiableList(builder.category);
+        type = Collections.unmodifiableList(builder.type);
+        specialty = Collections.unmodifiableList(builder.specialty);
+        location = Collections.unmodifiableList(builder.location);
         name = builder.name;
         comment = builder.comment;
         extraDetails = builder.extraDetails;
         photo = builder.photo;
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
-        coverageArea = Collections.unmodifiableList(ValidationSupport.checkList(builder.coverageArea, "coverageArea", Reference.class));
-        serviceProvisionCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.serviceProvisionCode, "serviceProvisionCode", CodeableConcept.class));
-        eligibility = Collections.unmodifiableList(ValidationSupport.checkList(builder.eligibility, "eligibility", Eligibility.class));
-        program = Collections.unmodifiableList(ValidationSupport.checkList(builder.program, "program", CodeableConcept.class));
-        characteristic = Collections.unmodifiableList(ValidationSupport.checkList(builder.characteristic, "characteristic", CodeableConcept.class));
-        communication = Collections.unmodifiableList(ValidationSupport.checkList(builder.communication, "communication", CodeableConcept.class));
-        referralMethod = Collections.unmodifiableList(ValidationSupport.checkList(builder.referralMethod, "referralMethod", CodeableConcept.class));
+        telecom = Collections.unmodifiableList(builder.telecom);
+        coverageArea = Collections.unmodifiableList(builder.coverageArea);
+        serviceProvisionCode = Collections.unmodifiableList(builder.serviceProvisionCode);
+        eligibility = Collections.unmodifiableList(builder.eligibility);
+        program = Collections.unmodifiableList(builder.program);
+        characteristic = Collections.unmodifiableList(builder.characteristic);
+        communication = Collections.unmodifiableList(builder.communication);
+        referralMethod = Collections.unmodifiableList(builder.referralMethod);
         appointmentRequired = builder.appointmentRequired;
-        availableTime = Collections.unmodifiableList(ValidationSupport.checkList(builder.availableTime, "availableTime", AvailableTime.class));
-        notAvailable = Collections.unmodifiableList(ValidationSupport.checkList(builder.notAvailable, "notAvailable", NotAvailable.class));
+        availableTime = Collections.unmodifiableList(builder.availableTime);
+        notAvailable = Collections.unmodifiableList(builder.notAvailable);
         availabilityExceptions = builder.availabilityExceptions;
-        endpoint = Collections.unmodifiableList(ValidationSupport.checkList(builder.endpoint, "endpoint", Reference.class));
-        ValidationSupport.checkValueSetBinding(communication, "communication", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
-        ValidationSupport.checkReferenceType(providedBy, "providedBy", "Organization");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(coverageArea, "coverageArea", "Location");
-        ValidationSupport.checkReferenceType(endpoint, "endpoint", "Endpoint");
+        endpoint = Collections.unmodifiableList(builder.endpoint);
     }
 
     /**
@@ -1544,7 +1539,36 @@ public Builder endpoint(Collection<Reference> endpoint) {
          */
         @Override
         public HealthcareService build() {
-            return new HealthcareService(this);
+            HealthcareService healthcareService = new HealthcareService(this);
+            if (validating) {
+                validate(healthcareService);
+            }
+            return healthcareService;
+        }
+
+        protected void validate(HealthcareService healthcareService) {
+            super.validate(healthcareService);
+            ValidationSupport.checkList(healthcareService.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(healthcareService.category, "category", CodeableConcept.class);
+            ValidationSupport.checkList(healthcareService.type, "type", CodeableConcept.class);
+            ValidationSupport.checkList(healthcareService.specialty, "specialty", CodeableConcept.class);
+            ValidationSupport.checkList(healthcareService.location, "location", Reference.class);
+            ValidationSupport.checkList(healthcareService.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.checkList(healthcareService.coverageArea, "coverageArea", Reference.class);
+            ValidationSupport.checkList(healthcareService.serviceProvisionCode, "serviceProvisionCode", CodeableConcept.class);
+            ValidationSupport.checkList(healthcareService.eligibility, "eligibility", Eligibility.class);
+            ValidationSupport.checkList(healthcareService.program, "program", CodeableConcept.class);
+            ValidationSupport.checkList(healthcareService.characteristic, "characteristic", CodeableConcept.class);
+            ValidationSupport.checkList(healthcareService.communication, "communication", CodeableConcept.class);
+            ValidationSupport.checkList(healthcareService.referralMethod, "referralMethod", CodeableConcept.class);
+            ValidationSupport.checkList(healthcareService.availableTime, "availableTime", AvailableTime.class);
+            ValidationSupport.checkList(healthcareService.notAvailable, "notAvailable", NotAvailable.class);
+            ValidationSupport.checkList(healthcareService.endpoint, "endpoint", Reference.class);
+            ValidationSupport.checkValueSetBinding(healthcareService.communication, "communication", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+            ValidationSupport.checkReferenceType(healthcareService.providedBy, "providedBy", "Organization");
+            ValidationSupport.checkReferenceType(healthcareService.location, "location", "Location");
+            ValidationSupport.checkReferenceType(healthcareService.coverageArea, "coverageArea", "Location");
+            ValidationSupport.checkReferenceType(healthcareService.endpoint, "endpoint", "Endpoint");
         }
 
         protected Builder from(HealthcareService healthcareService) {
@@ -1593,7 +1617,6 @@ private Eligibility(Builder builder) {
             super(builder);
             code = builder.code;
             comment = builder.comment;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1829,7 +1852,16 @@ public Builder comment(Markdown comment) {
              */
             @Override
             public Eligibility build() {
-                return new Eligibility(this);
+                Eligibility eligibility = new Eligibility(this);
+                if (validating) {
+                    validate(eligibility);
+                }
+                return eligibility;
+            }
+
+            protected void validate(Eligibility eligibility) {
+                super.validate(eligibility);
+                ValidationSupport.requireValueOrChildren(eligibility);
             }
 
             protected Builder from(Eligibility eligibility) {
@@ -1858,11 +1890,10 @@ public static class AvailableTime extends BackboneElement {
 
         private AvailableTime(Builder builder) {
             super(builder);
-            daysOfWeek = Collections.unmodifiableList(ValidationSupport.checkList(builder.daysOfWeek, "daysOfWeek", DaysOfWeek.class));
+            daysOfWeek = Collections.unmodifiableList(builder.daysOfWeek);
             allDay = builder.allDay;
             availableStartTime = builder.availableStartTime;
             availableEndTime = builder.availableEndTime;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2176,7 +2207,17 @@ public Builder availableEndTime(Time availableEndTime) {
              */
             @Override
             public AvailableTime build() {
-                return new AvailableTime(this);
+                AvailableTime availableTime = new AvailableTime(this);
+                if (validating) {
+                    validate(availableTime);
+                }
+                return availableTime;
+            }
+
+            protected void validate(AvailableTime availableTime) {
+                super.validate(availableTime);
+                ValidationSupport.checkList(availableTime.daysOfWeek, "daysOfWeek", DaysOfWeek.class);
+                ValidationSupport.requireValueOrChildren(availableTime);
             }
 
             protected Builder from(AvailableTime availableTime) {
@@ -2200,9 +2241,8 @@ public static class NotAvailable extends BackboneElement {
 
         private NotAvailable(Builder builder) {
             super(builder);
-            description = ValidationSupport.requireNonNull(builder.description, "description");
+            description = builder.description;
             during = builder.during;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2445,7 +2485,17 @@ public Builder during(Period during) {
              */
             @Override
             public NotAvailable build() {
-                return new NotAvailable(this);
+                NotAvailable notAvailable = new NotAvailable(this);
+                if (validating) {
+                    validate(notAvailable);
+                }
+                return notAvailable;
+            }
+
+            protected void validate(NotAvailable notAvailable) {
+                super.validate(notAvailable);
+                ValidationSupport.requireNonNull(notAvailable.description, "description");
+                ValidationSupport.requireValueOrChildren(notAvailable);
             }
 
             protected Builder from(NotAvailable notAvailable) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImagingStudy.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImagingStudy.java
index cb0ea239744..a3b2a236cf2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImagingStudy.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImagingStudy.java
@@ -173,35 +173,26 @@ public class ImagingStudy extends DomainResource {
 
     private ImagingStudy(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        modality = Collections.unmodifiableList(ValidationSupport.checkList(builder.modality, "modality", Coding.class));
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        modality = Collections.unmodifiableList(builder.modality);
+        subject = builder.subject;
         encounter = builder.encounter;
         started = builder.started;
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
+        basedOn = Collections.unmodifiableList(builder.basedOn);
         referrer = builder.referrer;
-        interpreter = Collections.unmodifiableList(ValidationSupport.checkList(builder.interpreter, "interpreter", Reference.class));
-        endpoint = Collections.unmodifiableList(ValidationSupport.checkList(builder.endpoint, "endpoint", Reference.class));
+        interpreter = Collections.unmodifiableList(builder.interpreter);
+        endpoint = Collections.unmodifiableList(builder.endpoint);
         numberOfSeries = builder.numberOfSeries;
         numberOfInstances = builder.numberOfInstances;
         procedureReference = builder.procedureReference;
-        procedureCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.procedureCode, "procedureCode", CodeableConcept.class));
+        procedureCode = Collections.unmodifiableList(builder.procedureCode);
         location = builder.location;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        note = Collections.unmodifiableList(builder.note);
         description = builder.description;
-        series = Collections.unmodifiableList(ValidationSupport.checkList(builder.series, "series", Series.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Device", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "CarePlan", "ServiceRequest", "Appointment", "AppointmentResponse", "Task");
-        ValidationSupport.checkReferenceType(referrer, "referrer", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(interpreter, "interpreter", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(endpoint, "endpoint", "Endpoint");
-        ValidationSupport.checkReferenceType(procedureReference, "procedureReference", "Procedure");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "Media", "DiagnosticReport", "DocumentReference");
+        series = Collections.unmodifiableList(builder.series);
     }
 
     /**
@@ -1390,7 +1381,36 @@ public Builder series(Collection<Series> series) {
          */
         @Override
         public ImagingStudy build() {
-            return new ImagingStudy(this);
+            ImagingStudy imagingStudy = new ImagingStudy(this);
+            if (validating) {
+                validate(imagingStudy);
+            }
+            return imagingStudy;
+        }
+
+        protected void validate(ImagingStudy imagingStudy) {
+            super.validate(imagingStudy);
+            ValidationSupport.checkList(imagingStudy.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(imagingStudy.status, "status");
+            ValidationSupport.checkList(imagingStudy.modality, "modality", Coding.class);
+            ValidationSupport.requireNonNull(imagingStudy.subject, "subject");
+            ValidationSupport.checkList(imagingStudy.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(imagingStudy.interpreter, "interpreter", Reference.class);
+            ValidationSupport.checkList(imagingStudy.endpoint, "endpoint", Reference.class);
+            ValidationSupport.checkList(imagingStudy.procedureCode, "procedureCode", CodeableConcept.class);
+            ValidationSupport.checkList(imagingStudy.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(imagingStudy.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(imagingStudy.note, "note", Annotation.class);
+            ValidationSupport.checkList(imagingStudy.series, "series", Series.class);
+            ValidationSupport.checkReferenceType(imagingStudy.subject, "subject", "Patient", "Device", "Group");
+            ValidationSupport.checkReferenceType(imagingStudy.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(imagingStudy.basedOn, "basedOn", "CarePlan", "ServiceRequest", "Appointment", "AppointmentResponse", "Task");
+            ValidationSupport.checkReferenceType(imagingStudy.referrer, "referrer", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(imagingStudy.interpreter, "interpreter", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(imagingStudy.endpoint, "endpoint", "Endpoint");
+            ValidationSupport.checkReferenceType(imagingStudy.procedureReference, "procedureReference", "Procedure");
+            ValidationSupport.checkReferenceType(imagingStudy.location, "location", "Location");
+            ValidationSupport.checkReferenceType(imagingStudy.reasonReference, "reasonReference", "Condition", "Observation", "Media", "DiagnosticReport", "DocumentReference");
         }
 
         protected Builder from(ImagingStudy imagingStudy) {
@@ -1471,21 +1491,18 @@ public static class Series extends BackboneElement {
 
         private Series(Builder builder) {
             super(builder);
-            uid = ValidationSupport.requireNonNull(builder.uid, "uid");
+            uid = builder.uid;
             number = builder.number;
-            modality = ValidationSupport.requireNonNull(builder.modality, "modality");
+            modality = builder.modality;
             description = builder.description;
             numberOfInstances = builder.numberOfInstances;
-            endpoint = Collections.unmodifiableList(ValidationSupport.checkList(builder.endpoint, "endpoint", Reference.class));
+            endpoint = Collections.unmodifiableList(builder.endpoint);
             bodySite = builder.bodySite;
             laterality = builder.laterality;
-            specimen = Collections.unmodifiableList(ValidationSupport.checkList(builder.specimen, "specimen", Reference.class));
+            specimen = Collections.unmodifiableList(builder.specimen);
             started = builder.started;
-            performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Performer.class));
-            instance = Collections.unmodifiableList(ValidationSupport.checkList(builder.instance, "instance", Instance.class));
-            ValidationSupport.checkReferenceType(endpoint, "endpoint", "Endpoint");
-            ValidationSupport.checkReferenceType(specimen, "specimen", "Specimen");
-            ValidationSupport.requireValueOrChildren(this);
+            performer = Collections.unmodifiableList(builder.performer);
+            instance = Collections.unmodifiableList(builder.instance);
         }
 
         /**
@@ -2139,7 +2156,24 @@ public Builder instance(Collection<Instance> instance) {
              */
             @Override
             public Series build() {
-                return new Series(this);
+                Series series = new Series(this);
+                if (validating) {
+                    validate(series);
+                }
+                return series;
+            }
+
+            protected void validate(Series series) {
+                super.validate(series);
+                ValidationSupport.requireNonNull(series.uid, "uid");
+                ValidationSupport.requireNonNull(series.modality, "modality");
+                ValidationSupport.checkList(series.endpoint, "endpoint", Reference.class);
+                ValidationSupport.checkList(series.specimen, "specimen", Reference.class);
+                ValidationSupport.checkList(series.performer, "performer", Performer.class);
+                ValidationSupport.checkList(series.instance, "instance", Instance.class);
+                ValidationSupport.checkReferenceType(series.endpoint, "endpoint", "Endpoint");
+                ValidationSupport.checkReferenceType(series.specimen, "specimen", "Specimen");
+                ValidationSupport.requireValueOrChildren(series);
             }
 
             protected Builder from(Series series) {
@@ -2180,9 +2214,7 @@ public static class Performer extends BackboneElement {
             private Performer(Builder builder) {
                 super(builder);
                 function = builder.function;
-                actor = ValidationSupport.requireNonNull(builder.actor, "actor");
-                ValidationSupport.checkReferenceType(actor, "actor", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "Patient", "Device", "RelatedPerson");
-                ValidationSupport.requireValueOrChildren(this);
+                actor = builder.actor;
             }
 
             /**
@@ -2436,7 +2468,18 @@ public Builder actor(Reference actor) {
                  */
                 @Override
                 public Performer build() {
-                    return new Performer(this);
+                    Performer performer = new Performer(this);
+                    if (validating) {
+                        validate(performer);
+                    }
+                    return performer;
+                }
+
+                protected void validate(Performer performer) {
+                    super.validate(performer);
+                    ValidationSupport.requireNonNull(performer.actor, "actor");
+                    ValidationSupport.checkReferenceType(performer.actor, "actor", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "Patient", "Device", "RelatedPerson");
+                    ValidationSupport.requireValueOrChildren(performer);
                 }
 
                 protected Builder from(Performer performer) {
@@ -2467,11 +2510,10 @@ public static class Instance extends BackboneElement {
 
             private Instance(Builder builder) {
                 super(builder);
-                uid = ValidationSupport.requireNonNull(builder.uid, "uid");
-                sopClass = ValidationSupport.requireNonNull(builder.sopClass, "sopClass");
+                uid = builder.uid;
+                sopClass = builder.sopClass;
                 number = builder.number;
                 title = builder.title;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2775,7 +2817,18 @@ public Builder title(String title) {
                  */
                 @Override
                 public Instance build() {
-                    return new Instance(this);
+                    Instance instance = new Instance(this);
+                    if (validating) {
+                        validate(instance);
+                    }
+                    return instance;
+                }
+
+                protected void validate(Instance instance) {
+                    super.validate(instance);
+                    ValidationSupport.requireNonNull(instance.uid, "uid");
+                    ValidationSupport.requireNonNull(instance.sopClass, "sopClass");
+                    ValidationSupport.requireValueOrChildren(instance);
                 }
 
                 protected Builder from(Instance instance) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Immunization.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Immunization.java
index 288753da65c..82174b0a8b4 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Immunization.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Immunization.java
@@ -180,13 +180,13 @@ public class Immunization extends DomainResource {
 
     private Immunization(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         statusReason = builder.statusReason;
-        vaccineCode = ValidationSupport.requireNonNull(builder.vaccineCode, "vaccineCode");
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
+        vaccineCode = builder.vaccineCode;
+        patient = builder.patient;
         encounter = builder.encounter;
-        occurrence = ValidationSupport.requireChoiceElement(builder.occurrence, "occurrence", DateTime.class, String.class);
+        occurrence = builder.occurrence;
         recorded = builder.recorded;
         primarySource = builder.primarySource;
         reportOrigin = builder.reportOrigin;
@@ -197,22 +197,17 @@ private Immunization(Builder builder) {
         site = builder.site;
         route = builder.route;
         doseQuantity = builder.doseQuantity;
-        performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Performer.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
+        performer = Collections.unmodifiableList(builder.performer);
+        note = Collections.unmodifiableList(builder.note);
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
         isSubpotent = builder.isSubpotent;
-        subpotentReason = Collections.unmodifiableList(ValidationSupport.checkList(builder.subpotentReason, "subpotentReason", CodeableConcept.class));
-        education = Collections.unmodifiableList(ValidationSupport.checkList(builder.education, "education", Education.class));
-        programEligibility = Collections.unmodifiableList(ValidationSupport.checkList(builder.programEligibility, "programEligibility", CodeableConcept.class));
+        subpotentReason = Collections.unmodifiableList(builder.subpotentReason);
+        education = Collections.unmodifiableList(builder.education);
+        programEligibility = Collections.unmodifiableList(builder.programEligibility);
         fundingSource = builder.fundingSource;
-        reaction = Collections.unmodifiableList(ValidationSupport.checkList(builder.reaction, "reaction", Reaction.class));
-        protocolApplied = Collections.unmodifiableList(ValidationSupport.checkList(builder.protocolApplied, "protocolApplied", ProtocolApplied.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(manufacturer, "manufacturer", "Organization");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport");
+        reaction = Collections.unmodifiableList(builder.reaction);
+        protocolApplied = Collections.unmodifiableList(builder.protocolApplied);
     }
 
     /**
@@ -1580,7 +1575,34 @@ public Builder protocolApplied(Collection<ProtocolApplied> protocolApplied) {
          */
         @Override
         public Immunization build() {
-            return new Immunization(this);
+            Immunization immunization = new Immunization(this);
+            if (validating) {
+                validate(immunization);
+            }
+            return immunization;
+        }
+
+        protected void validate(Immunization immunization) {
+            super.validate(immunization);
+            ValidationSupport.checkList(immunization.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(immunization.status, "status");
+            ValidationSupport.requireNonNull(immunization.vaccineCode, "vaccineCode");
+            ValidationSupport.requireNonNull(immunization.patient, "patient");
+            ValidationSupport.requireChoiceElement(immunization.occurrence, "occurrence", DateTime.class, String.class);
+            ValidationSupport.checkList(immunization.performer, "performer", Performer.class);
+            ValidationSupport.checkList(immunization.note, "note", Annotation.class);
+            ValidationSupport.checkList(immunization.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(immunization.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(immunization.subpotentReason, "subpotentReason", CodeableConcept.class);
+            ValidationSupport.checkList(immunization.education, "education", Education.class);
+            ValidationSupport.checkList(immunization.programEligibility, "programEligibility", CodeableConcept.class);
+            ValidationSupport.checkList(immunization.reaction, "reaction", Reaction.class);
+            ValidationSupport.checkList(immunization.protocolApplied, "protocolApplied", ProtocolApplied.class);
+            ValidationSupport.checkReferenceType(immunization.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(immunization.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(immunization.location, "location", "Location");
+            ValidationSupport.checkReferenceType(immunization.manufacturer, "manufacturer", "Organization");
+            ValidationSupport.checkReferenceType(immunization.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport");
         }
 
         protected Builder from(Immunization immunization) {
@@ -1637,9 +1659,7 @@ public static class Performer extends BackboneElement {
         private Performer(Builder builder) {
             super(builder);
             function = builder.function;
-            actor = ValidationSupport.requireNonNull(builder.actor, "actor");
-            ValidationSupport.checkReferenceType(actor, "actor", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
+            actor = builder.actor;
         }
 
         /**
@@ -1889,7 +1909,18 @@ public Builder actor(Reference actor) {
              */
             @Override
             public Performer build() {
-                return new Performer(this);
+                Performer performer = new Performer(this);
+                if (validating) {
+                    validate(performer);
+                }
+                return performer;
+            }
+
+            protected void validate(Performer performer) {
+                super.validate(performer);
+                ValidationSupport.requireNonNull(performer.actor, "actor");
+                ValidationSupport.checkReferenceType(performer.actor, "actor", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.requireValueOrChildren(performer);
             }
 
             protected Builder from(Performer performer) {
@@ -1916,7 +1947,6 @@ private Education(Builder builder) {
             reference = builder.reference;
             publicationDate = builder.publicationDate;
             presentationDate = builder.presentationDate;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2210,7 +2240,16 @@ public Builder presentationDate(DateTime presentationDate) {
              */
             @Override
             public Education build() {
-                return new Education(this);
+                Education education = new Education(this);
+                if (validating) {
+                    validate(education);
+                }
+                return education;
+            }
+
+            protected void validate(Education education) {
+                super.validate(education);
+                ValidationSupport.requireValueOrChildren(education);
             }
 
             protected Builder from(Education education) {
@@ -2238,8 +2277,6 @@ private Reaction(Builder builder) {
             date = builder.date;
             detail = builder.detail;
             reported = builder.reported;
-            ValidationSupport.checkReferenceType(detail, "detail", "Observation");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2509,7 +2546,17 @@ public Builder reported(Boolean reported) {
              */
             @Override
             public Reaction build() {
-                return new Reaction(this);
+                Reaction reaction = new Reaction(this);
+                if (validating) {
+                    validate(reaction);
+                }
+                return reaction;
+            }
+
+            protected void validate(Reaction reaction) {
+                super.validate(reaction);
+                ValidationSupport.checkReferenceType(reaction.detail, "detail", "Observation");
+                ValidationSupport.requireValueOrChildren(reaction);
             }
 
             protected Builder from(Reaction reaction) {
@@ -2546,11 +2593,9 @@ private ProtocolApplied(Builder builder) {
             super(builder);
             series = builder.series;
             authority = builder.authority;
-            targetDisease = Collections.unmodifiableList(ValidationSupport.checkList(builder.targetDisease, "targetDisease", CodeableConcept.class));
-            doseNumber = ValidationSupport.requireChoiceElement(builder.doseNumber, "doseNumber", PositiveInt.class, String.class);
-            seriesDoses = ValidationSupport.choiceElement(builder.seriesDoses, "seriesDoses", PositiveInt.class, String.class);
-            ValidationSupport.checkReferenceType(authority, "authority", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
+            targetDisease = Collections.unmodifiableList(builder.targetDisease);
+            doseNumber = builder.doseNumber;
+            seriesDoses = builder.seriesDoses;
         }
 
         /**
@@ -2917,7 +2962,20 @@ public Builder seriesDoses(Element seriesDoses) {
              */
             @Override
             public ProtocolApplied build() {
-                return new ProtocolApplied(this);
+                ProtocolApplied protocolApplied = new ProtocolApplied(this);
+                if (validating) {
+                    validate(protocolApplied);
+                }
+                return protocolApplied;
+            }
+
+            protected void validate(ProtocolApplied protocolApplied) {
+                super.validate(protocolApplied);
+                ValidationSupport.checkList(protocolApplied.targetDisease, "targetDisease", CodeableConcept.class);
+                ValidationSupport.requireChoiceElement(protocolApplied.doseNumber, "doseNumber", PositiveInt.class, String.class);
+                ValidationSupport.choiceElement(protocolApplied.seriesDoses, "seriesDoses", PositiveInt.class, String.class);
+                ValidationSupport.checkReferenceType(protocolApplied.authority, "authority", "Organization");
+                ValidationSupport.requireValueOrChildren(protocolApplied);
             }
 
             protected Builder from(ProtocolApplied protocolApplied) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImmunizationEvaluation.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImmunizationEvaluation.java
index e2420994da2..90a57326544 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImmunizationEvaluation.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImmunizationEvaluation.java
@@ -105,22 +105,19 @@ public class ImmunizationEvaluation extends DomainResource {
 
     private ImmunizationEvaluation(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        patient = builder.patient;
         date = builder.date;
         authority = builder.authority;
-        targetDisease = ValidationSupport.requireNonNull(builder.targetDisease, "targetDisease");
-        immunizationEvent = ValidationSupport.requireNonNull(builder.immunizationEvent, "immunizationEvent");
-        doseStatus = ValidationSupport.requireNonNull(builder.doseStatus, "doseStatus");
-        doseStatusReason = Collections.unmodifiableList(ValidationSupport.checkList(builder.doseStatusReason, "doseStatusReason", CodeableConcept.class));
+        targetDisease = builder.targetDisease;
+        immunizationEvent = builder.immunizationEvent;
+        doseStatus = builder.doseStatus;
+        doseStatusReason = Collections.unmodifiableList(builder.doseStatusReason);
         description = builder.description;
         series = builder.series;
-        doseNumber = ValidationSupport.choiceElement(builder.doseNumber, "doseNumber", PositiveInt.class, String.class);
-        seriesDoses = ValidationSupport.choiceElement(builder.seriesDoses, "seriesDoses", PositiveInt.class, String.class);
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(authority, "authority", "Organization");
-        ValidationSupport.checkReferenceType(immunizationEvent, "immunizationEvent", "Immunization");
+        doseNumber = builder.doseNumber;
+        seriesDoses = builder.seriesDoses;
     }
 
     /**
@@ -874,7 +871,27 @@ public Builder seriesDoses(Element seriesDoses) {
          */
         @Override
         public ImmunizationEvaluation build() {
-            return new ImmunizationEvaluation(this);
+            ImmunizationEvaluation immunizationEvaluation = new ImmunizationEvaluation(this);
+            if (validating) {
+                validate(immunizationEvaluation);
+            }
+            return immunizationEvaluation;
+        }
+
+        protected void validate(ImmunizationEvaluation immunizationEvaluation) {
+            super.validate(immunizationEvaluation);
+            ValidationSupport.checkList(immunizationEvaluation.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(immunizationEvaluation.status, "status");
+            ValidationSupport.requireNonNull(immunizationEvaluation.patient, "patient");
+            ValidationSupport.requireNonNull(immunizationEvaluation.targetDisease, "targetDisease");
+            ValidationSupport.requireNonNull(immunizationEvaluation.immunizationEvent, "immunizationEvent");
+            ValidationSupport.requireNonNull(immunizationEvaluation.doseStatus, "doseStatus");
+            ValidationSupport.checkList(immunizationEvaluation.doseStatusReason, "doseStatusReason", CodeableConcept.class);
+            ValidationSupport.choiceElement(immunizationEvaluation.doseNumber, "doseNumber", PositiveInt.class, String.class);
+            ValidationSupport.choiceElement(immunizationEvaluation.seriesDoses, "seriesDoses", PositiveInt.class, String.class);
+            ValidationSupport.checkReferenceType(immunizationEvaluation.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(immunizationEvaluation.authority, "authority", "Organization");
+            ValidationSupport.checkReferenceType(immunizationEvaluation.immunizationEvent, "immunizationEvent", "Immunization");
         }
 
         protected Builder from(ImmunizationEvaluation immunizationEvaluation) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImmunizationRecommendation.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImmunizationRecommendation.java
index 5329a26efbf..45b74cce531 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImmunizationRecommendation.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImmunizationRecommendation.java
@@ -75,13 +75,11 @@ public class ImmunizationRecommendation extends DomainResource {
 
     private ImmunizationRecommendation(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
-        date = ValidationSupport.requireNonNull(builder.date, "date");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        patient = builder.patient;
+        date = builder.date;
         authority = builder.authority;
-        recommendation = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.recommendation, "recommendation", Recommendation.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(authority, "authority", "Organization");
+        recommendation = Collections.unmodifiableList(builder.recommendation);
     }
 
     /**
@@ -579,7 +577,21 @@ public Builder recommendation(Collection<Recommendation> recommendation) {
          */
         @Override
         public ImmunizationRecommendation build() {
-            return new ImmunizationRecommendation(this);
+            ImmunizationRecommendation immunizationRecommendation = new ImmunizationRecommendation(this);
+            if (validating) {
+                validate(immunizationRecommendation);
+            }
+            return immunizationRecommendation;
+        }
+
+        protected void validate(ImmunizationRecommendation immunizationRecommendation) {
+            super.validate(immunizationRecommendation);
+            ValidationSupport.checkList(immunizationRecommendation.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(immunizationRecommendation.patient, "patient");
+            ValidationSupport.requireNonNull(immunizationRecommendation.date, "date");
+            ValidationSupport.checkNonEmptyList(immunizationRecommendation.recommendation, "recommendation", Recommendation.class);
+            ValidationSupport.checkReferenceType(immunizationRecommendation.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(immunizationRecommendation.authority, "authority", "Organization");
         }
 
         protected Builder from(ImmunizationRecommendation immunizationRecommendation) {
@@ -652,20 +664,18 @@ public static class Recommendation extends BackboneElement {
 
         private Recommendation(Builder builder) {
             super(builder);
-            vaccineCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.vaccineCode, "vaccineCode", CodeableConcept.class));
+            vaccineCode = Collections.unmodifiableList(builder.vaccineCode);
             targetDisease = builder.targetDisease;
-            contraindicatedVaccineCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.contraindicatedVaccineCode, "contraindicatedVaccineCode", CodeableConcept.class));
-            forecastStatus = ValidationSupport.requireNonNull(builder.forecastStatus, "forecastStatus");
-            forecastReason = Collections.unmodifiableList(ValidationSupport.checkList(builder.forecastReason, "forecastReason", CodeableConcept.class));
-            dateCriterion = Collections.unmodifiableList(ValidationSupport.checkList(builder.dateCriterion, "dateCriterion", DateCriterion.class));
+            contraindicatedVaccineCode = Collections.unmodifiableList(builder.contraindicatedVaccineCode);
+            forecastStatus = builder.forecastStatus;
+            forecastReason = Collections.unmodifiableList(builder.forecastReason);
+            dateCriterion = Collections.unmodifiableList(builder.dateCriterion);
             description = builder.description;
             series = builder.series;
-            doseNumber = ValidationSupport.choiceElement(builder.doseNumber, "doseNumber", PositiveInt.class, String.class);
-            seriesDoses = ValidationSupport.choiceElement(builder.seriesDoses, "seriesDoses", PositiveInt.class, String.class);
-            supportingImmunization = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingImmunization, "supportingImmunization", Reference.class));
-            supportingPatientInformation = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingPatientInformation, "supportingPatientInformation", Reference.class));
-            ValidationSupport.checkReferenceType(supportingImmunization, "supportingImmunization", "Immunization", "ImmunizationEvaluation");
-            ValidationSupport.requireValueOrChildren(this);
+            doseNumber = builder.doseNumber;
+            seriesDoses = builder.seriesDoses;
+            supportingImmunization = Collections.unmodifiableList(builder.supportingImmunization);
+            supportingPatientInformation = Collections.unmodifiableList(builder.supportingPatientInformation);
         }
 
         /**
@@ -1345,7 +1355,26 @@ public Builder supportingPatientInformation(Collection<Reference> supportingPati
              */
             @Override
             public Recommendation build() {
-                return new Recommendation(this);
+                Recommendation recommendation = new Recommendation(this);
+                if (validating) {
+                    validate(recommendation);
+                }
+                return recommendation;
+            }
+
+            protected void validate(Recommendation recommendation) {
+                super.validate(recommendation);
+                ValidationSupport.checkList(recommendation.vaccineCode, "vaccineCode", CodeableConcept.class);
+                ValidationSupport.checkList(recommendation.contraindicatedVaccineCode, "contraindicatedVaccineCode", CodeableConcept.class);
+                ValidationSupport.requireNonNull(recommendation.forecastStatus, "forecastStatus");
+                ValidationSupport.checkList(recommendation.forecastReason, "forecastReason", CodeableConcept.class);
+                ValidationSupport.checkList(recommendation.dateCriterion, "dateCriterion", DateCriterion.class);
+                ValidationSupport.choiceElement(recommendation.doseNumber, "doseNumber", PositiveInt.class, String.class);
+                ValidationSupport.choiceElement(recommendation.seriesDoses, "seriesDoses", PositiveInt.class, String.class);
+                ValidationSupport.checkList(recommendation.supportingImmunization, "supportingImmunization", Reference.class);
+                ValidationSupport.checkList(recommendation.supportingPatientInformation, "supportingPatientInformation", Reference.class);
+                ValidationSupport.checkReferenceType(recommendation.supportingImmunization, "supportingImmunization", "Immunization", "ImmunizationEvaluation");
+                ValidationSupport.requireValueOrChildren(recommendation);
             }
 
             protected Builder from(Recommendation recommendation) {
@@ -1383,9 +1412,8 @@ public static class DateCriterion extends BackboneElement {
 
             private DateCriterion(Builder builder) {
                 super(builder);
-                code = ValidationSupport.requireNonNull(builder.code, "code");
-                value = ValidationSupport.requireNonNull(builder.value, "value");
-                ValidationSupport.requireValueOrChildren(this);
+                code = builder.code;
+                value = builder.value;
             }
 
             /**
@@ -1631,7 +1659,18 @@ public Builder value(DateTime value) {
                  */
                 @Override
                 public DateCriterion build() {
-                    return new DateCriterion(this);
+                    DateCriterion dateCriterion = new DateCriterion(this);
+                    if (validating) {
+                        validate(dateCriterion);
+                    }
+                    return dateCriterion;
+                }
+
+                protected void validate(DateCriterion dateCriterion) {
+                    super.validate(dateCriterion);
+                    ValidationSupport.requireNonNull(dateCriterion.code, "code");
+                    ValidationSupport.requireNonNull(dateCriterion.value, "value");
+                    ValidationSupport.requireValueOrChildren(dateCriterion);
                 }
 
                 protected Builder from(DateCriterion dateCriterion) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImplementationGuide.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImplementationGuide.java
index e09cc91e5c8..fd8e13edf49 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImplementationGuide.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ImplementationGuide.java
@@ -160,24 +160,24 @@ public class ImplementationGuide extends DomainResource {
 
     private ImplementationGuide(Builder builder) {
         super(builder);
-        url = ValidationSupport.requireNonNull(builder.url, "url");
+        url = builder.url;
         version = builder.version;
-        name = ValidationSupport.requireNonNull(builder.name, "name");
+        name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         copyright = builder.copyright;
-        packageId = ValidationSupport.requireNonNull(builder.packageId, "packageId");
+        packageId = builder.packageId;
         license = builder.license;
-        fhirVersion = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.fhirVersion, "fhirVersion", FHIRVersion.class));
-        dependsOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.dependsOn, "dependsOn", DependsOn.class));
-        global = Collections.unmodifiableList(ValidationSupport.checkList(builder.global, "global", Global.class));
+        fhirVersion = Collections.unmodifiableList(builder.fhirVersion);
+        dependsOn = Collections.unmodifiableList(builder.dependsOn);
+        global = Collections.unmodifiableList(builder.global);
         definition = builder.definition;
         manifest = builder.manifest;
     }
@@ -1231,7 +1231,25 @@ public Builder manifest(Manifest manifest) {
          */
         @Override
         public ImplementationGuide build() {
-            return new ImplementationGuide(this);
+            ImplementationGuide implementationGuide = new ImplementationGuide(this);
+            if (validating) {
+                validate(implementationGuide);
+            }
+            return implementationGuide;
+        }
+
+        protected void validate(ImplementationGuide implementationGuide) {
+            super.validate(implementationGuide);
+            ValidationSupport.requireNonNull(implementationGuide.url, "url");
+            ValidationSupport.requireNonNull(implementationGuide.name, "name");
+            ValidationSupport.requireNonNull(implementationGuide.status, "status");
+            ValidationSupport.checkList(implementationGuide.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(implementationGuide.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(implementationGuide.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.requireNonNull(implementationGuide.packageId, "packageId");
+            ValidationSupport.checkNonEmptyList(implementationGuide.fhirVersion, "fhirVersion", FHIRVersion.class);
+            ValidationSupport.checkList(implementationGuide.dependsOn, "dependsOn", DependsOn.class);
+            ValidationSupport.checkList(implementationGuide.global, "global", Global.class);
         }
 
         protected Builder from(ImplementationGuide implementationGuide) {
@@ -1275,10 +1293,9 @@ public static class DependsOn extends BackboneElement {
 
         private DependsOn(Builder builder) {
             super(builder);
-            uri = ValidationSupport.requireNonNull(builder.uri, "uri");
+            uri = builder.uri;
             packageId = builder.packageId;
             version = builder.version;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1550,7 +1567,17 @@ public Builder version(String version) {
              */
             @Override
             public DependsOn build() {
-                return new DependsOn(this);
+                DependsOn dependsOn = new DependsOn(this);
+                if (validating) {
+                    validate(dependsOn);
+                }
+                return dependsOn;
+            }
+
+            protected void validate(DependsOn dependsOn) {
+                super.validate(dependsOn);
+                ValidationSupport.requireNonNull(dependsOn.uri, "uri");
+                ValidationSupport.requireValueOrChildren(dependsOn);
             }
 
             protected Builder from(DependsOn dependsOn) {
@@ -1582,9 +1609,8 @@ public static class Global extends BackboneElement {
 
         private Global(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            profile = ValidationSupport.requireNonNull(builder.profile, "profile");
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            profile = builder.profile;
         }
 
         /**
@@ -1830,7 +1856,18 @@ public Builder profile(Canonical profile) {
              */
             @Override
             public Global build() {
-                return new Global(this);
+                Global global = new Global(this);
+                if (validating) {
+                    validate(global);
+                }
+                return global;
+            }
+
+            protected void validate(Global global) {
+                super.validate(global);
+                ValidationSupport.requireNonNull(global.type, "type");
+                ValidationSupport.requireNonNull(global.profile, "profile");
+                ValidationSupport.requireValueOrChildren(global);
             }
 
             protected Builder from(Global global) {
@@ -1855,12 +1892,11 @@ public static class Definition extends BackboneElement {
 
         private Definition(Builder builder) {
             super(builder);
-            grouping = Collections.unmodifiableList(ValidationSupport.checkList(builder.grouping, "grouping", Grouping.class));
-            resource = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.resource, "resource", Resource.class));
+            grouping = Collections.unmodifiableList(builder.grouping);
+            resource = Collections.unmodifiableList(builder.resource);
             page = builder.page;
-            parameter = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameter, "parameter", Parameter.class));
-            template = Collections.unmodifiableList(ValidationSupport.checkList(builder.template, "template", Template.class));
-            ValidationSupport.requireValueOrChildren(this);
+            parameter = Collections.unmodifiableList(builder.parameter);
+            template = Collections.unmodifiableList(builder.template);
         }
 
         /**
@@ -2278,7 +2314,20 @@ public Builder template(Collection<Template> template) {
              */
             @Override
             public Definition build() {
-                return new Definition(this);
+                Definition definition = new Definition(this);
+                if (validating) {
+                    validate(definition);
+                }
+                return definition;
+            }
+
+            protected void validate(Definition definition) {
+                super.validate(definition);
+                ValidationSupport.checkList(definition.grouping, "grouping", Grouping.class);
+                ValidationSupport.checkNonEmptyList(definition.resource, "resource", Resource.class);
+                ValidationSupport.checkList(definition.parameter, "parameter", Parameter.class);
+                ValidationSupport.checkList(definition.template, "template", Template.class);
+                ValidationSupport.requireValueOrChildren(definition);
             }
 
             protected Builder from(Definition definition) {
@@ -2302,9 +2351,8 @@ public static class Grouping extends BackboneElement {
 
             private Grouping(Builder builder) {
                 super(builder);
-                name = ValidationSupport.requireNonNull(builder.name, "name");
+                name = builder.name;
                 description = builder.description;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2547,7 +2595,17 @@ public Builder description(String description) {
                  */
                 @Override
                 public Grouping build() {
-                    return new Grouping(this);
+                    Grouping grouping = new Grouping(this);
+                    if (validating) {
+                        validate(grouping);
+                    }
+                    return grouping;
+                }
+
+                protected void validate(Grouping grouping) {
+                    super.validate(grouping);
+                    ValidationSupport.requireNonNull(grouping.name, "name");
+                    ValidationSupport.requireValueOrChildren(grouping);
                 }
 
                 protected Builder from(Grouping grouping) {
@@ -2582,13 +2640,12 @@ public static class Resource extends BackboneElement {
 
             private Resource(Builder builder) {
                 super(builder);
-                reference = ValidationSupport.requireNonNull(builder.reference, "reference");
-                fhirVersion = Collections.unmodifiableList(ValidationSupport.checkList(builder.fhirVersion, "fhirVersion", FHIRVersion.class));
+                reference = builder.reference;
+                fhirVersion = Collections.unmodifiableList(builder.fhirVersion);
                 name = builder.name;
                 description = builder.description;
-                example = ValidationSupport.choiceElement(builder.example, "example", Boolean.class, Canonical.class);
+                example = builder.example;
                 groupingId = builder.groupingId;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2980,7 +3037,19 @@ public Builder groupingId(Id groupingId) {
                  */
                 @Override
                 public Resource build() {
-                    return new Resource(this);
+                    Resource resource = new Resource(this);
+                    if (validating) {
+                        validate(resource);
+                    }
+                    return resource;
+                }
+
+                protected void validate(Resource resource) {
+                    super.validate(resource);
+                    ValidationSupport.requireNonNull(resource.reference, "reference");
+                    ValidationSupport.checkList(resource.fhirVersion, "fhirVersion", FHIRVersion.class);
+                    ValidationSupport.choiceElement(resource.example, "example", Boolean.class, Canonical.class);
+                    ValidationSupport.requireValueOrChildren(resource);
                 }
 
                 protected Builder from(Resource resource) {
@@ -3018,12 +3087,10 @@ public static class Page extends BackboneElement {
 
             private Page(Builder builder) {
                 super(builder);
-                name = ValidationSupport.requireChoiceElement(builder.name, "name", Url.class, Reference.class);
-                title = ValidationSupport.requireNonNull(builder.title, "title");
-                generation = ValidationSupport.requireNonNull(builder.generation, "generation");
-                page = Collections.unmodifiableList(ValidationSupport.checkList(builder.page, "page", ImplementationGuide.Definition.Page.class));
-                ValidationSupport.checkReferenceType(name, "name", "Binary");
-                ValidationSupport.requireValueOrChildren(this);
+                name = builder.name;
+                title = builder.title;
+                generation = builder.generation;
+                page = Collections.unmodifiableList(builder.page);
             }
 
             /**
@@ -3361,7 +3428,21 @@ public Builder page(Collection<ImplementationGuide.Definition.Page> page) {
                  */
                 @Override
                 public Page build() {
-                    return new Page(this);
+                    Page page = new Page(this);
+                    if (validating) {
+                        validate(page);
+                    }
+                    return page;
+                }
+
+                protected void validate(Page page) {
+                    super.validate(page);
+                    ValidationSupport.requireChoiceElement(page.name, "name", Url.class, Reference.class);
+                    ValidationSupport.requireNonNull(page.title, "title");
+                    ValidationSupport.requireNonNull(page.generation, "generation");
+                    ValidationSupport.checkList(page.page, "page", ImplementationGuide.Definition.Page.class);
+                    ValidationSupport.checkReferenceType(page.name, "name", "Binary");
+                    ValidationSupport.requireValueOrChildren(page);
                 }
 
                 protected Builder from(Page page) {
@@ -3392,9 +3473,8 @@ public static class Parameter extends BackboneElement {
 
             private Parameter(Builder builder) {
                 super(builder);
-                code = ValidationSupport.requireNonNull(builder.code, "code");
-                value = ValidationSupport.requireNonNull(builder.value, "value");
-                ValidationSupport.requireValueOrChildren(this);
+                code = builder.code;
+                value = builder.value;
             }
 
             /**
@@ -3643,7 +3723,18 @@ public Builder value(String value) {
                  */
                 @Override
                 public Parameter build() {
-                    return new Parameter(this);
+                    Parameter parameter = new Parameter(this);
+                    if (validating) {
+                        validate(parameter);
+                    }
+                    return parameter;
+                }
+
+                protected void validate(Parameter parameter) {
+                    super.validate(parameter);
+                    ValidationSupport.requireNonNull(parameter.code, "code");
+                    ValidationSupport.requireNonNull(parameter.value, "value");
+                    ValidationSupport.requireValueOrChildren(parameter);
                 }
 
                 protected Builder from(Parameter parameter) {
@@ -3667,10 +3758,9 @@ public static class Template extends BackboneElement {
 
             private Template(Builder builder) {
                 super(builder);
-                code = ValidationSupport.requireNonNull(builder.code, "code");
-                source = ValidationSupport.requireNonNull(builder.source, "source");
+                code = builder.code;
+                source = builder.source;
                 scope = builder.scope;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -3945,7 +4035,18 @@ public Builder scope(String scope) {
                  */
                 @Override
                 public Template build() {
-                    return new Template(this);
+                    Template template = new Template(this);
+                    if (validating) {
+                        validate(template);
+                    }
+                    return template;
+                }
+
+                protected void validate(Template template) {
+                    super.validate(template);
+                    ValidationSupport.requireNonNull(template.code, "code");
+                    ValidationSupport.requireNonNull(template.source, "source");
+                    ValidationSupport.requireValueOrChildren(template);
                 }
 
                 protected Builder from(Template template) {
@@ -3975,11 +4076,10 @@ public static class Manifest extends BackboneElement {
         private Manifest(Builder builder) {
             super(builder);
             rendering = builder.rendering;
-            resource = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.resource, "resource", Resource.class));
-            page = Collections.unmodifiableList(ValidationSupport.checkList(builder.page, "page", Page.class));
-            image = Collections.unmodifiableList(ValidationSupport.checkList(builder.image, "image", String.class));
-            other = Collections.unmodifiableList(ValidationSupport.checkList(builder.other, "other", String.class));
-            ValidationSupport.requireValueOrChildren(this);
+            resource = Collections.unmodifiableList(builder.resource);
+            page = Collections.unmodifiableList(builder.page);
+            image = Collections.unmodifiableList(builder.image);
+            other = Collections.unmodifiableList(builder.other);
         }
 
         /**
@@ -4400,7 +4500,20 @@ public Builder other(Collection<String> other) {
              */
             @Override
             public Manifest build() {
-                return new Manifest(this);
+                Manifest manifest = new Manifest(this);
+                if (validating) {
+                    validate(manifest);
+                }
+                return manifest;
+            }
+
+            protected void validate(Manifest manifest) {
+                super.validate(manifest);
+                ValidationSupport.checkNonEmptyList(manifest.resource, "resource", Resource.class);
+                ValidationSupport.checkList(manifest.page, "page", Page.class);
+                ValidationSupport.checkList(manifest.image, "image", String.class);
+                ValidationSupport.checkList(manifest.other, "other", String.class);
+                ValidationSupport.requireValueOrChildren(manifest);
             }
 
             protected Builder from(Manifest manifest) {
@@ -4429,10 +4542,9 @@ public static class Resource extends BackboneElement {
 
             private Resource(Builder builder) {
                 super(builder);
-                reference = ValidationSupport.requireNonNull(builder.reference, "reference");
-                example = ValidationSupport.choiceElement(builder.example, "example", Boolean.class, Canonical.class);
+                reference = builder.reference;
+                example = builder.example;
                 relativePath = builder.relativePath;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -4712,7 +4824,18 @@ public Builder relativePath(Url relativePath) {
                  */
                 @Override
                 public Resource build() {
-                    return new Resource(this);
+                    Resource resource = new Resource(this);
+                    if (validating) {
+                        validate(resource);
+                    }
+                    return resource;
+                }
+
+                protected void validate(Resource resource) {
+                    super.validate(resource);
+                    ValidationSupport.requireNonNull(resource.reference, "reference");
+                    ValidationSupport.choiceElement(resource.example, "example", Boolean.class, Canonical.class);
+                    ValidationSupport.requireValueOrChildren(resource);
                 }
 
                 protected Builder from(Resource resource) {
@@ -4736,10 +4859,9 @@ public static class Page extends BackboneElement {
 
             private Page(Builder builder) {
                 super(builder);
-                name = ValidationSupport.requireNonNull(builder.name, "name");
+                name = builder.name;
                 title = builder.title;
-                anchor = Collections.unmodifiableList(ValidationSupport.checkList(builder.anchor, "anchor", String.class));
-                ValidationSupport.requireValueOrChildren(this);
+                anchor = Collections.unmodifiableList(builder.anchor);
             }
 
             /**
@@ -5031,7 +5153,18 @@ public Builder anchor(Collection<String> anchor) {
                  */
                 @Override
                 public Page build() {
-                    return new Page(this);
+                    Page page = new Page(this);
+                    if (validating) {
+                        validate(page);
+                    }
+                    return page;
+                }
+
+                protected void validate(Page page) {
+                    super.validate(page);
+                    ValidationSupport.requireNonNull(page.name, "name");
+                    ValidationSupport.checkList(page.anchor, "anchor", String.class);
+                    ValidationSupport.requireValueOrChildren(page);
                 }
 
                 protected Builder from(Page page) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/InsurancePlan.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/InsurancePlan.java
index 41f455969b9..0411b2023bd 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/InsurancePlan.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/InsurancePlan.java
@@ -110,25 +110,20 @@ public class InsurancePlan extends DomainResource {
 
     private InsurancePlan(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         status = builder.status;
-        type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+        type = Collections.unmodifiableList(builder.type);
         name = builder.name;
-        alias = Collections.unmodifiableList(ValidationSupport.checkList(builder.alias, "alias", String.class));
+        alias = Collections.unmodifiableList(builder.alias);
         period = builder.period;
         ownedBy = builder.ownedBy;
         administeredBy = builder.administeredBy;
-        coverageArea = Collections.unmodifiableList(ValidationSupport.checkList(builder.coverageArea, "coverageArea", Reference.class));
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", Contact.class));
-        endpoint = Collections.unmodifiableList(ValidationSupport.checkList(builder.endpoint, "endpoint", Reference.class));
-        network = Collections.unmodifiableList(ValidationSupport.checkList(builder.network, "network", Reference.class));
-        coverage = Collections.unmodifiableList(ValidationSupport.checkList(builder.coverage, "coverage", Coverage.class));
-        plan = Collections.unmodifiableList(ValidationSupport.checkList(builder.plan, "plan", Plan.class));
-        ValidationSupport.checkReferenceType(ownedBy, "ownedBy", "Organization");
-        ValidationSupport.checkReferenceType(administeredBy, "administeredBy", "Organization");
-        ValidationSupport.checkReferenceType(coverageArea, "coverageArea", "Location");
-        ValidationSupport.checkReferenceType(endpoint, "endpoint", "Endpoint");
-        ValidationSupport.checkReferenceType(network, "network", "Organization");
+        coverageArea = Collections.unmodifiableList(builder.coverageArea);
+        contact = Collections.unmodifiableList(builder.contact);
+        endpoint = Collections.unmodifiableList(builder.endpoint);
+        network = Collections.unmodifiableList(builder.network);
+        coverage = Collections.unmodifiableList(builder.coverage);
+        plan = Collections.unmodifiableList(builder.plan);
     }
 
     /**
@@ -1049,7 +1044,29 @@ public Builder plan(Collection<Plan> plan) {
          */
         @Override
         public InsurancePlan build() {
-            return new InsurancePlan(this);
+            InsurancePlan insurancePlan = new InsurancePlan(this);
+            if (validating) {
+                validate(insurancePlan);
+            }
+            return insurancePlan;
+        }
+
+        protected void validate(InsurancePlan insurancePlan) {
+            super.validate(insurancePlan);
+            ValidationSupport.checkList(insurancePlan.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(insurancePlan.type, "type", CodeableConcept.class);
+            ValidationSupport.checkList(insurancePlan.alias, "alias", String.class);
+            ValidationSupport.checkList(insurancePlan.coverageArea, "coverageArea", Reference.class);
+            ValidationSupport.checkList(insurancePlan.contact, "contact", Contact.class);
+            ValidationSupport.checkList(insurancePlan.endpoint, "endpoint", Reference.class);
+            ValidationSupport.checkList(insurancePlan.network, "network", Reference.class);
+            ValidationSupport.checkList(insurancePlan.coverage, "coverage", Coverage.class);
+            ValidationSupport.checkList(insurancePlan.plan, "plan", Plan.class);
+            ValidationSupport.checkReferenceType(insurancePlan.ownedBy, "ownedBy", "Organization");
+            ValidationSupport.checkReferenceType(insurancePlan.administeredBy, "administeredBy", "Organization");
+            ValidationSupport.checkReferenceType(insurancePlan.coverageArea, "coverageArea", "Location");
+            ValidationSupport.checkReferenceType(insurancePlan.endpoint, "endpoint", "Endpoint");
+            ValidationSupport.checkReferenceType(insurancePlan.network, "network", "Organization");
         }
 
         protected Builder from(InsurancePlan insurancePlan) {
@@ -1091,9 +1108,8 @@ private Contact(Builder builder) {
             super(builder);
             purpose = builder.purpose;
             name = builder.name;
-            telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
+            telecom = Collections.unmodifiableList(builder.telecom);
             address = builder.address;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1407,7 +1423,17 @@ public Builder address(Address address) {
              */
             @Override
             public Contact build() {
-                return new Contact(this);
+                Contact contact = new Contact(this);
+                if (validating) {
+                    validate(contact);
+                }
+                return contact;
+            }
+
+            protected void validate(Contact contact) {
+                super.validate(contact);
+                ValidationSupport.checkList(contact.telecom, "telecom", ContactPoint.class);
+                ValidationSupport.requireValueOrChildren(contact);
             }
 
             protected Builder from(Contact contact) {
@@ -1434,11 +1460,9 @@ public static class Coverage extends BackboneElement {
 
         private Coverage(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            network = Collections.unmodifiableList(ValidationSupport.checkList(builder.network, "network", Reference.class));
-            benefit = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.benefit, "benefit", Benefit.class));
-            ValidationSupport.checkReferenceType(network, "network", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            network = Collections.unmodifiableList(builder.network);
+            benefit = Collections.unmodifiableList(builder.benefit);
         }
 
         /**
@@ -1767,7 +1791,20 @@ public Builder benefit(Collection<Benefit> benefit) {
              */
             @Override
             public Coverage build() {
-                return new Coverage(this);
+                Coverage coverage = new Coverage(this);
+                if (validating) {
+                    validate(coverage);
+                }
+                return coverage;
+            }
+
+            protected void validate(Coverage coverage) {
+                super.validate(coverage);
+                ValidationSupport.requireNonNull(coverage.type, "type");
+                ValidationSupport.checkList(coverage.network, "network", Reference.class);
+                ValidationSupport.checkNonEmptyList(coverage.benefit, "benefit", Benefit.class);
+                ValidationSupport.checkReferenceType(coverage.network, "network", "Organization");
+                ValidationSupport.requireValueOrChildren(coverage);
             }
 
             protected Builder from(Coverage coverage) {
@@ -1790,10 +1827,9 @@ public static class Benefit extends BackboneElement {
 
             private Benefit(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
+                type = builder.type;
                 requirement = builder.requirement;
-                limit = Collections.unmodifiableList(ValidationSupport.checkList(builder.limit, "limit", Limit.class));
-                ValidationSupport.requireValueOrChildren(this);
+                limit = Collections.unmodifiableList(builder.limit);
             }
 
             /**
@@ -2085,7 +2121,18 @@ public Builder limit(Collection<Limit> limit) {
                  */
                 @Override
                 public Benefit build() {
-                    return new Benefit(this);
+                    Benefit benefit = new Benefit(this);
+                    if (validating) {
+                        validate(benefit);
+                    }
+                    return benefit;
+                }
+
+                protected void validate(Benefit benefit) {
+                    super.validate(benefit);
+                    ValidationSupport.requireNonNull(benefit.type, "type");
+                    ValidationSupport.checkList(benefit.limit, "limit", Limit.class);
+                    ValidationSupport.requireValueOrChildren(benefit);
                 }
 
                 protected Builder from(Benefit benefit) {
@@ -2108,7 +2155,6 @@ private Limit(Builder builder) {
                     super(builder);
                     value = builder.value;
                     code = builder.code;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -2346,7 +2392,16 @@ public Builder code(CodeableConcept code) {
                      */
                     @Override
                     public Limit build() {
-                        return new Limit(this);
+                        Limit limit = new Limit(this);
+                        if (validating) {
+                            validate(limit);
+                        }
+                        return limit;
+                    }
+
+                    protected void validate(Limit limit) {
+                        super.validate(limit);
+                        ValidationSupport.requireValueOrChildren(limit);
                     }
 
                     protected Builder from(Limit limit) {
@@ -2377,15 +2432,12 @@ public static class Plan extends BackboneElement {
 
         private Plan(Builder builder) {
             super(builder);
-            identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+            identifier = Collections.unmodifiableList(builder.identifier);
             type = builder.type;
-            coverageArea = Collections.unmodifiableList(ValidationSupport.checkList(builder.coverageArea, "coverageArea", Reference.class));
-            network = Collections.unmodifiableList(ValidationSupport.checkList(builder.network, "network", Reference.class));
-            generalCost = Collections.unmodifiableList(ValidationSupport.checkList(builder.generalCost, "generalCost", GeneralCost.class));
-            specificCost = Collections.unmodifiableList(ValidationSupport.checkList(builder.specificCost, "specificCost", SpecificCost.class));
-            ValidationSupport.checkReferenceType(coverageArea, "coverageArea", "Location");
-            ValidationSupport.checkReferenceType(network, "network", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
+            coverageArea = Collections.unmodifiableList(builder.coverageArea);
+            network = Collections.unmodifiableList(builder.network);
+            generalCost = Collections.unmodifiableList(builder.generalCost);
+            specificCost = Collections.unmodifiableList(builder.specificCost);
         }
 
         /**
@@ -2860,7 +2912,23 @@ public Builder specificCost(Collection<SpecificCost> specificCost) {
              */
             @Override
             public Plan build() {
-                return new Plan(this);
+                Plan plan = new Plan(this);
+                if (validating) {
+                    validate(plan);
+                }
+                return plan;
+            }
+
+            protected void validate(Plan plan) {
+                super.validate(plan);
+                ValidationSupport.checkList(plan.identifier, "identifier", Identifier.class);
+                ValidationSupport.checkList(plan.coverageArea, "coverageArea", Reference.class);
+                ValidationSupport.checkList(plan.network, "network", Reference.class);
+                ValidationSupport.checkList(plan.generalCost, "generalCost", GeneralCost.class);
+                ValidationSupport.checkList(plan.specificCost, "specificCost", SpecificCost.class);
+                ValidationSupport.checkReferenceType(plan.coverageArea, "coverageArea", "Location");
+                ValidationSupport.checkReferenceType(plan.network, "network", "Organization");
+                ValidationSupport.requireValueOrChildren(plan);
             }
 
             protected Builder from(Plan plan) {
@@ -2890,7 +2958,6 @@ private GeneralCost(Builder builder) {
                 groupSize = builder.groupSize;
                 cost = builder.cost;
                 comment = builder.comment;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -3184,7 +3251,16 @@ public Builder comment(String comment) {
                  */
                 @Override
                 public GeneralCost build() {
-                    return new GeneralCost(this);
+                    GeneralCost generalCost = new GeneralCost(this);
+                    if (validating) {
+                        validate(generalCost);
+                    }
+                    return generalCost;
+                }
+
+                protected void validate(GeneralCost generalCost) {
+                    super.validate(generalCost);
+                    ValidationSupport.requireValueOrChildren(generalCost);
                 }
 
                 protected Builder from(GeneralCost generalCost) {
@@ -3208,9 +3284,8 @@ public static class SpecificCost extends BackboneElement {
 
             private SpecificCost(Builder builder) {
                 super(builder);
-                category = ValidationSupport.requireNonNull(builder.category, "category");
-                benefit = Collections.unmodifiableList(ValidationSupport.checkList(builder.benefit, "benefit", Benefit.class));
-                ValidationSupport.requireValueOrChildren(this);
+                category = builder.category;
+                benefit = Collections.unmodifiableList(builder.benefit);
             }
 
             /**
@@ -3473,7 +3548,18 @@ public Builder benefit(Collection<Benefit> benefit) {
                  */
                 @Override
                 public SpecificCost build() {
-                    return new SpecificCost(this);
+                    SpecificCost specificCost = new SpecificCost(this);
+                    if (validating) {
+                        validate(specificCost);
+                    }
+                    return specificCost;
+                }
+
+                protected void validate(SpecificCost specificCost) {
+                    super.validate(specificCost);
+                    ValidationSupport.requireNonNull(specificCost.category, "category");
+                    ValidationSupport.checkList(specificCost.benefit, "benefit", Benefit.class);
+                    ValidationSupport.requireValueOrChildren(specificCost);
                 }
 
                 protected Builder from(SpecificCost specificCost) {
@@ -3494,9 +3580,8 @@ public static class Benefit extends BackboneElement {
 
                 private Benefit(Builder builder) {
                     super(builder);
-                    type = ValidationSupport.requireNonNull(builder.type, "type");
-                    cost = Collections.unmodifiableList(ValidationSupport.checkList(builder.cost, "cost", Cost.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    type = builder.type;
+                    cost = Collections.unmodifiableList(builder.cost);
                 }
 
                 /**
@@ -3761,7 +3846,18 @@ public Builder cost(Collection<Cost> cost) {
                      */
                     @Override
                     public Benefit build() {
-                        return new Benefit(this);
+                        Benefit benefit = new Benefit(this);
+                        if (validating) {
+                            validate(benefit);
+                        }
+                        return benefit;
+                    }
+
+                    protected void validate(Benefit benefit) {
+                        super.validate(benefit);
+                        ValidationSupport.requireNonNull(benefit.type, "type");
+                        ValidationSupport.checkList(benefit.cost, "cost", Cost.class);
+                        ValidationSupport.requireValueOrChildren(benefit);
                     }
 
                     protected Builder from(Benefit benefit) {
@@ -3790,12 +3886,10 @@ public static class Cost extends BackboneElement {
 
                     private Cost(Builder builder) {
                         super(builder);
-                        type = ValidationSupport.requireNonNull(builder.type, "type");
+                        type = builder.type;
                         applicability = builder.applicability;
-                        qualifiers = Collections.unmodifiableList(ValidationSupport.checkList(builder.qualifiers, "qualifiers", CodeableConcept.class));
+                        qualifiers = Collections.unmodifiableList(builder.qualifiers);
                         value = builder.value;
-                        ValidationSupport.checkValueSetBinding(applicability, "applicability", "http://hl7.org/fhir/ValueSet/insuranceplan-applicability", "http://terminology.hl7.org/CodeSystem/applicability", "in-network", "out-of-network", "other");
-                        ValidationSupport.requireValueOrChildren(this);
                     }
 
                     /**
@@ -4118,7 +4212,19 @@ public Builder value(Quantity value) {
                          */
                         @Override
                         public Cost build() {
-                            return new Cost(this);
+                            Cost cost = new Cost(this);
+                            if (validating) {
+                                validate(cost);
+                            }
+                            return cost;
+                        }
+
+                        protected void validate(Cost cost) {
+                            super.validate(cost);
+                            ValidationSupport.requireNonNull(cost.type, "type");
+                            ValidationSupport.checkList(cost.qualifiers, "qualifiers", CodeableConcept.class);
+                            ValidationSupport.checkValueSetBinding(cost.applicability, "applicability", "http://hl7.org/fhir/ValueSet/insuranceplan-applicability", "http://terminology.hl7.org/CodeSystem/applicability", "in-network", "out-of-network", "other");
+                            ValidationSupport.requireValueOrChildren(cost);
                         }
 
                         protected Builder from(Cost cost) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Invoice.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Invoice.java
index fc4a5af9c3c..170020a1f09 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Invoice.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Invoice.java
@@ -94,26 +94,22 @@ public class Invoice extends DomainResource {
 
     private Invoice(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         cancelledReason = builder.cancelledReason;
         type = builder.type;
         subject = builder.subject;
         recipient = builder.recipient;
         date = builder.date;
-        participant = Collections.unmodifiableList(ValidationSupport.checkList(builder.participant, "participant", Participant.class));
+        participant = Collections.unmodifiableList(builder.participant);
         issuer = builder.issuer;
         account = builder.account;
-        lineItem = Collections.unmodifiableList(ValidationSupport.checkList(builder.lineItem, "lineItem", LineItem.class));
-        totalPriceComponent = Collections.unmodifiableList(ValidationSupport.checkList(builder.totalPriceComponent, "totalPriceComponent", Invoice.LineItem.PriceComponent.class));
+        lineItem = Collections.unmodifiableList(builder.lineItem);
+        totalPriceComponent = Collections.unmodifiableList(builder.totalPriceComponent);
         totalNet = builder.totalNet;
         totalGross = builder.totalGross;
         paymentTerms = builder.paymentTerms;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(recipient, "recipient", "Organization", "Patient", "RelatedPerson");
-        ValidationSupport.checkReferenceType(issuer, "issuer", "Organization");
-        ValidationSupport.checkReferenceType(account, "account", "Account");
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -1004,7 +1000,25 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public Invoice build() {
-            return new Invoice(this);
+            Invoice invoice = new Invoice(this);
+            if (validating) {
+                validate(invoice);
+            }
+            return invoice;
+        }
+
+        protected void validate(Invoice invoice) {
+            super.validate(invoice);
+            ValidationSupport.checkList(invoice.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(invoice.status, "status");
+            ValidationSupport.checkList(invoice.participant, "participant", Participant.class);
+            ValidationSupport.checkList(invoice.lineItem, "lineItem", LineItem.class);
+            ValidationSupport.checkList(invoice.totalPriceComponent, "totalPriceComponent", Invoice.LineItem.PriceComponent.class);
+            ValidationSupport.checkList(invoice.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(invoice.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(invoice.recipient, "recipient", "Organization", "Patient", "RelatedPerson");
+            ValidationSupport.checkReferenceType(invoice.issuer, "issuer", "Organization");
+            ValidationSupport.checkReferenceType(invoice.account, "account", "Account");
         }
 
         protected Builder from(Invoice invoice) {
@@ -1041,9 +1055,7 @@ public static class Participant extends BackboneElement {
         private Participant(Builder builder) {
             super(builder);
             role = builder.role;
-            actor = ValidationSupport.requireNonNull(builder.actor, "actor");
-            ValidationSupport.checkReferenceType(actor, "actor", "Practitioner", "Organization", "Patient", "PractitionerRole", "Device", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
+            actor = builder.actor;
         }
 
         /**
@@ -1298,7 +1310,18 @@ public Builder actor(Reference actor) {
              */
             @Override
             public Participant build() {
-                return new Participant(this);
+                Participant participant = new Participant(this);
+                if (validating) {
+                    validate(participant);
+                }
+                return participant;
+            }
+
+            protected void validate(Participant participant) {
+                super.validate(participant);
+                ValidationSupport.requireNonNull(participant.actor, "actor");
+                ValidationSupport.checkReferenceType(participant.actor, "actor", "Practitioner", "Organization", "Patient", "PractitionerRole", "Device", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(participant);
             }
 
             protected Builder from(Participant participant) {
@@ -1325,10 +1348,8 @@ public static class LineItem extends BackboneElement {
         private LineItem(Builder builder) {
             super(builder);
             sequence = builder.sequence;
-            chargeItem = ValidationSupport.requireChoiceElement(builder.chargeItem, "chargeItem", Reference.class, CodeableConcept.class);
-            priceComponent = Collections.unmodifiableList(ValidationSupport.checkList(builder.priceComponent, "priceComponent", PriceComponent.class));
-            ValidationSupport.checkReferenceType(chargeItem, "chargeItem", "ChargeItem");
-            ValidationSupport.requireValueOrChildren(this);
+            chargeItem = builder.chargeItem;
+            priceComponent = Collections.unmodifiableList(builder.priceComponent);
         }
 
         /**
@@ -1642,7 +1663,19 @@ public Builder priceComponent(Collection<PriceComponent> priceComponent) {
              */
             @Override
             public LineItem build() {
-                return new LineItem(this);
+                LineItem lineItem = new LineItem(this);
+                if (validating) {
+                    validate(lineItem);
+                }
+                return lineItem;
+            }
+
+            protected void validate(LineItem lineItem) {
+                super.validate(lineItem);
+                ValidationSupport.requireChoiceElement(lineItem.chargeItem, "chargeItem", Reference.class, CodeableConcept.class);
+                ValidationSupport.checkList(lineItem.priceComponent, "priceComponent", PriceComponent.class);
+                ValidationSupport.checkReferenceType(lineItem.chargeItem, "chargeItem", "ChargeItem");
+                ValidationSupport.requireValueOrChildren(lineItem);
             }
 
             protected Builder from(LineItem lineItem) {
@@ -1675,11 +1708,10 @@ public static class PriceComponent extends BackboneElement {
 
             private PriceComponent(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
+                type = builder.type;
                 code = builder.code;
                 factor = builder.factor;
                 amount = builder.amount;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1982,7 +2014,17 @@ public Builder amount(Money amount) {
                  */
                 @Override
                 public PriceComponent build() {
-                    return new PriceComponent(this);
+                    PriceComponent priceComponent = new PriceComponent(this);
+                    if (validating) {
+                        validate(priceComponent);
+                    }
+                    return priceComponent;
+                }
+
+                protected void validate(PriceComponent priceComponent) {
+                    super.validate(priceComponent);
+                    ValidationSupport.requireNonNull(priceComponent.type, "type");
+                    ValidationSupport.requireValueOrChildren(priceComponent);
                 }
 
                 protected Builder from(PriceComponent priceComponent) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Library.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Library.java
index 9966ad53a15..6afb9a9bd0f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Library.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Library.java
@@ -177,37 +177,36 @@ public class Library extends DomainResource {
     private Library(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
         subtitle = builder.subtitle;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
-        type = ValidationSupport.requireNonNull(builder.type, "type");
-        subject = ValidationSupport.choiceElement(builder.subject, "subject", CodeableConcept.class, Reference.class);
+        type = builder.type;
+        subject = builder.subject;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         usage = builder.usage;
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
-        parameter = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameter, "parameter", ParameterDefinition.class));
-        dataRequirement = Collections.unmodifiableList(ValidationSupport.checkList(builder.dataRequirement, "dataRequirement", DataRequirement.class));
-        content = Collections.unmodifiableList(ValidationSupport.checkList(builder.content, "content", Attachment.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Group");
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
+        parameter = Collections.unmodifiableList(builder.parameter);
+        dataRequirement = Collections.unmodifiableList(builder.dataRequirement);
+        content = Collections.unmodifiableList(builder.content);
     }
 
     /**
@@ -1728,7 +1727,32 @@ public Builder content(Collection<Attachment> content) {
          */
         @Override
         public Library build() {
-            return new Library(this);
+            Library library = new Library(this);
+            if (validating) {
+                validate(library);
+            }
+            return library;
+        }
+
+        protected void validate(Library library) {
+            super.validate(library);
+            ValidationSupport.checkList(library.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(library.status, "status");
+            ValidationSupport.requireNonNull(library.type, "type");
+            ValidationSupport.choiceElement(library.subject, "subject", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(library.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(library.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(library.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(library.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(library.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(library.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(library.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(library.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(library.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.checkList(library.parameter, "parameter", ParameterDefinition.class);
+            ValidationSupport.checkList(library.dataRequirement, "dataRequirement", DataRequirement.class);
+            ValidationSupport.checkList(library.content, "content", Attachment.class);
+            ValidationSupport.checkReferenceType(library.subject, "subject", "Group");
         }
 
         protected Builder from(Library library) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Linkage.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Linkage.java
index 1613775913c..fa5120dd47c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Linkage.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Linkage.java
@@ -65,8 +65,7 @@ private Linkage(Builder builder) {
         super(builder);
         active = builder.active;
         author = builder.author;
-        item = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.item, "item", Item.class));
-        ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole", "Organization");
+        item = Collections.unmodifiableList(builder.item);
     }
 
     /**
@@ -482,7 +481,17 @@ public Builder item(Collection<Item> item) {
          */
         @Override
         public Linkage build() {
-            return new Linkage(this);
+            Linkage linkage = new Linkage(this);
+            if (validating) {
+                validate(linkage);
+            }
+            return linkage;
+        }
+
+        protected void validate(Linkage linkage) {
+            super.validate(linkage);
+            ValidationSupport.checkNonEmptyList(linkage.item, "item", Item.class);
+            ValidationSupport.checkReferenceType(linkage.author, "author", "Practitioner", "PractitionerRole", "Organization");
         }
 
         protected Builder from(Linkage linkage) {
@@ -514,9 +523,8 @@ public static class Item extends BackboneElement {
 
         private Item(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            resource = ValidationSupport.requireNonNull(builder.resource, "resource");
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            resource = builder.resource;
         }
 
         /**
@@ -764,7 +772,18 @@ public Builder resource(Reference resource) {
              */
             @Override
             public Item build() {
-                return new Item(this);
+                Item item = new Item(this);
+                if (validating) {
+                    validate(item);
+                }
+                return item;
+            }
+
+            protected void validate(Item item) {
+                super.validate(item);
+                ValidationSupport.requireNonNull(item.type, "type");
+                ValidationSupport.requireNonNull(item.resource, "resource");
+                ValidationSupport.requireValueOrChildren(item);
             }
 
             protected Builder from(Item item) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/List.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/List.java
index b1048925934..f20d25e9236 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/List.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/List.java
@@ -145,9 +145,9 @@ public class List extends DomainResource {
 
     private List(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        mode = ValidationSupport.requireNonNull(builder.mode, "mode");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        mode = builder.mode;
         title = builder.title;
         code = builder.code;
         subject = builder.subject;
@@ -155,12 +155,9 @@ private List(Builder builder) {
         date = builder.date;
         source = builder.source;
         orderedBy = builder.orderedBy;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        entry = Collections.unmodifiableList(ValidationSupport.checkList(builder.entry, "entry", Entry.class));
+        note = Collections.unmodifiableList(builder.note);
+        entry = Collections.unmodifiableList(builder.entry);
         emptyReason = builder.emptyReason;
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group", "Device", "Location");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(source, "source", "Practitioner", "PractitionerRole", "Patient", "Device");
     }
 
     /**
@@ -922,7 +919,23 @@ public Builder emptyReason(CodeableConcept emptyReason) {
          */
         @Override
         public List build() {
-            return new List(this);
+            List list = new List(this);
+            if (validating) {
+                validate(list);
+            }
+            return list;
+        }
+
+        protected void validate(List list) {
+            super.validate(list);
+            ValidationSupport.checkList(list.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(list.status, "status");
+            ValidationSupport.requireNonNull(list.mode, "mode");
+            ValidationSupport.checkList(list.note, "note", Annotation.class);
+            ValidationSupport.checkList(list.entry, "entry", Entry.class);
+            ValidationSupport.checkReferenceType(list.subject, "subject", "Patient", "Group", "Device", "Location");
+            ValidationSupport.checkReferenceType(list.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(list.source, "source", "Practitioner", "PractitionerRole", "Patient", "Device");
         }
 
         protected Builder from(List list) {
@@ -965,8 +978,7 @@ private Entry(Builder builder) {
             flag = builder.flag;
             deleted = builder.deleted;
             date = builder.date;
-            item = ValidationSupport.requireNonNull(builder.item, "item");
-            ValidationSupport.requireValueOrChildren(this);
+            item = builder.item;
         }
 
         /**
@@ -1267,7 +1279,17 @@ public Builder item(Reference item) {
              */
             @Override
             public Entry build() {
-                return new Entry(this);
+                Entry entry = new Entry(this);
+                if (validating) {
+                    validate(entry);
+                }
+                return entry;
+            }
+
+            protected void validate(Entry entry) {
+                super.validate(entry);
+                ValidationSupport.requireNonNull(entry.item, "item");
+                ValidationSupport.requireValueOrChildren(entry);
             }
 
             protected Builder from(Entry entry) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Location.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Location.java
index e8589f17021..8a049f4e04f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Location.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Location.java
@@ -134,26 +134,23 @@ public class Location extends DomainResource {
 
     private Location(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         status = builder.status;
         operationalStatus = builder.operationalStatus;
         name = builder.name;
-        alias = Collections.unmodifiableList(ValidationSupport.checkList(builder.alias, "alias", String.class));
+        alias = Collections.unmodifiableList(builder.alias);
         description = builder.description;
         mode = builder.mode;
-        type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
+        type = Collections.unmodifiableList(builder.type);
+        telecom = Collections.unmodifiableList(builder.telecom);
         address = builder.address;
         physicalType = builder.physicalType;
         position = builder.position;
         managingOrganization = builder.managingOrganization;
         partOf = builder.partOf;
-        hoursOfOperation = Collections.unmodifiableList(ValidationSupport.checkList(builder.hoursOfOperation, "hoursOfOperation", HoursOfOperation.class));
+        hoursOfOperation = Collections.unmodifiableList(builder.hoursOfOperation);
         availabilityExceptions = builder.availabilityExceptions;
-        endpoint = Collections.unmodifiableList(ValidationSupport.checkList(builder.endpoint, "endpoint", Reference.class));
-        ValidationSupport.checkReferenceType(managingOrganization, "managingOrganization", "Organization");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "Location");
-        ValidationSupport.checkReferenceType(endpoint, "endpoint", "Endpoint");
+        endpoint = Collections.unmodifiableList(builder.endpoint);
     }
 
     /**
@@ -1088,7 +1085,24 @@ public Builder endpoint(Collection<Reference> endpoint) {
          */
         @Override
         public Location build() {
-            return new Location(this);
+            Location location = new Location(this);
+            if (validating) {
+                validate(location);
+            }
+            return location;
+        }
+
+        protected void validate(Location location) {
+            super.validate(location);
+            ValidationSupport.checkList(location.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(location.alias, "alias", String.class);
+            ValidationSupport.checkList(location.type, "type", CodeableConcept.class);
+            ValidationSupport.checkList(location.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.checkList(location.hoursOfOperation, "hoursOfOperation", HoursOfOperation.class);
+            ValidationSupport.checkList(location.endpoint, "endpoint", Reference.class);
+            ValidationSupport.checkReferenceType(location.managingOrganization, "managingOrganization", "Organization");
+            ValidationSupport.checkReferenceType(location.partOf, "partOf", "Location");
+            ValidationSupport.checkReferenceType(location.endpoint, "endpoint", "Endpoint");
         }
 
         protected Builder from(Location location) {
@@ -1127,10 +1141,9 @@ public static class Position extends BackboneElement {
 
         private Position(Builder builder) {
             super(builder);
-            longitude = ValidationSupport.requireNonNull(builder.longitude, "longitude");
-            latitude = ValidationSupport.requireNonNull(builder.latitude, "latitude");
+            longitude = builder.longitude;
+            latitude = builder.latitude;
             altitude = builder.altitude;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1411,7 +1424,18 @@ public Builder altitude(Decimal altitude) {
              */
             @Override
             public Position build() {
-                return new Position(this);
+                Position position = new Position(this);
+                if (validating) {
+                    validate(position);
+                }
+                return position;
+            }
+
+            protected void validate(Position position) {
+                super.validate(position);
+                ValidationSupport.requireNonNull(position.longitude, "longitude");
+                ValidationSupport.requireNonNull(position.latitude, "latitude");
+                ValidationSupport.requireValueOrChildren(position);
             }
 
             protected Builder from(Position position) {
@@ -1441,11 +1465,10 @@ public static class HoursOfOperation extends BackboneElement {
 
         private HoursOfOperation(Builder builder) {
             super(builder);
-            daysOfWeek = Collections.unmodifiableList(ValidationSupport.checkList(builder.daysOfWeek, "daysOfWeek", DaysOfWeek.class));
+            daysOfWeek = Collections.unmodifiableList(builder.daysOfWeek);
             allDay = builder.allDay;
             openingTime = builder.openingTime;
             closingTime = builder.closingTime;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1759,7 +1782,17 @@ public Builder closingTime(Time closingTime) {
              */
             @Override
             public HoursOfOperation build() {
-                return new HoursOfOperation(this);
+                HoursOfOperation hoursOfOperation = new HoursOfOperation(this);
+                if (validating) {
+                    validate(hoursOfOperation);
+                }
+                return hoursOfOperation;
+            }
+
+            protected void validate(HoursOfOperation hoursOfOperation) {
+                super.validate(hoursOfOperation);
+                ValidationSupport.checkList(hoursOfOperation.daysOfWeek, "daysOfWeek", DaysOfWeek.class);
+                ValidationSupport.requireValueOrChildren(hoursOfOperation);
             }
 
             protected Builder from(HoursOfOperation hoursOfOperation) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Measure.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Measure.java
index d1c3c4fc01f..6d430952643 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Measure.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Measure.java
@@ -250,48 +250,46 @@ public class Measure extends DomainResource {
     private Measure(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
         subtitle = builder.subtitle;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
-        subject = ValidationSupport.choiceElement(builder.subject, "subject", CodeableConcept.class, Reference.class);
+        subject = builder.subject;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         usage = builder.usage;
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
-        library = Collections.unmodifiableList(ValidationSupport.checkList(builder.library, "library", Canonical.class));
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
+        library = Collections.unmodifiableList(builder.library);
         disclaimer = builder.disclaimer;
         scoring = builder.scoring;
         compositeScoring = builder.compositeScoring;
-        type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+        type = Collections.unmodifiableList(builder.type);
         riskAdjustment = builder.riskAdjustment;
         rateAggregation = builder.rateAggregation;
         rationale = builder.rationale;
         clinicalRecommendationStatement = builder.clinicalRecommendationStatement;
         improvementNotation = builder.improvementNotation;
-        definition = Collections.unmodifiableList(ValidationSupport.checkList(builder.definition, "definition", Markdown.class));
+        definition = Collections.unmodifiableList(builder.definition);
         guidance = builder.guidance;
-        group = Collections.unmodifiableList(ValidationSupport.checkList(builder.group, "group", Group.class));
-        supplementalData = Collections.unmodifiableList(ValidationSupport.checkList(builder.supplementalData, "supplementalData", SupplementalData.class));
-        ValidationSupport.checkValueSetBinding(improvementNotation, "improvementNotation", "http://hl7.org/fhir/ValueSet/measure-improvement-notation", "http://terminology.hl7.org/CodeSystem/measure-improvement-notation", "increase", "decrease");
-        ValidationSupport.checkReferenceType(subject, "subject", "Group");
+        group = Collections.unmodifiableList(builder.group);
+        supplementalData = Collections.unmodifiableList(builder.supplementalData);
     }
 
     /**
@@ -2152,7 +2150,34 @@ public Builder supplementalData(Collection<SupplementalData> supplementalData) {
          */
         @Override
         public Measure build() {
-            return new Measure(this);
+            Measure measure = new Measure(this);
+            if (validating) {
+                validate(measure);
+            }
+            return measure;
+        }
+
+        protected void validate(Measure measure) {
+            super.validate(measure);
+            ValidationSupport.checkList(measure.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(measure.status, "status");
+            ValidationSupport.choiceElement(measure.subject, "subject", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(measure.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(measure.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(measure.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(measure.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(measure.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(measure.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(measure.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(measure.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(measure.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.checkList(measure.library, "library", Canonical.class);
+            ValidationSupport.checkList(measure.type, "type", CodeableConcept.class);
+            ValidationSupport.checkList(measure.definition, "definition", Markdown.class);
+            ValidationSupport.checkList(measure.group, "group", Group.class);
+            ValidationSupport.checkList(measure.supplementalData, "supplementalData", SupplementalData.class);
+            ValidationSupport.checkValueSetBinding(measure.improvementNotation, "improvementNotation", "http://hl7.org/fhir/ValueSet/measure-improvement-notation", "http://terminology.hl7.org/CodeSystem/measure-improvement-notation", "increase", "decrease");
+            ValidationSupport.checkReferenceType(measure.subject, "subject", "Group");
         }
 
         protected Builder from(Measure measure) {
@@ -2215,9 +2240,8 @@ private Group(Builder builder) {
             super(builder);
             code = builder.code;
             description = builder.description;
-            population = Collections.unmodifiableList(ValidationSupport.checkList(builder.population, "population", Population.class));
-            stratifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.stratifier, "stratifier", Stratifier.class));
-            ValidationSupport.requireValueOrChildren(this);
+            population = Collections.unmodifiableList(builder.population);
+            stratifier = Collections.unmodifiableList(builder.stratifier);
         }
 
         /**
@@ -2556,7 +2580,18 @@ public Builder stratifier(Collection<Stratifier> stratifier) {
              */
             @Override
             public Group build() {
-                return new Group(this);
+                Group group = new Group(this);
+                if (validating) {
+                    validate(group);
+                }
+                return group;
+            }
+
+            protected void validate(Group group) {
+                super.validate(group);
+                ValidationSupport.checkList(group.population, "population", Population.class);
+                ValidationSupport.checkList(group.stratifier, "stratifier", Stratifier.class);
+                ValidationSupport.requireValueOrChildren(group);
             }
 
             protected Builder from(Group group) {
@@ -2588,8 +2623,7 @@ private Population(Builder builder) {
                 super(builder);
                 code = builder.code;
                 description = builder.description;
-                criteria = ValidationSupport.requireNonNull(builder.criteria, "criteria");
-                ValidationSupport.requireValueOrChildren(this);
+                criteria = builder.criteria;
             }
 
             /**
@@ -2862,7 +2896,17 @@ public Builder criteria(Expression criteria) {
                  */
                 @Override
                 public Population build() {
-                    return new Population(this);
+                    Population population = new Population(this);
+                    if (validating) {
+                        validate(population);
+                    }
+                    return population;
+                }
+
+                protected void validate(Population population) {
+                    super.validate(population);
+                    ValidationSupport.requireNonNull(population.criteria, "criteria");
+                    ValidationSupport.requireValueOrChildren(population);
                 }
 
                 protected Builder from(Population population) {
@@ -2890,8 +2934,7 @@ private Stratifier(Builder builder) {
                 code = builder.code;
                 description = builder.description;
                 criteria = builder.criteria;
-                component = Collections.unmodifiableList(ValidationSupport.checkList(builder.component, "component", Component.class));
-                ValidationSupport.requireValueOrChildren(this);
+                component = Collections.unmodifiableList(builder.component);
             }
 
             /**
@@ -3212,7 +3255,17 @@ public Builder component(Collection<Component> component) {
                  */
                 @Override
                 public Stratifier build() {
-                    return new Stratifier(this);
+                    Stratifier stratifier = new Stratifier(this);
+                    if (validating) {
+                        validate(stratifier);
+                    }
+                    return stratifier;
+                }
+
+                protected void validate(Stratifier stratifier) {
+                    super.validate(stratifier);
+                    ValidationSupport.checkList(stratifier.component, "component", Component.class);
+                    ValidationSupport.requireValueOrChildren(stratifier);
                 }
 
                 protected Builder from(Stratifier stratifier) {
@@ -3239,8 +3292,7 @@ private Component(Builder builder) {
                     super(builder);
                     code = builder.code;
                     description = builder.description;
-                    criteria = ValidationSupport.requireNonNull(builder.criteria, "criteria");
-                    ValidationSupport.requireValueOrChildren(this);
+                    criteria = builder.criteria;
                 }
 
                 /**
@@ -3516,7 +3568,17 @@ public Builder criteria(Expression criteria) {
                      */
                     @Override
                     public Component build() {
-                        return new Component(this);
+                        Component component = new Component(this);
+                        if (validating) {
+                            validate(component);
+                        }
+                        return component;
+                    }
+
+                    protected void validate(Component component) {
+                        super.validate(component);
+                        ValidationSupport.requireNonNull(component.criteria, "criteria");
+                        ValidationSupport.requireValueOrChildren(component);
                     }
 
                     protected Builder from(Component component) {
@@ -3551,10 +3613,9 @@ public static class SupplementalData extends BackboneElement {
         private SupplementalData(Builder builder) {
             super(builder);
             code = builder.code;
-            usage = Collections.unmodifiableList(ValidationSupport.checkList(builder.usage, "usage", CodeableConcept.class));
+            usage = Collections.unmodifiableList(builder.usage);
             description = builder.description;
-            criteria = ValidationSupport.requireNonNull(builder.criteria, "criteria");
-            ValidationSupport.requireValueOrChildren(this);
+            criteria = builder.criteria;
         }
 
         /**
@@ -3889,7 +3950,18 @@ public Builder criteria(Expression criteria) {
              */
             @Override
             public SupplementalData build() {
-                return new SupplementalData(this);
+                SupplementalData supplementalData = new SupplementalData(this);
+                if (validating) {
+                    validate(supplementalData);
+                }
+                return supplementalData;
+            }
+
+            protected void validate(SupplementalData supplementalData) {
+                super.validate(supplementalData);
+                ValidationSupport.checkList(supplementalData.usage, "usage", CodeableConcept.class);
+                ValidationSupport.requireNonNull(supplementalData.criteria, "criteria");
+                ValidationSupport.requireValueOrChildren(supplementalData);
             }
 
             protected Builder from(SupplementalData supplementalData) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MeasureReport.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MeasureReport.java
index 5be5e952814..20f63657664 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MeasureReport.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MeasureReport.java
@@ -130,20 +130,17 @@ public class MeasureReport extends DomainResource {
 
     private MeasureReport(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        type = ValidationSupport.requireNonNull(builder.type, "type");
-        measure = ValidationSupport.requireNonNull(builder.measure, "measure");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        type = builder.type;
+        measure = builder.measure;
         subject = builder.subject;
         date = builder.date;
         reporter = builder.reporter;
-        period = ValidationSupport.requireNonNull(builder.period, "period");
+        period = builder.period;
         improvementNotation = builder.improvementNotation;
-        group = Collections.unmodifiableList(ValidationSupport.checkList(builder.group, "group", Group.class));
-        evaluatedResource = Collections.unmodifiableList(ValidationSupport.checkList(builder.evaluatedResource, "evaluatedResource", Reference.class));
-        ValidationSupport.checkValueSetBinding(improvementNotation, "improvementNotation", "http://hl7.org/fhir/ValueSet/measure-improvement-notation", "http://terminology.hl7.org/CodeSystem/measure-improvement-notation", "increase", "decrease");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Practitioner", "PractitionerRole", "Location", "Device", "RelatedPerson", "Group");
-        ValidationSupport.checkReferenceType(reporter, "reporter", "Practitioner", "PractitionerRole", "Location", "Organization");
+        group = Collections.unmodifiableList(builder.group);
+        evaluatedResource = Collections.unmodifiableList(builder.evaluatedResource);
     }
 
     /**
@@ -856,7 +853,25 @@ public Builder evaluatedResource(Collection<Reference> evaluatedResource) {
          */
         @Override
         public MeasureReport build() {
-            return new MeasureReport(this);
+            MeasureReport measureReport = new MeasureReport(this);
+            if (validating) {
+                validate(measureReport);
+            }
+            return measureReport;
+        }
+
+        protected void validate(MeasureReport measureReport) {
+            super.validate(measureReport);
+            ValidationSupport.checkList(measureReport.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(measureReport.status, "status");
+            ValidationSupport.requireNonNull(measureReport.type, "type");
+            ValidationSupport.requireNonNull(measureReport.measure, "measure");
+            ValidationSupport.requireNonNull(measureReport.period, "period");
+            ValidationSupport.checkList(measureReport.group, "group", Group.class);
+            ValidationSupport.checkList(measureReport.evaluatedResource, "evaluatedResource", Reference.class);
+            ValidationSupport.checkValueSetBinding(measureReport.improvementNotation, "improvementNotation", "http://hl7.org/fhir/ValueSet/measure-improvement-notation", "http://terminology.hl7.org/CodeSystem/measure-improvement-notation", "increase", "decrease");
+            ValidationSupport.checkReferenceType(measureReport.subject, "subject", "Patient", "Practitioner", "PractitionerRole", "Location", "Device", "RelatedPerson", "Group");
+            ValidationSupport.checkReferenceType(measureReport.reporter, "reporter", "Practitioner", "PractitionerRole", "Location", "Organization");
         }
 
         protected Builder from(MeasureReport measureReport) {
@@ -890,10 +905,9 @@ public static class Group extends BackboneElement {
         private Group(Builder builder) {
             super(builder);
             code = builder.code;
-            population = Collections.unmodifiableList(ValidationSupport.checkList(builder.population, "population", Population.class));
+            population = Collections.unmodifiableList(builder.population);
             measureScore = builder.measureScore;
-            stratifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.stratifier, "stratifier", Stratifier.class));
-            ValidationSupport.requireValueOrChildren(this);
+            stratifier = Collections.unmodifiableList(builder.stratifier);
         }
 
         /**
@@ -1232,7 +1246,18 @@ public Builder stratifier(Collection<Stratifier> stratifier) {
              */
             @Override
             public Group build() {
-                return new Group(this);
+                Group group = new Group(this);
+                if (validating) {
+                    validate(group);
+                }
+                return group;
+            }
+
+            protected void validate(Group group) {
+                super.validate(group);
+                ValidationSupport.checkList(group.population, "population", Population.class);
+                ValidationSupport.checkList(group.stratifier, "stratifier", Stratifier.class);
+                ValidationSupport.requireValueOrChildren(group);
             }
 
             protected Builder from(Group group) {
@@ -1266,8 +1291,6 @@ private Population(Builder builder) {
                 code = builder.code;
                 count = builder.count;
                 subjectResults = builder.subjectResults;
-                ValidationSupport.checkReferenceType(subjectResults, "subjectResults", "List");
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1538,7 +1561,17 @@ public Builder subjectResults(Reference subjectResults) {
                  */
                 @Override
                 public Population build() {
-                    return new Population(this);
+                    Population population = new Population(this);
+                    if (validating) {
+                        validate(population);
+                    }
+                    return population;
+                }
+
+                protected void validate(Population population) {
+                    super.validate(population);
+                    ValidationSupport.checkReferenceType(population.subjectResults, "subjectResults", "List");
+                    ValidationSupport.requireValueOrChildren(population);
                 }
 
                 protected Builder from(Population population) {
@@ -1561,9 +1594,8 @@ public static class Stratifier extends BackboneElement {
 
             private Stratifier(Builder builder) {
                 super(builder);
-                code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
-                stratum = Collections.unmodifiableList(ValidationSupport.checkList(builder.stratum, "stratum", Stratum.class));
-                ValidationSupport.requireValueOrChildren(this);
+                code = Collections.unmodifiableList(builder.code);
+                stratum = Collections.unmodifiableList(builder.stratum);
             }
 
             /**
@@ -1842,7 +1874,18 @@ public Builder stratum(Collection<Stratum> stratum) {
                  */
                 @Override
                 public Stratifier build() {
-                    return new Stratifier(this);
+                    Stratifier stratifier = new Stratifier(this);
+                    if (validating) {
+                        validate(stratifier);
+                    }
+                    return stratifier;
+                }
+
+                protected void validate(Stratifier stratifier) {
+                    super.validate(stratifier);
+                    ValidationSupport.checkList(stratifier.code, "code", CodeableConcept.class);
+                    ValidationSupport.checkList(stratifier.stratum, "stratum", Stratum.class);
+                    ValidationSupport.requireValueOrChildren(stratifier);
                 }
 
                 protected Builder from(Stratifier stratifier) {
@@ -1866,10 +1909,9 @@ public static class Stratum extends BackboneElement {
                 private Stratum(Builder builder) {
                     super(builder);
                     value = builder.value;
-                    component = Collections.unmodifiableList(ValidationSupport.checkList(builder.component, "component", Component.class));
-                    population = Collections.unmodifiableList(ValidationSupport.checkList(builder.population, "population", Population.class));
+                    component = Collections.unmodifiableList(builder.component);
+                    population = Collections.unmodifiableList(builder.population);
                     measureScore = builder.measureScore;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -2207,7 +2249,18 @@ public Builder measureScore(Quantity measureScore) {
                      */
                     @Override
                     public Stratum build() {
-                        return new Stratum(this);
+                        Stratum stratum = new Stratum(this);
+                        if (validating) {
+                            validate(stratum);
+                        }
+                        return stratum;
+                    }
+
+                    protected void validate(Stratum stratum) {
+                        super.validate(stratum);
+                        ValidationSupport.checkList(stratum.component, "component", Component.class);
+                        ValidationSupport.checkList(stratum.population, "population", Population.class);
+                        ValidationSupport.requireValueOrChildren(stratum);
                     }
 
                     protected Builder from(Stratum stratum) {
@@ -2231,9 +2284,8 @@ public static class Component extends BackboneElement {
 
                     private Component(Builder builder) {
                         super(builder);
-                        code = ValidationSupport.requireNonNull(builder.code, "code");
-                        value = ValidationSupport.requireNonNull(builder.value, "value");
-                        ValidationSupport.requireValueOrChildren(this);
+                        code = builder.code;
+                        value = builder.value;
                     }
 
                     /**
@@ -2479,7 +2531,18 @@ public Builder value(CodeableConcept value) {
                          */
                         @Override
                         public Component build() {
-                            return new Component(this);
+                            Component component = new Component(this);
+                            if (validating) {
+                                validate(component);
+                            }
+                            return component;
+                        }
+
+                        protected void validate(Component component) {
+                            super.validate(component);
+                            ValidationSupport.requireNonNull(component.code, "code");
+                            ValidationSupport.requireNonNull(component.value, "value");
+                            ValidationSupport.requireValueOrChildren(component);
                         }
 
                         protected Builder from(Component component) {
@@ -2511,8 +2574,6 @@ private Population(Builder builder) {
                         code = builder.code;
                         count = builder.count;
                         subjectResults = builder.subjectResults;
-                        ValidationSupport.checkReferenceType(subjectResults, "subjectResults", "List");
-                        ValidationSupport.requireValueOrChildren(this);
                     }
 
                     /**
@@ -2785,7 +2846,17 @@ public Builder subjectResults(Reference subjectResults) {
                          */
                         @Override
                         public Population build() {
-                            return new Population(this);
+                            Population population = new Population(this);
+                            if (validating) {
+                                validate(population);
+                            }
+                            return population;
+                        }
+
+                        protected void validate(Population population) {
+                            super.validate(population);
+                            ValidationSupport.checkReferenceType(population.subjectResults, "subjectResults", "List");
+                            ValidationSupport.requireValueOrChildren(population);
                         }
 
                         protected Builder from(Population population) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Media.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Media.java
index 6ae89776d3f..45a8cd8aa62 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Media.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Media.java
@@ -154,19 +154,19 @@ public class Media extends DomainResource {
 
     private Media(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        status = builder.status;
         type = builder.type;
         modality = builder.modality;
         view = builder.view;
         subject = builder.subject;
         encounter = builder.encounter;
-        created = ValidationSupport.choiceElement(builder.created, "created", DateTime.class, Period.class);
+        created = builder.created;
         issued = builder.issued;
         operator = builder.operator;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
         bodySite = builder.bodySite;
         deviceName = builder.deviceName;
         device = builder.device;
@@ -174,13 +174,8 @@ private Media(Builder builder) {
         width = builder.width;
         frames = builder.frames;
         duration = builder.duration;
-        content = ValidationSupport.requireNonNull(builder.content, "content");
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "ServiceRequest", "CarePlan");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Practitioner", "PractitionerRole", "Group", "Device", "Specimen", "Location");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(operator, "operator", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "Patient", "Device", "RelatedPerson");
-        ValidationSupport.checkReferenceType(device, "device", "Device", "DeviceMetric", "Device");
+        content = builder.content;
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -1277,7 +1272,28 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public Media build() {
-            return new Media(this);
+            Media media = new Media(this);
+            if (validating) {
+                validate(media);
+            }
+            return media;
+        }
+
+        protected void validate(Media media) {
+            super.validate(media);
+            ValidationSupport.checkList(media.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(media.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(media.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(media.status, "status");
+            ValidationSupport.choiceElement(media.created, "created", DateTime.class, Period.class);
+            ValidationSupport.checkList(media.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.requireNonNull(media.content, "content");
+            ValidationSupport.checkList(media.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(media.basedOn, "basedOn", "ServiceRequest", "CarePlan");
+            ValidationSupport.checkReferenceType(media.subject, "subject", "Patient", "Practitioner", "PractitionerRole", "Group", "Device", "Specimen", "Location");
+            ValidationSupport.checkReferenceType(media.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(media.operator, "operator", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "Patient", "Device", "RelatedPerson");
+            ValidationSupport.checkReferenceType(media.device, "device", "Device", "DeviceMetric", "Device");
         }
 
         protected Builder from(Media media) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Medication.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Medication.java
index 120952b65a4..9575b229a45 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Medication.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Medication.java
@@ -87,15 +87,14 @@ public class Medication extends DomainResource {
 
     private Medication(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         code = builder.code;
         status = builder.status;
         manufacturer = builder.manufacturer;
         form = builder.form;
         amount = builder.amount;
-        ingredient = Collections.unmodifiableList(ValidationSupport.checkList(builder.ingredient, "ingredient", Ingredient.class));
+        ingredient = Collections.unmodifiableList(builder.ingredient);
         batch = builder.batch;
-        ValidationSupport.checkReferenceType(manufacturer, "manufacturer", "Organization");
     }
 
     /**
@@ -670,7 +669,18 @@ public Builder batch(Batch batch) {
          */
         @Override
         public Medication build() {
-            return new Medication(this);
+            Medication medication = new Medication(this);
+            if (validating) {
+                validate(medication);
+            }
+            return medication;
+        }
+
+        protected void validate(Medication medication) {
+            super.validate(medication);
+            ValidationSupport.checkList(medication.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(medication.ingredient, "ingredient", Ingredient.class);
+            ValidationSupport.checkReferenceType(medication.manufacturer, "manufacturer", "Organization");
         }
 
         protected Builder from(Medication medication) {
@@ -700,11 +710,9 @@ public static class Ingredient extends BackboneElement {
 
         private Ingredient(Builder builder) {
             super(builder);
-            item = ValidationSupport.requireChoiceElement(builder.item, "item", CodeableConcept.class, Reference.class);
+            item = builder.item;
             isActive = builder.isActive;
             strength = builder.strength;
-            ValidationSupport.checkReferenceType(item, "item", "Substance", "Medication");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -990,7 +998,18 @@ public Builder strength(Ratio strength) {
              */
             @Override
             public Ingredient build() {
-                return new Ingredient(this);
+                Ingredient ingredient = new Ingredient(this);
+                if (validating) {
+                    validate(ingredient);
+                }
+                return ingredient;
+            }
+
+            protected void validate(Ingredient ingredient) {
+                super.validate(ingredient);
+                ValidationSupport.requireChoiceElement(ingredient.item, "item", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkReferenceType(ingredient.item, "item", "Substance", "Medication");
+                ValidationSupport.requireValueOrChildren(ingredient);
             }
 
             protected Builder from(Ingredient ingredient) {
@@ -1014,7 +1033,6 @@ private Batch(Builder builder) {
             super(builder);
             lotNumber = builder.lotNumber;
             expirationDate = builder.expirationDate;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1250,7 +1268,16 @@ public Builder expirationDate(DateTime expirationDate) {
              */
             @Override
             public Batch build() {
-                return new Batch(this);
+                Batch batch = new Batch(this);
+                if (validating) {
+                    validate(batch);
+                }
+                return batch;
+            }
+
+            protected void validate(Batch batch) {
+                super.validate(batch);
+                ValidationSupport.requireValueOrChildren(batch);
             }
 
             protected Builder from(Batch batch) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationAdministration.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationAdministration.java
index 06ccc3e4ee6..915bcac48da 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationAdministration.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationAdministration.java
@@ -144,33 +144,25 @@ public class MedicationAdministration extends DomainResource {
 
     private MedicationAdministration(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        instantiates = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiates, "instantiates", Uri.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        statusReason = Collections.unmodifiableList(ValidationSupport.checkList(builder.statusReason, "statusReason", CodeableConcept.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        instantiates = Collections.unmodifiableList(builder.instantiates);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        status = builder.status;
+        statusReason = Collections.unmodifiableList(builder.statusReason);
         category = builder.category;
-        medication = ValidationSupport.requireChoiceElement(builder.medication, "medication", CodeableConcept.class, Reference.class);
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        medication = builder.medication;
+        subject = builder.subject;
         context = builder.context;
-        supportingInformation = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInformation, "supportingInformation", Reference.class));
-        effective = ValidationSupport.requireChoiceElement(builder.effective, "effective", DateTime.class, Period.class);
-        performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Performer.class));
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
+        supportingInformation = Collections.unmodifiableList(builder.supportingInformation);
+        effective = builder.effective;
+        performer = Collections.unmodifiableList(builder.performer);
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
         request = builder.request;
-        device = Collections.unmodifiableList(ValidationSupport.checkList(builder.device, "device", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
+        device = Collections.unmodifiableList(builder.device);
+        note = Collections.unmodifiableList(builder.note);
         dosage = builder.dosage;
-        eventHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.eventHistory, "eventHistory", Reference.class));
-        ValidationSupport.checkReferenceType(partOf, "partOf", "MedicationAdministration", "Procedure");
-        ValidationSupport.checkReferenceType(medication, "medication", "Medication");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(context, "context", "Encounter", "EpisodeOfCare");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport");
-        ValidationSupport.checkReferenceType(request, "request", "MedicationRequest");
-        ValidationSupport.checkReferenceType(device, "device", "Device");
-        ValidationSupport.checkReferenceType(eventHistory, "eventHistory", "Provenance");
+        eventHistory = Collections.unmodifiableList(builder.eventHistory);
     }
 
     /**
@@ -1346,7 +1338,38 @@ public Builder eventHistory(Collection<Reference> eventHistory) {
          */
         @Override
         public MedicationAdministration build() {
-            return new MedicationAdministration(this);
+            MedicationAdministration medicationAdministration = new MedicationAdministration(this);
+            if (validating) {
+                validate(medicationAdministration);
+            }
+            return medicationAdministration;
+        }
+
+        protected void validate(MedicationAdministration medicationAdministration) {
+            super.validate(medicationAdministration);
+            ValidationSupport.checkList(medicationAdministration.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(medicationAdministration.instantiates, "instantiates", Uri.class);
+            ValidationSupport.checkList(medicationAdministration.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(medicationAdministration.status, "status");
+            ValidationSupport.checkList(medicationAdministration.statusReason, "statusReason", CodeableConcept.class);
+            ValidationSupport.requireChoiceElement(medicationAdministration.medication, "medication", CodeableConcept.class, Reference.class);
+            ValidationSupport.requireNonNull(medicationAdministration.subject, "subject");
+            ValidationSupport.checkList(medicationAdministration.supportingInformation, "supportingInformation", Reference.class);
+            ValidationSupport.requireChoiceElement(medicationAdministration.effective, "effective", DateTime.class, Period.class);
+            ValidationSupport.checkList(medicationAdministration.performer, "performer", Performer.class);
+            ValidationSupport.checkList(medicationAdministration.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(medicationAdministration.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(medicationAdministration.device, "device", Reference.class);
+            ValidationSupport.checkList(medicationAdministration.note, "note", Annotation.class);
+            ValidationSupport.checkList(medicationAdministration.eventHistory, "eventHistory", Reference.class);
+            ValidationSupport.checkReferenceType(medicationAdministration.partOf, "partOf", "MedicationAdministration", "Procedure");
+            ValidationSupport.checkReferenceType(medicationAdministration.medication, "medication", "Medication");
+            ValidationSupport.checkReferenceType(medicationAdministration.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(medicationAdministration.context, "context", "Encounter", "EpisodeOfCare");
+            ValidationSupport.checkReferenceType(medicationAdministration.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport");
+            ValidationSupport.checkReferenceType(medicationAdministration.request, "request", "MedicationRequest");
+            ValidationSupport.checkReferenceType(medicationAdministration.device, "device", "Device");
+            ValidationSupport.checkReferenceType(medicationAdministration.eventHistory, "eventHistory", "Provenance");
         }
 
         protected Builder from(MedicationAdministration medicationAdministration) {
@@ -1393,9 +1416,7 @@ public static class Performer extends BackboneElement {
         private Performer(Builder builder) {
             super(builder);
             function = builder.function;
-            actor = ValidationSupport.requireNonNull(builder.actor, "actor");
-            ValidationSupport.checkReferenceType(actor, "actor", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson", "Device");
-            ValidationSupport.requireValueOrChildren(this);
+            actor = builder.actor;
         }
 
         /**
@@ -1647,7 +1668,18 @@ public Builder actor(Reference actor) {
              */
             @Override
             public Performer build() {
-                return new Performer(this);
+                Performer performer = new Performer(this);
+                if (validating) {
+                    validate(performer);
+                }
+                return performer;
+            }
+
+            protected void validate(Performer performer) {
+                super.validate(performer);
+                ValidationSupport.requireNonNull(performer.actor, "actor");
+                ValidationSupport.checkReferenceType(performer.actor, "actor", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson", "Device");
+                ValidationSupport.requireValueOrChildren(performer);
             }
 
             protected Builder from(Performer performer) {
@@ -1696,8 +1728,7 @@ private Dosage(Builder builder) {
             route = builder.route;
             method = builder.method;
             dose = builder.dose;
-            rate = ValidationSupport.choiceElement(builder.rate, "rate", Ratio.class, SimpleQuantity.class);
-            ValidationSupport.requireValueOrChildren(this);
+            rate = builder.rate;
         }
 
         /**
@@ -2071,7 +2102,17 @@ public Builder rate(Element rate) {
              */
             @Override
             public Dosage build() {
-                return new Dosage(this);
+                Dosage dosage = new Dosage(this);
+                if (validating) {
+                    validate(dosage);
+                }
+                return dosage;
+            }
+
+            protected void validate(Dosage dosage) {
+                super.validate(dosage);
+                ValidationSupport.choiceElement(dosage.rate, "rate", Ratio.class, SimpleQuantity.class);
+                ValidationSupport.requireValueOrChildren(dosage);
             }
 
             protected Builder from(Dosage dosage) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationDispense.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationDispense.java
index 29a3fc9f53b..8b6b8cc773c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationDispense.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationDispense.java
@@ -146,41 +146,30 @@ public class MedicationDispense extends DomainResource {
 
     private MedicationDispense(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        statusReason = ValidationSupport.choiceElement(builder.statusReason, "statusReason", CodeableConcept.class, Reference.class);
+        identifier = Collections.unmodifiableList(builder.identifier);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        status = builder.status;
+        statusReason = builder.statusReason;
         category = builder.category;
-        medication = ValidationSupport.requireChoiceElement(builder.medication, "medication", CodeableConcept.class, Reference.class);
+        medication = builder.medication;
         subject = builder.subject;
         context = builder.context;
-        supportingInformation = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInformation, "supportingInformation", Reference.class));
-        performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Performer.class));
+        supportingInformation = Collections.unmodifiableList(builder.supportingInformation);
+        performer = Collections.unmodifiableList(builder.performer);
         location = builder.location;
-        authorizingPrescription = Collections.unmodifiableList(ValidationSupport.checkList(builder.authorizingPrescription, "authorizingPrescription", Reference.class));
+        authorizingPrescription = Collections.unmodifiableList(builder.authorizingPrescription);
         type = builder.type;
         quantity = builder.quantity;
         daysSupply = builder.daysSupply;
         whenPrepared = builder.whenPrepared;
         whenHandedOver = builder.whenHandedOver;
         destination = builder.destination;
-        receiver = Collections.unmodifiableList(ValidationSupport.checkList(builder.receiver, "receiver", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        dosageInstruction = Collections.unmodifiableList(ValidationSupport.checkList(builder.dosageInstruction, "dosageInstruction", Dosage.class));
+        receiver = Collections.unmodifiableList(builder.receiver);
+        note = Collections.unmodifiableList(builder.note);
+        dosageInstruction = Collections.unmodifiableList(builder.dosageInstruction);
         substitution = builder.substitution;
-        detectedIssue = Collections.unmodifiableList(ValidationSupport.checkList(builder.detectedIssue, "detectedIssue", Reference.class));
-        eventHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.eventHistory, "eventHistory", Reference.class));
-        ValidationSupport.checkReferenceType(partOf, "partOf", "Procedure");
-        ValidationSupport.checkReferenceType(statusReason, "statusReason", "DetectedIssue");
-        ValidationSupport.checkReferenceType(medication, "medication", "Medication");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(context, "context", "Encounter", "EpisodeOfCare");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(authorizingPrescription, "authorizingPrescription", "MedicationRequest");
-        ValidationSupport.checkReferenceType(destination, "destination", "Location");
-        ValidationSupport.checkReferenceType(receiver, "receiver", "Patient", "Practitioner");
-        ValidationSupport.checkReferenceType(detectedIssue, "detectedIssue", "DetectedIssue");
-        ValidationSupport.checkReferenceType(eventHistory, "eventHistory", "Provenance");
+        detectedIssue = Collections.unmodifiableList(builder.detectedIssue);
+        eventHistory = Collections.unmodifiableList(builder.eventHistory);
     }
 
     /**
@@ -1495,7 +1484,39 @@ public Builder eventHistory(Collection<Reference> eventHistory) {
          */
         @Override
         public MedicationDispense build() {
-            return new MedicationDispense(this);
+            MedicationDispense medicationDispense = new MedicationDispense(this);
+            if (validating) {
+                validate(medicationDispense);
+            }
+            return medicationDispense;
+        }
+
+        protected void validate(MedicationDispense medicationDispense) {
+            super.validate(medicationDispense);
+            ValidationSupport.checkList(medicationDispense.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(medicationDispense.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(medicationDispense.status, "status");
+            ValidationSupport.choiceElement(medicationDispense.statusReason, "statusReason", CodeableConcept.class, Reference.class);
+            ValidationSupport.requireChoiceElement(medicationDispense.medication, "medication", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(medicationDispense.supportingInformation, "supportingInformation", Reference.class);
+            ValidationSupport.checkList(medicationDispense.performer, "performer", Performer.class);
+            ValidationSupport.checkList(medicationDispense.authorizingPrescription, "authorizingPrescription", Reference.class);
+            ValidationSupport.checkList(medicationDispense.receiver, "receiver", Reference.class);
+            ValidationSupport.checkList(medicationDispense.note, "note", Annotation.class);
+            ValidationSupport.checkList(medicationDispense.dosageInstruction, "dosageInstruction", Dosage.class);
+            ValidationSupport.checkList(medicationDispense.detectedIssue, "detectedIssue", Reference.class);
+            ValidationSupport.checkList(medicationDispense.eventHistory, "eventHistory", Reference.class);
+            ValidationSupport.checkReferenceType(medicationDispense.partOf, "partOf", "Procedure");
+            ValidationSupport.checkReferenceType(medicationDispense.statusReason, "statusReason", "DetectedIssue");
+            ValidationSupport.checkReferenceType(medicationDispense.medication, "medication", "Medication");
+            ValidationSupport.checkReferenceType(medicationDispense.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(medicationDispense.context, "context", "Encounter", "EpisodeOfCare");
+            ValidationSupport.checkReferenceType(medicationDispense.location, "location", "Location");
+            ValidationSupport.checkReferenceType(medicationDispense.authorizingPrescription, "authorizingPrescription", "MedicationRequest");
+            ValidationSupport.checkReferenceType(medicationDispense.destination, "destination", "Location");
+            ValidationSupport.checkReferenceType(medicationDispense.receiver, "receiver", "Patient", "Practitioner");
+            ValidationSupport.checkReferenceType(medicationDispense.detectedIssue, "detectedIssue", "DetectedIssue");
+            ValidationSupport.checkReferenceType(medicationDispense.eventHistory, "eventHistory", "Provenance");
         }
 
         protected Builder from(MedicationDispense medicationDispense) {
@@ -1546,9 +1567,7 @@ public static class Performer extends BackboneElement {
         private Performer(Builder builder) {
             super(builder);
             function = builder.function;
-            actor = ValidationSupport.requireNonNull(builder.actor, "actor");
-            ValidationSupport.checkReferenceType(actor, "actor", "Practitioner", "PractitionerRole", "Organization", "Patient", "Device", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
+            actor = builder.actor;
         }
 
         /**
@@ -1803,7 +1822,18 @@ public Builder actor(Reference actor) {
              */
             @Override
             public Performer build() {
-                return new Performer(this);
+                Performer performer = new Performer(this);
+                if (validating) {
+                    validate(performer);
+                }
+                return performer;
+            }
+
+            protected void validate(Performer performer) {
+                super.validate(performer);
+                ValidationSupport.requireNonNull(performer.actor, "actor");
+                ValidationSupport.checkReferenceType(performer.actor, "actor", "Practitioner", "PractitionerRole", "Organization", "Patient", "Device", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(performer);
             }
 
             protected Builder from(Performer performer) {
@@ -1842,12 +1872,10 @@ public static class Substitution extends BackboneElement {
 
         private Substitution(Builder builder) {
             super(builder);
-            wasSubstituted = ValidationSupport.requireNonNull(builder.wasSubstituted, "wasSubstituted");
+            wasSubstituted = builder.wasSubstituted;
             type = builder.type;
-            reason = Collections.unmodifiableList(ValidationSupport.checkList(builder.reason, "reason", CodeableConcept.class));
-            responsibleParty = Collections.unmodifiableList(ValidationSupport.checkList(builder.responsibleParty, "responsibleParty", Reference.class));
-            ValidationSupport.checkReferenceType(responsibleParty, "responsibleParty", "Practitioner", "PractitionerRole");
-            ValidationSupport.requireValueOrChildren(this);
+            reason = Collections.unmodifiableList(builder.reason);
+            responsibleParty = Collections.unmodifiableList(builder.responsibleParty);
         }
 
         /**
@@ -2200,7 +2228,20 @@ public Builder responsibleParty(Collection<Reference> responsibleParty) {
              */
             @Override
             public Substitution build() {
-                return new Substitution(this);
+                Substitution substitution = new Substitution(this);
+                if (validating) {
+                    validate(substitution);
+                }
+                return substitution;
+            }
+
+            protected void validate(Substitution substitution) {
+                super.validate(substitution);
+                ValidationSupport.requireNonNull(substitution.wasSubstituted, "wasSubstituted");
+                ValidationSupport.checkList(substitution.reason, "reason", CodeableConcept.class);
+                ValidationSupport.checkList(substitution.responsibleParty, "responsibleParty", Reference.class);
+                ValidationSupport.checkReferenceType(substitution.responsibleParty, "responsibleParty", "Practitioner", "PractitionerRole");
+                ValidationSupport.requireValueOrChildren(substitution);
             }
 
             protected Builder from(Substitution substitution) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationKnowledge.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationKnowledge.java
index 8d0bb097b1b..a13c7ea0653 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationKnowledge.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationKnowledge.java
@@ -116,26 +116,23 @@ private MedicationKnowledge(Builder builder) {
         manufacturer = builder.manufacturer;
         doseForm = builder.doseForm;
         amount = builder.amount;
-        synonym = Collections.unmodifiableList(ValidationSupport.checkList(builder.synonym, "synonym", String.class));
-        relatedMedicationKnowledge = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedMedicationKnowledge, "relatedMedicationKnowledge", RelatedMedicationKnowledge.class));
-        associatedMedication = Collections.unmodifiableList(ValidationSupport.checkList(builder.associatedMedication, "associatedMedication", Reference.class));
-        productType = Collections.unmodifiableList(ValidationSupport.checkList(builder.productType, "productType", CodeableConcept.class));
-        monograph = Collections.unmodifiableList(ValidationSupport.checkList(builder.monograph, "monograph", Monograph.class));
-        ingredient = Collections.unmodifiableList(ValidationSupport.checkList(builder.ingredient, "ingredient", Ingredient.class));
+        synonym = Collections.unmodifiableList(builder.synonym);
+        relatedMedicationKnowledge = Collections.unmodifiableList(builder.relatedMedicationKnowledge);
+        associatedMedication = Collections.unmodifiableList(builder.associatedMedication);
+        productType = Collections.unmodifiableList(builder.productType);
+        monograph = Collections.unmodifiableList(builder.monograph);
+        ingredient = Collections.unmodifiableList(builder.ingredient);
         preparationInstruction = builder.preparationInstruction;
-        intendedRoute = Collections.unmodifiableList(ValidationSupport.checkList(builder.intendedRoute, "intendedRoute", CodeableConcept.class));
-        cost = Collections.unmodifiableList(ValidationSupport.checkList(builder.cost, "cost", Cost.class));
-        monitoringProgram = Collections.unmodifiableList(ValidationSupport.checkList(builder.monitoringProgram, "monitoringProgram", MonitoringProgram.class));
-        administrationGuidelines = Collections.unmodifiableList(ValidationSupport.checkList(builder.administrationGuidelines, "administrationGuidelines", AdministrationGuidelines.class));
-        medicineClassification = Collections.unmodifiableList(ValidationSupport.checkList(builder.medicineClassification, "medicineClassification", MedicineClassification.class));
+        intendedRoute = Collections.unmodifiableList(builder.intendedRoute);
+        cost = Collections.unmodifiableList(builder.cost);
+        monitoringProgram = Collections.unmodifiableList(builder.monitoringProgram);
+        administrationGuidelines = Collections.unmodifiableList(builder.administrationGuidelines);
+        medicineClassification = Collections.unmodifiableList(builder.medicineClassification);
         packaging = builder.packaging;
-        drugCharacteristic = Collections.unmodifiableList(ValidationSupport.checkList(builder.drugCharacteristic, "drugCharacteristic", DrugCharacteristic.class));
-        contraindication = Collections.unmodifiableList(ValidationSupport.checkList(builder.contraindication, "contraindication", Reference.class));
-        regulatory = Collections.unmodifiableList(ValidationSupport.checkList(builder.regulatory, "regulatory", Regulatory.class));
-        kinetics = Collections.unmodifiableList(ValidationSupport.checkList(builder.kinetics, "kinetics", Kinetics.class));
-        ValidationSupport.checkReferenceType(manufacturer, "manufacturer", "Organization");
-        ValidationSupport.checkReferenceType(associatedMedication, "associatedMedication", "Medication");
-        ValidationSupport.checkReferenceType(contraindication, "contraindication", "DetectedIssue");
+        drugCharacteristic = Collections.unmodifiableList(builder.drugCharacteristic);
+        contraindication = Collections.unmodifiableList(builder.contraindication);
+        regulatory = Collections.unmodifiableList(builder.regulatory);
+        kinetics = Collections.unmodifiableList(builder.kinetics);
     }
 
     /**
@@ -1413,7 +1410,33 @@ public Builder kinetics(Collection<Kinetics> kinetics) {
          */
         @Override
         public MedicationKnowledge build() {
-            return new MedicationKnowledge(this);
+            MedicationKnowledge medicationKnowledge = new MedicationKnowledge(this);
+            if (validating) {
+                validate(medicationKnowledge);
+            }
+            return medicationKnowledge;
+        }
+
+        protected void validate(MedicationKnowledge medicationKnowledge) {
+            super.validate(medicationKnowledge);
+            ValidationSupport.checkList(medicationKnowledge.synonym, "synonym", String.class);
+            ValidationSupport.checkList(medicationKnowledge.relatedMedicationKnowledge, "relatedMedicationKnowledge", RelatedMedicationKnowledge.class);
+            ValidationSupport.checkList(medicationKnowledge.associatedMedication, "associatedMedication", Reference.class);
+            ValidationSupport.checkList(medicationKnowledge.productType, "productType", CodeableConcept.class);
+            ValidationSupport.checkList(medicationKnowledge.monograph, "monograph", Monograph.class);
+            ValidationSupport.checkList(medicationKnowledge.ingredient, "ingredient", Ingredient.class);
+            ValidationSupport.checkList(medicationKnowledge.intendedRoute, "intendedRoute", CodeableConcept.class);
+            ValidationSupport.checkList(medicationKnowledge.cost, "cost", Cost.class);
+            ValidationSupport.checkList(medicationKnowledge.monitoringProgram, "monitoringProgram", MonitoringProgram.class);
+            ValidationSupport.checkList(medicationKnowledge.administrationGuidelines, "administrationGuidelines", AdministrationGuidelines.class);
+            ValidationSupport.checkList(medicationKnowledge.medicineClassification, "medicineClassification", MedicineClassification.class);
+            ValidationSupport.checkList(medicationKnowledge.drugCharacteristic, "drugCharacteristic", DrugCharacteristic.class);
+            ValidationSupport.checkList(medicationKnowledge.contraindication, "contraindication", Reference.class);
+            ValidationSupport.checkList(medicationKnowledge.regulatory, "regulatory", Regulatory.class);
+            ValidationSupport.checkList(medicationKnowledge.kinetics, "kinetics", Kinetics.class);
+            ValidationSupport.checkReferenceType(medicationKnowledge.manufacturer, "manufacturer", "Organization");
+            ValidationSupport.checkReferenceType(medicationKnowledge.associatedMedication, "associatedMedication", "Medication");
+            ValidationSupport.checkReferenceType(medicationKnowledge.contraindication, "contraindication", "DetectedIssue");
         }
 
         protected Builder from(MedicationKnowledge medicationKnowledge) {
@@ -1456,10 +1479,8 @@ public static class RelatedMedicationKnowledge extends BackboneElement {
 
         private RelatedMedicationKnowledge(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            reference = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.reference, "reference", Reference.class));
-            ValidationSupport.checkReferenceType(reference, "reference", "MedicationKnowledge");
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            reference = Collections.unmodifiableList(builder.reference);
         }
 
         /**
@@ -1737,7 +1758,19 @@ public Builder reference(Collection<Reference> reference) {
              */
             @Override
             public RelatedMedicationKnowledge build() {
-                return new RelatedMedicationKnowledge(this);
+                RelatedMedicationKnowledge relatedMedicationKnowledge = new RelatedMedicationKnowledge(this);
+                if (validating) {
+                    validate(relatedMedicationKnowledge);
+                }
+                return relatedMedicationKnowledge;
+            }
+
+            protected void validate(RelatedMedicationKnowledge relatedMedicationKnowledge) {
+                super.validate(relatedMedicationKnowledge);
+                ValidationSupport.requireNonNull(relatedMedicationKnowledge.type, "type");
+                ValidationSupport.checkNonEmptyList(relatedMedicationKnowledge.reference, "reference", Reference.class);
+                ValidationSupport.checkReferenceType(relatedMedicationKnowledge.reference, "reference", "MedicationKnowledge");
+                ValidationSupport.requireValueOrChildren(relatedMedicationKnowledge);
             }
 
             protected Builder from(RelatedMedicationKnowledge relatedMedicationKnowledge) {
@@ -1761,8 +1794,6 @@ private Monograph(Builder builder) {
             super(builder);
             type = builder.type;
             source = builder.source;
-            ValidationSupport.checkReferenceType(source, "source", "DocumentReference", "Media");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2004,7 +2035,17 @@ public Builder source(Reference source) {
              */
             @Override
             public Monograph build() {
-                return new Monograph(this);
+                Monograph monograph = new Monograph(this);
+                if (validating) {
+                    validate(monograph);
+                }
+                return monograph;
+            }
+
+            protected void validate(Monograph monograph) {
+                super.validate(monograph);
+                ValidationSupport.checkReferenceType(monograph.source, "source", "DocumentReference", "Media");
+                ValidationSupport.requireValueOrChildren(monograph);
             }
 
             protected Builder from(Monograph monograph) {
@@ -2029,11 +2070,9 @@ public static class Ingredient extends BackboneElement {
 
         private Ingredient(Builder builder) {
             super(builder);
-            item = ValidationSupport.requireChoiceElement(builder.item, "item", CodeableConcept.class, Reference.class);
+            item = builder.item;
             isActive = builder.isActive;
             strength = builder.strength;
-            ValidationSupport.checkReferenceType(item, "item", "Substance");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2318,7 +2357,18 @@ public Builder strength(Ratio strength) {
              */
             @Override
             public Ingredient build() {
-                return new Ingredient(this);
+                Ingredient ingredient = new Ingredient(this);
+                if (validating) {
+                    validate(ingredient);
+                }
+                return ingredient;
+            }
+
+            protected void validate(Ingredient ingredient) {
+                super.validate(ingredient);
+                ValidationSupport.requireChoiceElement(ingredient.item, "item", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkReferenceType(ingredient.item, "item", "Substance");
+                ValidationSupport.requireValueOrChildren(ingredient);
             }
 
             protected Builder from(Ingredient ingredient) {
@@ -2343,10 +2393,9 @@ public static class Cost extends BackboneElement {
 
         private Cost(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            type = builder.type;
             source = builder.source;
-            cost = ValidationSupport.requireNonNull(builder.cost, "cost");
-            ValidationSupport.requireValueOrChildren(this);
+            cost = builder.cost;
         }
 
         /**
@@ -2623,7 +2672,18 @@ public Builder cost(Money cost) {
              */
             @Override
             public Cost build() {
-                return new Cost(this);
+                Cost cost = new Cost(this);
+                if (validating) {
+                    validate(cost);
+                }
+                return cost;
+            }
+
+            protected void validate(Cost cost) {
+                super.validate(cost);
+                ValidationSupport.requireNonNull(cost.type, "type");
+                ValidationSupport.requireNonNull(cost.cost, "cost");
+                ValidationSupport.requireValueOrChildren(cost);
             }
 
             protected Builder from(Cost cost) {
@@ -2647,7 +2707,6 @@ private MonitoringProgram(Builder builder) {
             super(builder);
             type = builder.type;
             name = builder.name;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2883,7 +2942,16 @@ public Builder name(String name) {
              */
             @Override
             public MonitoringProgram build() {
-                return new MonitoringProgram(this);
+                MonitoringProgram monitoringProgram = new MonitoringProgram(this);
+                if (validating) {
+                    validate(monitoringProgram);
+                }
+                return monitoringProgram;
+            }
+
+            protected void validate(MonitoringProgram monitoringProgram) {
+                super.validate(monitoringProgram);
+                ValidationSupport.requireValueOrChildren(monitoringProgram);
             }
 
             protected Builder from(MonitoringProgram monitoringProgram) {
@@ -2907,11 +2975,9 @@ public static class AdministrationGuidelines extends BackboneElement {
 
         private AdministrationGuidelines(Builder builder) {
             super(builder);
-            dosage = Collections.unmodifiableList(ValidationSupport.checkList(builder.dosage, "dosage", Dosage.class));
-            indication = ValidationSupport.choiceElement(builder.indication, "indication", CodeableConcept.class, Reference.class);
-            patientCharacteristics = Collections.unmodifiableList(ValidationSupport.checkList(builder.patientCharacteristics, "patientCharacteristics", PatientCharacteristics.class));
-            ValidationSupport.checkReferenceType(indication, "indication", "ObservationDefinition");
-            ValidationSupport.requireValueOrChildren(this);
+            dosage = Collections.unmodifiableList(builder.dosage);
+            indication = builder.indication;
+            patientCharacteristics = Collections.unmodifiableList(builder.patientCharacteristics);
         }
 
         /**
@@ -3230,7 +3296,20 @@ public Builder patientCharacteristics(Collection<PatientCharacteristics> patient
              */
             @Override
             public AdministrationGuidelines build() {
-                return new AdministrationGuidelines(this);
+                AdministrationGuidelines administrationGuidelines = new AdministrationGuidelines(this);
+                if (validating) {
+                    validate(administrationGuidelines);
+                }
+                return administrationGuidelines;
+            }
+
+            protected void validate(AdministrationGuidelines administrationGuidelines) {
+                super.validate(administrationGuidelines);
+                ValidationSupport.checkList(administrationGuidelines.dosage, "dosage", Dosage.class);
+                ValidationSupport.choiceElement(administrationGuidelines.indication, "indication", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkList(administrationGuidelines.patientCharacteristics, "patientCharacteristics", PatientCharacteristics.class);
+                ValidationSupport.checkReferenceType(administrationGuidelines.indication, "indication", "ObservationDefinition");
+                ValidationSupport.requireValueOrChildren(administrationGuidelines);
             }
 
             protected Builder from(AdministrationGuidelines administrationGuidelines) {
@@ -3253,9 +3332,8 @@ public static class Dosage extends BackboneElement {
 
             private Dosage(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
-                dosage = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.dosage, "dosage", com.ibm.fhir.model.type.Dosage.class));
-                ValidationSupport.requireValueOrChildren(this);
+                type = builder.type;
+                dosage = Collections.unmodifiableList(builder.dosage);
             }
 
             /**
@@ -3523,7 +3601,18 @@ public Builder dosage(Collection<com.ibm.fhir.model.type.Dosage> dosage) {
                  */
                 @Override
                 public Dosage build() {
-                    return new Dosage(this);
+                    Dosage dosage = new Dosage(this);
+                    if (validating) {
+                        validate(dosage);
+                    }
+                    return dosage;
+                }
+
+                protected void validate(Dosage dosage) {
+                    super.validate(dosage);
+                    ValidationSupport.requireNonNull(dosage.type, "type");
+                    ValidationSupport.checkNonEmptyList(dosage.dosage, "dosage", com.ibm.fhir.model.type.Dosage.class);
+                    ValidationSupport.requireValueOrChildren(dosage);
                 }
 
                 protected Builder from(Dosage dosage) {
@@ -3547,9 +3636,8 @@ public static class PatientCharacteristics extends BackboneElement {
 
             private PatientCharacteristics(Builder builder) {
                 super(builder);
-                characteristic = ValidationSupport.requireChoiceElement(builder.characteristic, "characteristic", CodeableConcept.class, SimpleQuantity.class);
-                value = Collections.unmodifiableList(ValidationSupport.checkList(builder.value, "value", String.class));
-                ValidationSupport.requireValueOrChildren(this);
+                characteristic = builder.characteristic;
+                value = Collections.unmodifiableList(builder.value);
             }
 
             /**
@@ -3818,7 +3906,18 @@ public Builder value(Collection<String> value) {
                  */
                 @Override
                 public PatientCharacteristics build() {
-                    return new PatientCharacteristics(this);
+                    PatientCharacteristics patientCharacteristics = new PatientCharacteristics(this);
+                    if (validating) {
+                        validate(patientCharacteristics);
+                    }
+                    return patientCharacteristics;
+                }
+
+                protected void validate(PatientCharacteristics patientCharacteristics) {
+                    super.validate(patientCharacteristics);
+                    ValidationSupport.requireChoiceElement(patientCharacteristics.characteristic, "characteristic", CodeableConcept.class, SimpleQuantity.class);
+                    ValidationSupport.checkList(patientCharacteristics.value, "value", String.class);
+                    ValidationSupport.requireValueOrChildren(patientCharacteristics);
                 }
 
                 protected Builder from(PatientCharacteristics patientCharacteristics) {
@@ -3841,9 +3940,8 @@ public static class MedicineClassification extends BackboneElement {
 
         private MedicineClassification(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            classification = Collections.unmodifiableList(ValidationSupport.checkList(builder.classification, "classification", CodeableConcept.class));
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            classification = Collections.unmodifiableList(builder.classification);
         }
 
         /**
@@ -4106,7 +4204,18 @@ public Builder classification(Collection<CodeableConcept> classification) {
              */
             @Override
             public MedicineClassification build() {
-                return new MedicineClassification(this);
+                MedicineClassification medicineClassification = new MedicineClassification(this);
+                if (validating) {
+                    validate(medicineClassification);
+                }
+                return medicineClassification;
+            }
+
+            protected void validate(MedicineClassification medicineClassification) {
+                super.validate(medicineClassification);
+                ValidationSupport.requireNonNull(medicineClassification.type, "type");
+                ValidationSupport.checkList(medicineClassification.classification, "classification", CodeableConcept.class);
+                ValidationSupport.requireValueOrChildren(medicineClassification);
             }
 
             protected Builder from(MedicineClassification medicineClassification) {
@@ -4135,7 +4244,6 @@ private Packaging(Builder builder) {
             super(builder);
             type = builder.type;
             quantity = builder.quantity;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -4373,7 +4481,16 @@ public Builder quantity(SimpleQuantity quantity) {
              */
             @Override
             public Packaging build() {
-                return new Packaging(this);
+                Packaging packaging = new Packaging(this);
+                if (validating) {
+                    validate(packaging);
+                }
+                return packaging;
+            }
+
+            protected void validate(Packaging packaging) {
+                super.validate(packaging);
+                ValidationSupport.requireValueOrChildren(packaging);
             }
 
             protected Builder from(Packaging packaging) {
@@ -4402,8 +4519,7 @@ public static class DrugCharacteristic extends BackboneElement {
         private DrugCharacteristic(Builder builder) {
             super(builder);
             type = builder.type;
-            value = ValidationSupport.choiceElement(builder.value, "value", CodeableConcept.class, String.class, SimpleQuantity.class, Base64Binary.class);
-            ValidationSupport.requireValueOrChildren(this);
+            value = builder.value;
         }
 
         /**
@@ -4647,7 +4763,17 @@ public Builder value(Element value) {
              */
             @Override
             public DrugCharacteristic build() {
-                return new DrugCharacteristic(this);
+                DrugCharacteristic drugCharacteristic = new DrugCharacteristic(this);
+                if (validating) {
+                    validate(drugCharacteristic);
+                }
+                return drugCharacteristic;
+            }
+
+            protected void validate(DrugCharacteristic drugCharacteristic) {
+                super.validate(drugCharacteristic);
+                ValidationSupport.choiceElement(drugCharacteristic.value, "value", CodeableConcept.class, String.class, SimpleQuantity.class, Base64Binary.class);
+                ValidationSupport.requireValueOrChildren(drugCharacteristic);
             }
 
             protected Builder from(DrugCharacteristic drugCharacteristic) {
@@ -4672,12 +4798,10 @@ public static class Regulatory extends BackboneElement {
 
         private Regulatory(Builder builder) {
             super(builder);
-            regulatoryAuthority = ValidationSupport.requireNonNull(builder.regulatoryAuthority, "regulatoryAuthority");
-            substitution = Collections.unmodifiableList(ValidationSupport.checkList(builder.substitution, "substitution", Substitution.class));
-            schedule = Collections.unmodifiableList(ValidationSupport.checkList(builder.schedule, "schedule", Schedule.class));
+            regulatoryAuthority = builder.regulatoryAuthority;
+            substitution = Collections.unmodifiableList(builder.substitution);
+            schedule = Collections.unmodifiableList(builder.schedule);
             maxDispense = builder.maxDispense;
-            ValidationSupport.checkReferenceType(regulatoryAuthority, "regulatoryAuthority", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -5023,7 +5147,20 @@ public Builder maxDispense(MaxDispense maxDispense) {
              */
             @Override
             public Regulatory build() {
-                return new Regulatory(this);
+                Regulatory regulatory = new Regulatory(this);
+                if (validating) {
+                    validate(regulatory);
+                }
+                return regulatory;
+            }
+
+            protected void validate(Regulatory regulatory) {
+                super.validate(regulatory);
+                ValidationSupport.requireNonNull(regulatory.regulatoryAuthority, "regulatoryAuthority");
+                ValidationSupport.checkList(regulatory.substitution, "substitution", Substitution.class);
+                ValidationSupport.checkList(regulatory.schedule, "schedule", Schedule.class);
+                ValidationSupport.checkReferenceType(regulatory.regulatoryAuthority, "regulatoryAuthority", "Organization");
+                ValidationSupport.requireValueOrChildren(regulatory);
             }
 
             protected Builder from(Regulatory regulatory) {
@@ -5047,9 +5184,8 @@ public static class Substitution extends BackboneElement {
 
             private Substitution(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
-                allowed = ValidationSupport.requireNonNull(builder.allowed, "allowed");
-                ValidationSupport.requireValueOrChildren(this);
+                type = builder.type;
+                allowed = builder.allowed;
             }
 
             /**
@@ -5295,7 +5431,18 @@ public Builder allowed(Boolean allowed) {
                  */
                 @Override
                 public Substitution build() {
-                    return new Substitution(this);
+                    Substitution substitution = new Substitution(this);
+                    if (validating) {
+                        validate(substitution);
+                    }
+                    return substitution;
+                }
+
+                protected void validate(Substitution substitution) {
+                    super.validate(substitution);
+                    ValidationSupport.requireNonNull(substitution.type, "type");
+                    ValidationSupport.requireNonNull(substitution.allowed, "allowed");
+                    ValidationSupport.requireValueOrChildren(substitution);
                 }
 
                 protected Builder from(Substitution substitution) {
@@ -5316,8 +5463,7 @@ public static class Schedule extends BackboneElement {
 
             private Schedule(Builder builder) {
                 super(builder);
-                schedule = ValidationSupport.requireNonNull(builder.schedule, "schedule");
-                ValidationSupport.requireValueOrChildren(this);
+                schedule = builder.schedule;
             }
 
             /**
@@ -5531,7 +5677,17 @@ public Builder schedule(CodeableConcept schedule) {
                  */
                 @Override
                 public Schedule build() {
-                    return new Schedule(this);
+                    Schedule schedule = new Schedule(this);
+                    if (validating) {
+                        validate(schedule);
+                    }
+                    return schedule;
+                }
+
+                protected void validate(Schedule schedule) {
+                    super.validate(schedule);
+                    ValidationSupport.requireNonNull(schedule.schedule, "schedule");
+                    ValidationSupport.requireValueOrChildren(schedule);
                 }
 
                 protected Builder from(Schedule schedule) {
@@ -5552,9 +5708,8 @@ public static class MaxDispense extends BackboneElement {
 
             private MaxDispense(Builder builder) {
                 super(builder);
-                quantity = ValidationSupport.requireNonNull(builder.quantity, "quantity");
+                quantity = builder.quantity;
                 period = builder.period;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -5797,7 +5952,17 @@ public Builder period(Duration period) {
                  */
                 @Override
                 public MaxDispense build() {
-                    return new MaxDispense(this);
+                    MaxDispense maxDispense = new MaxDispense(this);
+                    if (validating) {
+                        validate(maxDispense);
+                    }
+                    return maxDispense;
+                }
+
+                protected void validate(MaxDispense maxDispense) {
+                    super.validate(maxDispense);
+                    ValidationSupport.requireNonNull(maxDispense.quantity, "quantity");
+                    ValidationSupport.requireValueOrChildren(maxDispense);
                 }
 
                 protected Builder from(MaxDispense maxDispense) {
@@ -5820,10 +5985,9 @@ public static class Kinetics extends BackboneElement {
 
         private Kinetics(Builder builder) {
             super(builder);
-            areaUnderCurve = Collections.unmodifiableList(ValidationSupport.checkList(builder.areaUnderCurve, "areaUnderCurve", SimpleQuantity.class));
-            lethalDose50 = Collections.unmodifiableList(ValidationSupport.checkList(builder.lethalDose50, "lethalDose50", SimpleQuantity.class));
+            areaUnderCurve = Collections.unmodifiableList(builder.areaUnderCurve);
+            lethalDose50 = Collections.unmodifiableList(builder.lethalDose50);
             halfLifePeriod = builder.halfLifePeriod;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -6128,7 +6292,18 @@ public Builder halfLifePeriod(Duration halfLifePeriod) {
              */
             @Override
             public Kinetics build() {
-                return new Kinetics(this);
+                Kinetics kinetics = new Kinetics(this);
+                if (validating) {
+                    validate(kinetics);
+                }
+                return kinetics;
+            }
+
+            protected void validate(Kinetics kinetics) {
+                super.validate(kinetics);
+                ValidationSupport.checkList(kinetics.areaUnderCurve, "areaUnderCurve", SimpleQuantity.class);
+                ValidationSupport.checkList(kinetics.lethalDose50, "lethalDose50", SimpleQuantity.class);
+                ValidationSupport.requireValueOrChildren(kinetics);
             }
 
             protected Builder from(Kinetics kinetics) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationRequest.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationRequest.java
index b2289a5e664..61dc369c7b0 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationRequest.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationRequest.java
@@ -183,51 +183,38 @@ public class MedicationRequest extends DomainResource {
 
     private MedicationRequest(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         statusReason = builder.statusReason;
-        intent = ValidationSupport.requireNonNull(builder.intent, "intent");
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        intent = builder.intent;
+        category = Collections.unmodifiableList(builder.category);
         priority = builder.priority;
         doNotPerform = builder.doNotPerform;
-        reported = ValidationSupport.choiceElement(builder.reported, "reported", Boolean.class, Reference.class);
-        medication = ValidationSupport.requireChoiceElement(builder.medication, "medication", CodeableConcept.class, Reference.class);
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        reported = builder.reported;
+        medication = builder.medication;
+        subject = builder.subject;
         encounter = builder.encounter;
-        supportingInformation = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInformation, "supportingInformation", Reference.class));
+        supportingInformation = Collections.unmodifiableList(builder.supportingInformation);
         authoredOn = builder.authoredOn;
         requester = builder.requester;
         performer = builder.performer;
         performerType = builder.performerType;
         recorder = builder.recorder;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-        instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+        instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
         groupIdentifier = builder.groupIdentifier;
         courseOfTherapyType = builder.courseOfTherapyType;
-        insurance = Collections.unmodifiableList(ValidationSupport.checkList(builder.insurance, "insurance", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        dosageInstruction = Collections.unmodifiableList(ValidationSupport.checkList(builder.dosageInstruction, "dosageInstruction", Dosage.class));
+        insurance = Collections.unmodifiableList(builder.insurance);
+        note = Collections.unmodifiableList(builder.note);
+        dosageInstruction = Collections.unmodifiableList(builder.dosageInstruction);
         dispenseRequest = builder.dispenseRequest;
         substitution = builder.substitution;
         priorPrescription = builder.priorPrescription;
-        detectedIssue = Collections.unmodifiableList(ValidationSupport.checkList(builder.detectedIssue, "detectedIssue", Reference.class));
-        eventHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.eventHistory, "eventHistory", Reference.class));
-        ValidationSupport.checkReferenceType(reported, "reported", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Organization");
-        ValidationSupport.checkReferenceType(medication, "medication", "Medication");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(requester, "requester", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
-        ValidationSupport.checkReferenceType(performer, "performer", "Practitioner", "PractitionerRole", "Organization", "Patient", "Device", "RelatedPerson", "CareTeam");
-        ValidationSupport.checkReferenceType(recorder, "recorder", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation");
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "CarePlan", "MedicationRequest", "ServiceRequest", "ImmunizationRecommendation");
-        ValidationSupport.checkReferenceType(insurance, "insurance", "Coverage", "ClaimResponse");
-        ValidationSupport.checkReferenceType(priorPrescription, "priorPrescription", "MedicationRequest");
-        ValidationSupport.checkReferenceType(detectedIssue, "detectedIssue", "DetectedIssue");
-        ValidationSupport.checkReferenceType(eventHistory, "eventHistory", "Provenance");
+        detectedIssue = Collections.unmodifiableList(builder.detectedIssue);
+        eventHistory = Collections.unmodifiableList(builder.eventHistory);
     }
 
     /**
@@ -1898,7 +1885,46 @@ public Builder eventHistory(Collection<Reference> eventHistory) {
          */
         @Override
         public MedicationRequest build() {
-            return new MedicationRequest(this);
+            MedicationRequest medicationRequest = new MedicationRequest(this);
+            if (validating) {
+                validate(medicationRequest);
+            }
+            return medicationRequest;
+        }
+
+        protected void validate(MedicationRequest medicationRequest) {
+            super.validate(medicationRequest);
+            ValidationSupport.checkList(medicationRequest.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(medicationRequest.status, "status");
+            ValidationSupport.requireNonNull(medicationRequest.intent, "intent");
+            ValidationSupport.checkList(medicationRequest.category, "category", CodeableConcept.class);
+            ValidationSupport.choiceElement(medicationRequest.reported, "reported", Boolean.class, Reference.class);
+            ValidationSupport.requireChoiceElement(medicationRequest.medication, "medication", CodeableConcept.class, Reference.class);
+            ValidationSupport.requireNonNull(medicationRequest.subject, "subject");
+            ValidationSupport.checkList(medicationRequest.supportingInformation, "supportingInformation", Reference.class);
+            ValidationSupport.checkList(medicationRequest.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(medicationRequest.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(medicationRequest.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+            ValidationSupport.checkList(medicationRequest.instantiatesUri, "instantiatesUri", Uri.class);
+            ValidationSupport.checkList(medicationRequest.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(medicationRequest.insurance, "insurance", Reference.class);
+            ValidationSupport.checkList(medicationRequest.note, "note", Annotation.class);
+            ValidationSupport.checkList(medicationRequest.dosageInstruction, "dosageInstruction", Dosage.class);
+            ValidationSupport.checkList(medicationRequest.detectedIssue, "detectedIssue", Reference.class);
+            ValidationSupport.checkList(medicationRequest.eventHistory, "eventHistory", Reference.class);
+            ValidationSupport.checkReferenceType(medicationRequest.reported, "reported", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Organization");
+            ValidationSupport.checkReferenceType(medicationRequest.medication, "medication", "Medication");
+            ValidationSupport.checkReferenceType(medicationRequest.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(medicationRequest.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(medicationRequest.requester, "requester", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
+            ValidationSupport.checkReferenceType(medicationRequest.performer, "performer", "Practitioner", "PractitionerRole", "Organization", "Patient", "Device", "RelatedPerson", "CareTeam");
+            ValidationSupport.checkReferenceType(medicationRequest.recorder, "recorder", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(medicationRequest.reasonReference, "reasonReference", "Condition", "Observation");
+            ValidationSupport.checkReferenceType(medicationRequest.basedOn, "basedOn", "CarePlan", "MedicationRequest", "ServiceRequest", "ImmunizationRecommendation");
+            ValidationSupport.checkReferenceType(medicationRequest.insurance, "insurance", "Coverage", "ClaimResponse");
+            ValidationSupport.checkReferenceType(medicationRequest.priorPrescription, "priorPrescription", "MedicationRequest");
+            ValidationSupport.checkReferenceType(medicationRequest.detectedIssue, "detectedIssue", "DetectedIssue");
+            ValidationSupport.checkReferenceType(medicationRequest.eventHistory, "eventHistory", "Provenance");
         }
 
         protected Builder from(MedicationRequest medicationRequest) {
@@ -1964,8 +1990,6 @@ private DispenseRequest(Builder builder) {
             quantity = builder.quantity;
             expectedSupplyDuration = builder.expectedSupplyDuration;
             performer = builder.performer;
-            ValidationSupport.checkReferenceType(performer, "performer", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2361,7 +2385,17 @@ public Builder performer(Reference performer) {
              */
             @Override
             public DispenseRequest build() {
-                return new DispenseRequest(this);
+                DispenseRequest dispenseRequest = new DispenseRequest(this);
+                if (validating) {
+                    validate(dispenseRequest);
+                }
+                return dispenseRequest;
+            }
+
+            protected void validate(DispenseRequest dispenseRequest) {
+                super.validate(dispenseRequest);
+                ValidationSupport.checkReferenceType(dispenseRequest.performer, "performer", "Organization");
+                ValidationSupport.requireValueOrChildren(dispenseRequest);
             }
 
             protected Builder from(DispenseRequest dispenseRequest) {
@@ -2388,7 +2422,6 @@ private InitialFill(Builder builder) {
                 super(builder);
                 quantity = builder.quantity;
                 duration = builder.duration;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2624,7 +2657,16 @@ public Builder duration(Duration duration) {
                  */
                 @Override
                 public InitialFill build() {
-                    return new InitialFill(this);
+                    InitialFill initialFill = new InitialFill(this);
+                    if (validating) {
+                        validate(initialFill);
+                    }
+                    return initialFill;
+                }
+
+                protected void validate(InitialFill initialFill) {
+                    super.validate(initialFill);
+                    ValidationSupport.requireValueOrChildren(initialFill);
                 }
 
                 protected Builder from(InitialFill initialFill) {
@@ -2662,9 +2704,8 @@ public static class Substitution extends BackboneElement {
 
         private Substitution(Builder builder) {
             super(builder);
-            allowed = ValidationSupport.requireChoiceElement(builder.allowed, "allowed", Boolean.class, CodeableConcept.class);
+            allowed = builder.allowed;
             reason = builder.reason;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2913,7 +2954,17 @@ public Builder reason(CodeableConcept reason) {
              */
             @Override
             public Substitution build() {
-                return new Substitution(this);
+                Substitution substitution = new Substitution(this);
+                if (validating) {
+                    validate(substitution);
+                }
+                return substitution;
+            }
+
+            protected void validate(Substitution substitution) {
+                super.validate(substitution);
+                ValidationSupport.requireChoiceElement(substitution.allowed, "allowed", Boolean.class, CodeableConcept.class);
+                ValidationSupport.requireValueOrChildren(substitution);
             }
 
             protected Builder from(Substitution substitution) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationStatement.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationStatement.java
index 2e260a3712d..6b02802a4da 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationStatement.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicationStatement.java
@@ -145,30 +145,23 @@ public class MedicationStatement extends DomainResource {
 
     private MedicationStatement(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        statusReason = Collections.unmodifiableList(ValidationSupport.checkList(builder.statusReason, "statusReason", CodeableConcept.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        status = builder.status;
+        statusReason = Collections.unmodifiableList(builder.statusReason);
         category = builder.category;
-        medication = ValidationSupport.requireChoiceElement(builder.medication, "medication", CodeableConcept.class, Reference.class);
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        medication = builder.medication;
+        subject = builder.subject;
         context = builder.context;
-        effective = ValidationSupport.choiceElement(builder.effective, "effective", DateTime.class, Period.class);
+        effective = builder.effective;
         dateAsserted = builder.dateAsserted;
         informationSource = builder.informationSource;
-        derivedFrom = Collections.unmodifiableList(ValidationSupport.checkList(builder.derivedFrom, "derivedFrom", Reference.class));
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        dosage = Collections.unmodifiableList(ValidationSupport.checkList(builder.dosage, "dosage", Dosage.class));
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "MedicationRequest", "CarePlan", "ServiceRequest");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "MedicationAdministration", "MedicationDispense", "MedicationStatement", "Procedure", "Observation");
-        ValidationSupport.checkReferenceType(medication, "medication", "Medication");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(context, "context", "Encounter", "EpisodeOfCare");
-        ValidationSupport.checkReferenceType(informationSource, "informationSource", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Organization");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport");
+        derivedFrom = Collections.unmodifiableList(builder.derivedFrom);
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        note = Collections.unmodifiableList(builder.note);
+        dosage = Collections.unmodifiableList(builder.dosage);
     }
 
     /**
@@ -1246,7 +1239,35 @@ public Builder dosage(Collection<Dosage> dosage) {
          */
         @Override
         public MedicationStatement build() {
-            return new MedicationStatement(this);
+            MedicationStatement medicationStatement = new MedicationStatement(this);
+            if (validating) {
+                validate(medicationStatement);
+            }
+            return medicationStatement;
+        }
+
+        protected void validate(MedicationStatement medicationStatement) {
+            super.validate(medicationStatement);
+            ValidationSupport.checkList(medicationStatement.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(medicationStatement.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(medicationStatement.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(medicationStatement.status, "status");
+            ValidationSupport.checkList(medicationStatement.statusReason, "statusReason", CodeableConcept.class);
+            ValidationSupport.requireChoiceElement(medicationStatement.medication, "medication", CodeableConcept.class, Reference.class);
+            ValidationSupport.requireNonNull(medicationStatement.subject, "subject");
+            ValidationSupport.choiceElement(medicationStatement.effective, "effective", DateTime.class, Period.class);
+            ValidationSupport.checkList(medicationStatement.derivedFrom, "derivedFrom", Reference.class);
+            ValidationSupport.checkList(medicationStatement.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(medicationStatement.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(medicationStatement.note, "note", Annotation.class);
+            ValidationSupport.checkList(medicationStatement.dosage, "dosage", Dosage.class);
+            ValidationSupport.checkReferenceType(medicationStatement.basedOn, "basedOn", "MedicationRequest", "CarePlan", "ServiceRequest");
+            ValidationSupport.checkReferenceType(medicationStatement.partOf, "partOf", "MedicationAdministration", "MedicationDispense", "MedicationStatement", "Procedure", "Observation");
+            ValidationSupport.checkReferenceType(medicationStatement.medication, "medication", "Medication");
+            ValidationSupport.checkReferenceType(medicationStatement.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(medicationStatement.context, "context", "Encounter", "EpisodeOfCare");
+            ValidationSupport.checkReferenceType(medicationStatement.informationSource, "informationSource", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Organization");
+            ValidationSupport.checkReferenceType(medicationStatement.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport");
         }
 
         protected Builder from(MedicationStatement medicationStatement) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProduct.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProduct.java
index 6f77df17149..26fa5444e4c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProduct.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProduct.java
@@ -98,32 +98,26 @@ public class MedicinalProduct extends DomainResource {
 
     private MedicinalProduct(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         type = builder.type;
         domain = builder.domain;
         combinedPharmaceuticalDoseForm = builder.combinedPharmaceuticalDoseForm;
         legalStatusOfSupply = builder.legalStatusOfSupply;
         additionalMonitoringIndicator = builder.additionalMonitoringIndicator;
-        specialMeasures = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialMeasures, "specialMeasures", String.class));
+        specialMeasures = Collections.unmodifiableList(builder.specialMeasures);
         paediatricUseIndicator = builder.paediatricUseIndicator;
-        productClassification = Collections.unmodifiableList(ValidationSupport.checkList(builder.productClassification, "productClassification", CodeableConcept.class));
-        marketingStatus = Collections.unmodifiableList(ValidationSupport.checkList(builder.marketingStatus, "marketingStatus", MarketingStatus.class));
-        pharmaceuticalProduct = Collections.unmodifiableList(ValidationSupport.checkList(builder.pharmaceuticalProduct, "pharmaceuticalProduct", Reference.class));
-        packagedMedicinalProduct = Collections.unmodifiableList(ValidationSupport.checkList(builder.packagedMedicinalProduct, "packagedMedicinalProduct", Reference.class));
-        attachedDocument = Collections.unmodifiableList(ValidationSupport.checkList(builder.attachedDocument, "attachedDocument", Reference.class));
-        masterFile = Collections.unmodifiableList(ValidationSupport.checkList(builder.masterFile, "masterFile", Reference.class));
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", Reference.class));
-        clinicalTrial = Collections.unmodifiableList(ValidationSupport.checkList(builder.clinicalTrial, "clinicalTrial", Reference.class));
-        name = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.name, "name", Name.class));
-        crossReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.crossReference, "crossReference", Identifier.class));
-        manufacturingBusinessOperation = Collections.unmodifiableList(ValidationSupport.checkList(builder.manufacturingBusinessOperation, "manufacturingBusinessOperation", ManufacturingBusinessOperation.class));
-        specialDesignation = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialDesignation, "specialDesignation", SpecialDesignation.class));
-        ValidationSupport.checkReferenceType(pharmaceuticalProduct, "pharmaceuticalProduct", "MedicinalProductPharmaceutical");
-        ValidationSupport.checkReferenceType(packagedMedicinalProduct, "packagedMedicinalProduct", "MedicinalProductPackaged");
-        ValidationSupport.checkReferenceType(attachedDocument, "attachedDocument", "DocumentReference");
-        ValidationSupport.checkReferenceType(masterFile, "masterFile", "DocumentReference");
-        ValidationSupport.checkReferenceType(contact, "contact", "Organization", "PractitionerRole");
-        ValidationSupport.checkReferenceType(clinicalTrial, "clinicalTrial", "ResearchStudy");
+        productClassification = Collections.unmodifiableList(builder.productClassification);
+        marketingStatus = Collections.unmodifiableList(builder.marketingStatus);
+        pharmaceuticalProduct = Collections.unmodifiableList(builder.pharmaceuticalProduct);
+        packagedMedicinalProduct = Collections.unmodifiableList(builder.packagedMedicinalProduct);
+        attachedDocument = Collections.unmodifiableList(builder.attachedDocument);
+        masterFile = Collections.unmodifiableList(builder.masterFile);
+        contact = Collections.unmodifiableList(builder.contact);
+        clinicalTrial = Collections.unmodifiableList(builder.clinicalTrial);
+        name = Collections.unmodifiableList(builder.name);
+        crossReference = Collections.unmodifiableList(builder.crossReference);
+        manufacturingBusinessOperation = Collections.unmodifiableList(builder.manufacturingBusinessOperation);
+        specialDesignation = Collections.unmodifiableList(builder.specialDesignation);
     }
 
     /**
@@ -1342,7 +1336,35 @@ public Builder specialDesignation(Collection<SpecialDesignation> specialDesignat
          */
         @Override
         public MedicinalProduct build() {
-            return new MedicinalProduct(this);
+            MedicinalProduct medicinalProduct = new MedicinalProduct(this);
+            if (validating) {
+                validate(medicinalProduct);
+            }
+            return medicinalProduct;
+        }
+
+        protected void validate(MedicinalProduct medicinalProduct) {
+            super.validate(medicinalProduct);
+            ValidationSupport.checkList(medicinalProduct.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(medicinalProduct.specialMeasures, "specialMeasures", String.class);
+            ValidationSupport.checkList(medicinalProduct.productClassification, "productClassification", CodeableConcept.class);
+            ValidationSupport.checkList(medicinalProduct.marketingStatus, "marketingStatus", MarketingStatus.class);
+            ValidationSupport.checkList(medicinalProduct.pharmaceuticalProduct, "pharmaceuticalProduct", Reference.class);
+            ValidationSupport.checkList(medicinalProduct.packagedMedicinalProduct, "packagedMedicinalProduct", Reference.class);
+            ValidationSupport.checkList(medicinalProduct.attachedDocument, "attachedDocument", Reference.class);
+            ValidationSupport.checkList(medicinalProduct.masterFile, "masterFile", Reference.class);
+            ValidationSupport.checkList(medicinalProduct.contact, "contact", Reference.class);
+            ValidationSupport.checkList(medicinalProduct.clinicalTrial, "clinicalTrial", Reference.class);
+            ValidationSupport.checkNonEmptyList(medicinalProduct.name, "name", Name.class);
+            ValidationSupport.checkList(medicinalProduct.crossReference, "crossReference", Identifier.class);
+            ValidationSupport.checkList(medicinalProduct.manufacturingBusinessOperation, "manufacturingBusinessOperation", ManufacturingBusinessOperation.class);
+            ValidationSupport.checkList(medicinalProduct.specialDesignation, "specialDesignation", SpecialDesignation.class);
+            ValidationSupport.checkReferenceType(medicinalProduct.pharmaceuticalProduct, "pharmaceuticalProduct", "MedicinalProductPharmaceutical");
+            ValidationSupport.checkReferenceType(medicinalProduct.packagedMedicinalProduct, "packagedMedicinalProduct", "MedicinalProductPackaged");
+            ValidationSupport.checkReferenceType(medicinalProduct.attachedDocument, "attachedDocument", "DocumentReference");
+            ValidationSupport.checkReferenceType(medicinalProduct.masterFile, "masterFile", "DocumentReference");
+            ValidationSupport.checkReferenceType(medicinalProduct.contact, "contact", "Organization", "PractitionerRole");
+            ValidationSupport.checkReferenceType(medicinalProduct.clinicalTrial, "clinicalTrial", "ResearchStudy");
         }
 
         protected Builder from(MedicinalProduct medicinalProduct) {
@@ -1385,10 +1407,9 @@ public static class Name extends BackboneElement {
 
         private Name(Builder builder) {
             super(builder);
-            productName = ValidationSupport.requireNonNull(builder.productName, "productName");
-            namePart = Collections.unmodifiableList(ValidationSupport.checkList(builder.namePart, "namePart", NamePart.class));
-            countryLanguage = Collections.unmodifiableList(ValidationSupport.checkList(builder.countryLanguage, "countryLanguage", CountryLanguage.class));
-            ValidationSupport.requireValueOrChildren(this);
+            productName = builder.productName;
+            namePart = Collections.unmodifiableList(builder.namePart);
+            countryLanguage = Collections.unmodifiableList(builder.countryLanguage);
         }
 
         /**
@@ -1700,7 +1721,19 @@ public Builder countryLanguage(Collection<CountryLanguage> countryLanguage) {
              */
             @Override
             public Name build() {
-                return new Name(this);
+                Name name = new Name(this);
+                if (validating) {
+                    validate(name);
+                }
+                return name;
+            }
+
+            protected void validate(Name name) {
+                super.validate(name);
+                ValidationSupport.requireNonNull(name.productName, "productName");
+                ValidationSupport.checkList(name.namePart, "namePart", NamePart.class);
+                ValidationSupport.checkList(name.countryLanguage, "countryLanguage", CountryLanguage.class);
+                ValidationSupport.requireValueOrChildren(name);
             }
 
             protected Builder from(Name name) {
@@ -1725,9 +1758,8 @@ public static class NamePart extends BackboneElement {
 
             private NamePart(Builder builder) {
                 super(builder);
-                part = ValidationSupport.requireNonNull(builder.part, "part");
-                type = ValidationSupport.requireNonNull(builder.type, "type");
-                ValidationSupport.requireValueOrChildren(this);
+                part = builder.part;
+                type = builder.type;
             }
 
             /**
@@ -1973,7 +2005,18 @@ public Builder type(Coding type) {
                  */
                 @Override
                 public NamePart build() {
-                    return new NamePart(this);
+                    NamePart namePart = new NamePart(this);
+                    if (validating) {
+                        validate(namePart);
+                    }
+                    return namePart;
+                }
+
+                protected void validate(NamePart namePart) {
+                    super.validate(namePart);
+                    ValidationSupport.requireNonNull(namePart.part, "part");
+                    ValidationSupport.requireNonNull(namePart.type, "type");
+                    ValidationSupport.requireValueOrChildren(namePart);
                 }
 
                 protected Builder from(NamePart namePart) {
@@ -2000,10 +2043,9 @@ public static class CountryLanguage extends BackboneElement {
 
             private CountryLanguage(Builder builder) {
                 super(builder);
-                country = ValidationSupport.requireNonNull(builder.country, "country");
+                country = builder.country;
                 jurisdiction = builder.jurisdiction;
-                language = ValidationSupport.requireNonNull(builder.language, "language");
-                ValidationSupport.requireValueOrChildren(this);
+                language = builder.language;
             }
 
             /**
@@ -2278,7 +2320,18 @@ public Builder language(CodeableConcept language) {
                  */
                 @Override
                 public CountryLanguage build() {
-                    return new CountryLanguage(this);
+                    CountryLanguage countryLanguage = new CountryLanguage(this);
+                    if (validating) {
+                        validate(countryLanguage);
+                    }
+                    return countryLanguage;
+                }
+
+                protected void validate(CountryLanguage countryLanguage) {
+                    super.validate(countryLanguage);
+                    ValidationSupport.requireNonNull(countryLanguage.country, "country");
+                    ValidationSupport.requireNonNull(countryLanguage.language, "language");
+                    ValidationSupport.requireValueOrChildren(countryLanguage);
                 }
 
                 protected Builder from(CountryLanguage countryLanguage) {
@@ -2317,11 +2370,8 @@ private ManufacturingBusinessOperation(Builder builder) {
             authorisationReferenceNumber = builder.authorisationReferenceNumber;
             effectiveDate = builder.effectiveDate;
             confidentialityIndicator = builder.confidentialityIndicator;
-            manufacturer = Collections.unmodifiableList(ValidationSupport.checkList(builder.manufacturer, "manufacturer", Reference.class));
+            manufacturer = Collections.unmodifiableList(builder.manufacturer);
             regulator = builder.regulator;
-            ValidationSupport.checkReferenceType(manufacturer, "manufacturer", "Organization");
-            ValidationSupport.checkReferenceType(regulator, "regulator", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2708,7 +2758,19 @@ public Builder regulator(Reference regulator) {
              */
             @Override
             public ManufacturingBusinessOperation build() {
-                return new ManufacturingBusinessOperation(this);
+                ManufacturingBusinessOperation manufacturingBusinessOperation = new ManufacturingBusinessOperation(this);
+                if (validating) {
+                    validate(manufacturingBusinessOperation);
+                }
+                return manufacturingBusinessOperation;
+            }
+
+            protected void validate(ManufacturingBusinessOperation manufacturingBusinessOperation) {
+                super.validate(manufacturingBusinessOperation);
+                ValidationSupport.checkList(manufacturingBusinessOperation.manufacturer, "manufacturer", Reference.class);
+                ValidationSupport.checkReferenceType(manufacturingBusinessOperation.manufacturer, "manufacturer", "Organization");
+                ValidationSupport.checkReferenceType(manufacturingBusinessOperation.regulator, "regulator", "Organization");
+                ValidationSupport.requireValueOrChildren(manufacturingBusinessOperation);
             }
 
             protected Builder from(ManufacturingBusinessOperation manufacturingBusinessOperation) {
@@ -2747,15 +2809,13 @@ public static class SpecialDesignation extends BackboneElement {
 
         private SpecialDesignation(Builder builder) {
             super(builder);
-            identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+            identifier = Collections.unmodifiableList(builder.identifier);
             type = builder.type;
             intendedUse = builder.intendedUse;
-            indication = ValidationSupport.choiceElement(builder.indication, "indication", CodeableConcept.class, Reference.class);
+            indication = builder.indication;
             status = builder.status;
             date = builder.date;
             species = builder.species;
-            ValidationSupport.checkReferenceType(indication, "indication", "MedicinalProductIndication");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3167,7 +3227,19 @@ public Builder species(CodeableConcept species) {
              */
             @Override
             public SpecialDesignation build() {
-                return new SpecialDesignation(this);
+                SpecialDesignation specialDesignation = new SpecialDesignation(this);
+                if (validating) {
+                    validate(specialDesignation);
+                }
+                return specialDesignation;
+            }
+
+            protected void validate(SpecialDesignation specialDesignation) {
+                super.validate(specialDesignation);
+                ValidationSupport.checkList(specialDesignation.identifier, "identifier", Identifier.class);
+                ValidationSupport.choiceElement(specialDesignation.indication, "indication", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkReferenceType(specialDesignation.indication, "indication", "MedicinalProductIndication");
+                ValidationSupport.requireValueOrChildren(specialDesignation);
             }
 
             protected Builder from(SpecialDesignation specialDesignation) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductAuthorization.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductAuthorization.java
index 16bf4873f19..7cb45028692 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductAuthorization.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductAuthorization.java
@@ -84,10 +84,10 @@ public class MedicinalProductAuthorization extends DomainResource {
 
     private MedicinalProductAuthorization(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         subject = builder.subject;
-        country = Collections.unmodifiableList(ValidationSupport.checkList(builder.country, "country", CodeableConcept.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        country = Collections.unmodifiableList(builder.country);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         status = builder.status;
         statusDate = builder.statusDate;
         restoreDate = builder.restoreDate;
@@ -96,13 +96,10 @@ private MedicinalProductAuthorization(Builder builder) {
         dateOfFirstAuthorization = builder.dateOfFirstAuthorization;
         internationalBirthDate = builder.internationalBirthDate;
         legalBasis = builder.legalBasis;
-        jurisdictionalAuthorization = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdictionalAuthorization, "jurisdictionalAuthorization", JurisdictionalAuthorization.class));
+        jurisdictionalAuthorization = Collections.unmodifiableList(builder.jurisdictionalAuthorization);
         holder = builder.holder;
         regulator = builder.regulator;
         procedure = builder.procedure;
-        ValidationSupport.checkReferenceType(subject, "subject", "MedicinalProduct", "MedicinalProductPackaged");
-        ValidationSupport.checkReferenceType(holder, "holder", "Organization");
-        ValidationSupport.checkReferenceType(regulator, "regulator", "Organization");
     }
 
     /**
@@ -953,7 +950,22 @@ public Builder procedure(Procedure procedure) {
          */
         @Override
         public MedicinalProductAuthorization build() {
-            return new MedicinalProductAuthorization(this);
+            MedicinalProductAuthorization medicinalProductAuthorization = new MedicinalProductAuthorization(this);
+            if (validating) {
+                validate(medicinalProductAuthorization);
+            }
+            return medicinalProductAuthorization;
+        }
+
+        protected void validate(MedicinalProductAuthorization medicinalProductAuthorization) {
+            super.validate(medicinalProductAuthorization);
+            ValidationSupport.checkList(medicinalProductAuthorization.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(medicinalProductAuthorization.country, "country", CodeableConcept.class);
+            ValidationSupport.checkList(medicinalProductAuthorization.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(medicinalProductAuthorization.jurisdictionalAuthorization, "jurisdictionalAuthorization", JurisdictionalAuthorization.class);
+            ValidationSupport.checkReferenceType(medicinalProductAuthorization.subject, "subject", "MedicinalProduct", "MedicinalProductPackaged");
+            ValidationSupport.checkReferenceType(medicinalProductAuthorization.holder, "holder", "Organization");
+            ValidationSupport.checkReferenceType(medicinalProductAuthorization.regulator, "regulator", "Organization");
         }
 
         protected Builder from(MedicinalProductAuthorization medicinalProductAuthorization) {
@@ -995,12 +1007,11 @@ public static class JurisdictionalAuthorization extends BackboneElement {
 
         private JurisdictionalAuthorization(Builder builder) {
             super(builder);
-            identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+            identifier = Collections.unmodifiableList(builder.identifier);
             country = builder.country;
-            jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+            jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
             legalStatusOfSupply = builder.legalStatusOfSupply;
             validityPeriod = builder.validityPeriod;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1363,7 +1374,18 @@ public Builder validityPeriod(Period validityPeriod) {
              */
             @Override
             public JurisdictionalAuthorization build() {
-                return new JurisdictionalAuthorization(this);
+                JurisdictionalAuthorization jurisdictionalAuthorization = new JurisdictionalAuthorization(this);
+                if (validating) {
+                    validate(jurisdictionalAuthorization);
+                }
+                return jurisdictionalAuthorization;
+            }
+
+            protected void validate(JurisdictionalAuthorization jurisdictionalAuthorization) {
+                super.validate(jurisdictionalAuthorization);
+                ValidationSupport.checkList(jurisdictionalAuthorization.identifier, "identifier", Identifier.class);
+                ValidationSupport.checkList(jurisdictionalAuthorization.jurisdiction, "jurisdiction", CodeableConcept.class);
+                ValidationSupport.requireValueOrChildren(jurisdictionalAuthorization);
             }
 
             protected Builder from(JurisdictionalAuthorization jurisdictionalAuthorization) {
@@ -1396,10 +1418,9 @@ public static class Procedure extends BackboneElement {
         private Procedure(Builder builder) {
             super(builder);
             identifier = builder.identifier;
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            date = ValidationSupport.choiceElement(builder.date, "date", Period.class, DateTime.class);
-            application = Collections.unmodifiableList(ValidationSupport.checkList(builder.application, "application", MedicinalProductAuthorization.Procedure.class));
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            date = builder.date;
+            application = Collections.unmodifiableList(builder.application);
         }
 
         /**
@@ -1726,7 +1747,19 @@ public Builder application(Collection<MedicinalProductAuthorization.Procedure> a
              */
             @Override
             public Procedure build() {
-                return new Procedure(this);
+                Procedure procedure = new Procedure(this);
+                if (validating) {
+                    validate(procedure);
+                }
+                return procedure;
+            }
+
+            protected void validate(Procedure procedure) {
+                super.validate(procedure);
+                ValidationSupport.requireNonNull(procedure.type, "type");
+                ValidationSupport.choiceElement(procedure.date, "date", Period.class, DateTime.class);
+                ValidationSupport.checkList(procedure.application, "application", MedicinalProductAuthorization.Procedure.class);
+                ValidationSupport.requireValueOrChildren(procedure);
             }
 
             protected Builder from(Procedure procedure) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductContraindication.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductContraindication.java
index 2efb322ef84..40a7303486f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductContraindication.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductContraindication.java
@@ -64,15 +64,13 @@ public class MedicinalProductContraindication extends DomainResource {
 
     private MedicinalProductContraindication(Builder builder) {
         super(builder);
-        subject = Collections.unmodifiableList(ValidationSupport.checkList(builder.subject, "subject", Reference.class));
+        subject = Collections.unmodifiableList(builder.subject);
         disease = builder.disease;
         diseaseStatus = builder.diseaseStatus;
-        comorbidity = Collections.unmodifiableList(ValidationSupport.checkList(builder.comorbidity, "comorbidity", CodeableConcept.class));
-        therapeuticIndication = Collections.unmodifiableList(ValidationSupport.checkList(builder.therapeuticIndication, "therapeuticIndication", Reference.class));
-        otherTherapy = Collections.unmodifiableList(ValidationSupport.checkList(builder.otherTherapy, "otherTherapy", OtherTherapy.class));
-        population = Collections.unmodifiableList(ValidationSupport.checkList(builder.population, "population", Population.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "MedicinalProduct", "Medication");
-        ValidationSupport.checkReferenceType(therapeuticIndication, "therapeuticIndication", "MedicinalProductIndication");
+        comorbidity = Collections.unmodifiableList(builder.comorbidity);
+        therapeuticIndication = Collections.unmodifiableList(builder.therapeuticIndication);
+        otherTherapy = Collections.unmodifiableList(builder.otherTherapy);
+        population = Collections.unmodifiableList(builder.population);
     }
 
     /**
@@ -685,7 +683,22 @@ public Builder population(Collection<Population> population) {
          */
         @Override
         public MedicinalProductContraindication build() {
-            return new MedicinalProductContraindication(this);
+            MedicinalProductContraindication medicinalProductContraindication = new MedicinalProductContraindication(this);
+            if (validating) {
+                validate(medicinalProductContraindication);
+            }
+            return medicinalProductContraindication;
+        }
+
+        protected void validate(MedicinalProductContraindication medicinalProductContraindication) {
+            super.validate(medicinalProductContraindication);
+            ValidationSupport.checkList(medicinalProductContraindication.subject, "subject", Reference.class);
+            ValidationSupport.checkList(medicinalProductContraindication.comorbidity, "comorbidity", CodeableConcept.class);
+            ValidationSupport.checkList(medicinalProductContraindication.therapeuticIndication, "therapeuticIndication", Reference.class);
+            ValidationSupport.checkList(medicinalProductContraindication.otherTherapy, "otherTherapy", OtherTherapy.class);
+            ValidationSupport.checkList(medicinalProductContraindication.population, "population", Population.class);
+            ValidationSupport.checkReferenceType(medicinalProductContraindication.subject, "subject", "MedicinalProduct", "Medication");
+            ValidationSupport.checkReferenceType(medicinalProductContraindication.therapeuticIndication, "therapeuticIndication", "MedicinalProductIndication");
         }
 
         protected Builder from(MedicinalProductContraindication medicinalProductContraindication) {
@@ -716,10 +729,8 @@ public static class OtherTherapy extends BackboneElement {
 
         private OtherTherapy(Builder builder) {
             super(builder);
-            therapyRelationshipType = ValidationSupport.requireNonNull(builder.therapyRelationshipType, "therapyRelationshipType");
-            medication = ValidationSupport.requireChoiceElement(builder.medication, "medication", CodeableConcept.class, Reference.class);
-            ValidationSupport.checkReferenceType(medication, "medication", "MedicinalProduct", "Medication", "Substance", "SubstanceSpecification");
-            ValidationSupport.requireValueOrChildren(this);
+            therapyRelationshipType = builder.therapyRelationshipType;
+            medication = builder.medication;
         }
 
         /**
@@ -982,7 +993,19 @@ public Builder medication(Element medication) {
              */
             @Override
             public OtherTherapy build() {
-                return new OtherTherapy(this);
+                OtherTherapy otherTherapy = new OtherTherapy(this);
+                if (validating) {
+                    validate(otherTherapy);
+                }
+                return otherTherapy;
+            }
+
+            protected void validate(OtherTherapy otherTherapy) {
+                super.validate(otherTherapy);
+                ValidationSupport.requireNonNull(otherTherapy.therapyRelationshipType, "therapyRelationshipType");
+                ValidationSupport.requireChoiceElement(otherTherapy.medication, "medication", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkReferenceType(otherTherapy.medication, "medication", "MedicinalProduct", "Medication", "Substance", "SubstanceSpecification");
+                ValidationSupport.requireValueOrChildren(otherTherapy);
             }
 
             protected Builder from(OtherTherapy otherTherapy) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductIndication.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductIndication.java
index 23146ceae75..36c7618fbd2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductIndication.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductIndication.java
@@ -68,17 +68,15 @@ public class MedicinalProductIndication extends DomainResource {
 
     private MedicinalProductIndication(Builder builder) {
         super(builder);
-        subject = Collections.unmodifiableList(ValidationSupport.checkList(builder.subject, "subject", Reference.class));
+        subject = Collections.unmodifiableList(builder.subject);
         diseaseSymptomProcedure = builder.diseaseSymptomProcedure;
         diseaseStatus = builder.diseaseStatus;
-        comorbidity = Collections.unmodifiableList(ValidationSupport.checkList(builder.comorbidity, "comorbidity", CodeableConcept.class));
+        comorbidity = Collections.unmodifiableList(builder.comorbidity);
         intendedEffect = builder.intendedEffect;
         duration = builder.duration;
-        otherTherapy = Collections.unmodifiableList(ValidationSupport.checkList(builder.otherTherapy, "otherTherapy", OtherTherapy.class));
-        undesirableEffect = Collections.unmodifiableList(ValidationSupport.checkList(builder.undesirableEffect, "undesirableEffect", Reference.class));
-        population = Collections.unmodifiableList(ValidationSupport.checkList(builder.population, "population", Population.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "MedicinalProduct", "Medication");
-        ValidationSupport.checkReferenceType(undesirableEffect, "undesirableEffect", "MedicinalProductUndesirableEffect");
+        otherTherapy = Collections.unmodifiableList(builder.otherTherapy);
+        undesirableEffect = Collections.unmodifiableList(builder.undesirableEffect);
+        population = Collections.unmodifiableList(builder.population);
     }
 
     /**
@@ -749,7 +747,22 @@ public Builder population(Collection<Population> population) {
          */
         @Override
         public MedicinalProductIndication build() {
-            return new MedicinalProductIndication(this);
+            MedicinalProductIndication medicinalProductIndication = new MedicinalProductIndication(this);
+            if (validating) {
+                validate(medicinalProductIndication);
+            }
+            return medicinalProductIndication;
+        }
+
+        protected void validate(MedicinalProductIndication medicinalProductIndication) {
+            super.validate(medicinalProductIndication);
+            ValidationSupport.checkList(medicinalProductIndication.subject, "subject", Reference.class);
+            ValidationSupport.checkList(medicinalProductIndication.comorbidity, "comorbidity", CodeableConcept.class);
+            ValidationSupport.checkList(medicinalProductIndication.otherTherapy, "otherTherapy", OtherTherapy.class);
+            ValidationSupport.checkList(medicinalProductIndication.undesirableEffect, "undesirableEffect", Reference.class);
+            ValidationSupport.checkList(medicinalProductIndication.population, "population", Population.class);
+            ValidationSupport.checkReferenceType(medicinalProductIndication.subject, "subject", "MedicinalProduct", "Medication");
+            ValidationSupport.checkReferenceType(medicinalProductIndication.undesirableEffect, "undesirableEffect", "MedicinalProductUndesirableEffect");
         }
 
         protected Builder from(MedicinalProductIndication medicinalProductIndication) {
@@ -782,10 +795,8 @@ public static class OtherTherapy extends BackboneElement {
 
         private OtherTherapy(Builder builder) {
             super(builder);
-            therapyRelationshipType = ValidationSupport.requireNonNull(builder.therapyRelationshipType, "therapyRelationshipType");
-            medication = ValidationSupport.requireChoiceElement(builder.medication, "medication", CodeableConcept.class, Reference.class);
-            ValidationSupport.checkReferenceType(medication, "medication", "MedicinalProduct", "Medication", "Substance", "SubstanceSpecification");
-            ValidationSupport.requireValueOrChildren(this);
+            therapyRelationshipType = builder.therapyRelationshipType;
+            medication = builder.medication;
         }
 
         /**
@@ -1048,7 +1059,19 @@ public Builder medication(Element medication) {
              */
             @Override
             public OtherTherapy build() {
-                return new OtherTherapy(this);
+                OtherTherapy otherTherapy = new OtherTherapy(this);
+                if (validating) {
+                    validate(otherTherapy);
+                }
+                return otherTherapy;
+            }
+
+            protected void validate(OtherTherapy otherTherapy) {
+                super.validate(otherTherapy);
+                ValidationSupport.requireNonNull(otherTherapy.therapyRelationshipType, "therapyRelationshipType");
+                ValidationSupport.requireChoiceElement(otherTherapy.medication, "medication", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkReferenceType(otherTherapy.medication, "medication", "MedicinalProduct", "Medication", "Substance", "SubstanceSpecification");
+                ValidationSupport.requireValueOrChildren(otherTherapy);
             }
 
             protected Builder from(OtherTherapy otherTherapy) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductIngredient.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductIngredient.java
index e69482b47c2..fc8696dcdd2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductIngredient.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductIngredient.java
@@ -63,12 +63,11 @@ public class MedicinalProductIngredient extends DomainResource {
     private MedicinalProductIngredient(Builder builder) {
         super(builder);
         identifier = builder.identifier;
-        role = ValidationSupport.requireNonNull(builder.role, "role");
+        role = builder.role;
         allergenicIndicator = builder.allergenicIndicator;
-        manufacturer = Collections.unmodifiableList(ValidationSupport.checkList(builder.manufacturer, "manufacturer", Reference.class));
-        specifiedSubstance = Collections.unmodifiableList(ValidationSupport.checkList(builder.specifiedSubstance, "specifiedSubstance", SpecifiedSubstance.class));
+        manufacturer = Collections.unmodifiableList(builder.manufacturer);
+        specifiedSubstance = Collections.unmodifiableList(builder.specifiedSubstance);
         substance = builder.substance;
-        ValidationSupport.checkReferenceType(manufacturer, "manufacturer", "Organization");
     }
 
     /**
@@ -589,7 +588,19 @@ public Builder substance(Substance substance) {
          */
         @Override
         public MedicinalProductIngredient build() {
-            return new MedicinalProductIngredient(this);
+            MedicinalProductIngredient medicinalProductIngredient = new MedicinalProductIngredient(this);
+            if (validating) {
+                validate(medicinalProductIngredient);
+            }
+            return medicinalProductIngredient;
+        }
+
+        protected void validate(MedicinalProductIngredient medicinalProductIngredient) {
+            super.validate(medicinalProductIngredient);
+            ValidationSupport.requireNonNull(medicinalProductIngredient.role, "role");
+            ValidationSupport.checkList(medicinalProductIngredient.manufacturer, "manufacturer", Reference.class);
+            ValidationSupport.checkList(medicinalProductIngredient.specifiedSubstance, "specifiedSubstance", SpecifiedSubstance.class);
+            ValidationSupport.checkReferenceType(medicinalProductIngredient.manufacturer, "manufacturer", "Organization");
         }
 
         protected Builder from(MedicinalProductIngredient medicinalProductIngredient) {
@@ -621,11 +632,10 @@ public static class SpecifiedSubstance extends BackboneElement {
 
         private SpecifiedSubstance(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            group = ValidationSupport.requireNonNull(builder.group, "group");
+            code = builder.code;
+            group = builder.group;
             confidentiality = builder.confidentiality;
-            strength = Collections.unmodifiableList(ValidationSupport.checkList(builder.strength, "strength", Strength.class));
-            ValidationSupport.requireValueOrChildren(this);
+            strength = Collections.unmodifiableList(builder.strength);
         }
 
         /**
@@ -949,7 +959,19 @@ public Builder strength(Collection<Strength> strength) {
              */
             @Override
             public SpecifiedSubstance build() {
-                return new SpecifiedSubstance(this);
+                SpecifiedSubstance specifiedSubstance = new SpecifiedSubstance(this);
+                if (validating) {
+                    validate(specifiedSubstance);
+                }
+                return specifiedSubstance;
+            }
+
+            protected void validate(SpecifiedSubstance specifiedSubstance) {
+                super.validate(specifiedSubstance);
+                ValidationSupport.requireNonNull(specifiedSubstance.code, "code");
+                ValidationSupport.requireNonNull(specifiedSubstance.group, "group");
+                ValidationSupport.checkList(specifiedSubstance.strength, "strength", Strength.class);
+                ValidationSupport.requireValueOrChildren(specifiedSubstance);
             }
 
             protected Builder from(SpecifiedSubstance specifiedSubstance) {
@@ -984,14 +1006,13 @@ public static class Strength extends BackboneElement {
 
             private Strength(Builder builder) {
                 super(builder);
-                presentation = ValidationSupport.requireNonNull(builder.presentation, "presentation");
+                presentation = builder.presentation;
                 presentationLowLimit = builder.presentationLowLimit;
                 concentration = builder.concentration;
                 concentrationLowLimit = builder.concentrationLowLimit;
                 measurementPoint = builder.measurementPoint;
-                country = Collections.unmodifiableList(ValidationSupport.checkList(builder.country, "country", CodeableConcept.class));
-                referenceStrength = Collections.unmodifiableList(ValidationSupport.checkList(builder.referenceStrength, "referenceStrength", ReferenceStrength.class));
-                ValidationSupport.requireValueOrChildren(this);
+                country = Collections.unmodifiableList(builder.country);
+                referenceStrength = Collections.unmodifiableList(builder.referenceStrength);
             }
 
             /**
@@ -1428,7 +1449,19 @@ public Builder referenceStrength(Collection<ReferenceStrength> referenceStrength
                  */
                 @Override
                 public Strength build() {
-                    return new Strength(this);
+                    Strength strength = new Strength(this);
+                    if (validating) {
+                        validate(strength);
+                    }
+                    return strength;
+                }
+
+                protected void validate(Strength strength) {
+                    super.validate(strength);
+                    ValidationSupport.requireNonNull(strength.presentation, "presentation");
+                    ValidationSupport.checkList(strength.country, "country", CodeableConcept.class);
+                    ValidationSupport.checkList(strength.referenceStrength, "referenceStrength", ReferenceStrength.class);
+                    ValidationSupport.requireValueOrChildren(strength);
                 }
 
                 protected Builder from(Strength strength) {
@@ -1463,11 +1496,10 @@ public static class ReferenceStrength extends BackboneElement {
                 private ReferenceStrength(Builder builder) {
                     super(builder);
                     substance = builder.substance;
-                    strength = ValidationSupport.requireNonNull(builder.strength, "strength");
+                    strength = builder.strength;
                     strengthLowLimit = builder.strengthLowLimit;
                     measurementPoint = builder.measurementPoint;
-                    country = Collections.unmodifiableList(ValidationSupport.checkList(builder.country, "country", CodeableConcept.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    country = Collections.unmodifiableList(builder.country);
                 }
 
                 /**
@@ -1817,7 +1849,18 @@ public Builder country(Collection<CodeableConcept> country) {
                      */
                     @Override
                     public ReferenceStrength build() {
-                        return new ReferenceStrength(this);
+                        ReferenceStrength referenceStrength = new ReferenceStrength(this);
+                        if (validating) {
+                            validate(referenceStrength);
+                        }
+                        return referenceStrength;
+                    }
+
+                    protected void validate(ReferenceStrength referenceStrength) {
+                        super.validate(referenceStrength);
+                        ValidationSupport.requireNonNull(referenceStrength.strength, "strength");
+                        ValidationSupport.checkList(referenceStrength.country, "country", CodeableConcept.class);
+                        ValidationSupport.requireValueOrChildren(referenceStrength);
                     }
 
                     protected Builder from(ReferenceStrength referenceStrength) {
@@ -1846,9 +1889,8 @@ public static class Substance extends BackboneElement {
 
         private Substance(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            strength = Collections.unmodifiableList(ValidationSupport.checkList(builder.strength, "strength", MedicinalProductIngredient.SpecifiedSubstance.Strength.class));
-            ValidationSupport.requireValueOrChildren(this);
+            code = builder.code;
+            strength = Collections.unmodifiableList(builder.strength);
         }
 
         /**
@@ -2111,7 +2153,18 @@ public Builder strength(Collection<MedicinalProductIngredient.SpecifiedSubstance
              */
             @Override
             public Substance build() {
-                return new Substance(this);
+                Substance substance = new Substance(this);
+                if (validating) {
+                    validate(substance);
+                }
+                return substance;
+            }
+
+            protected void validate(Substance substance) {
+                super.validate(substance);
+                ValidationSupport.requireNonNull(substance.code, "code");
+                ValidationSupport.checkList(substance.strength, "strength", MedicinalProductIngredient.SpecifiedSubstance.Strength.class);
+                ValidationSupport.requireValueOrChildren(substance);
             }
 
             protected Builder from(Substance substance) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductInteraction.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductInteraction.java
index b599d92490b..de792e15c5e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductInteraction.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductInteraction.java
@@ -62,14 +62,13 @@ public class MedicinalProductInteraction extends DomainResource {
 
     private MedicinalProductInteraction(Builder builder) {
         super(builder);
-        subject = Collections.unmodifiableList(ValidationSupport.checkList(builder.subject, "subject", Reference.class));
+        subject = Collections.unmodifiableList(builder.subject);
         description = builder.description;
-        interactant = Collections.unmodifiableList(ValidationSupport.checkList(builder.interactant, "interactant", Interactant.class));
+        interactant = Collections.unmodifiableList(builder.interactant);
         type = builder.type;
         effect = builder.effect;
         incidence = builder.incidence;
         management = builder.management;
-        ValidationSupport.checkReferenceType(subject, "subject", "MedicinalProduct", "Medication", "Substance");
     }
 
     /**
@@ -614,7 +613,18 @@ public Builder management(CodeableConcept management) {
          */
         @Override
         public MedicinalProductInteraction build() {
-            return new MedicinalProductInteraction(this);
+            MedicinalProductInteraction medicinalProductInteraction = new MedicinalProductInteraction(this);
+            if (validating) {
+                validate(medicinalProductInteraction);
+            }
+            return medicinalProductInteraction;
+        }
+
+        protected void validate(MedicinalProductInteraction medicinalProductInteraction) {
+            super.validate(medicinalProductInteraction);
+            ValidationSupport.checkList(medicinalProductInteraction.subject, "subject", Reference.class);
+            ValidationSupport.checkList(medicinalProductInteraction.interactant, "interactant", Interactant.class);
+            ValidationSupport.checkReferenceType(medicinalProductInteraction.subject, "subject", "MedicinalProduct", "Medication", "Substance");
         }
 
         protected Builder from(MedicinalProductInteraction medicinalProductInteraction) {
@@ -642,9 +652,7 @@ public static class Interactant extends BackboneElement {
 
         private Interactant(Builder builder) {
             super(builder);
-            item = ValidationSupport.requireChoiceElement(builder.item, "item", Reference.class, CodeableConcept.class);
-            ValidationSupport.checkReferenceType(item, "item", "MedicinalProduct", "Medication", "Substance", "ObservationDefinition");
-            ValidationSupport.requireValueOrChildren(this);
+            item = builder.item;
         }
 
         /**
@@ -872,7 +880,18 @@ public Builder item(Element item) {
              */
             @Override
             public Interactant build() {
-                return new Interactant(this);
+                Interactant interactant = new Interactant(this);
+                if (validating) {
+                    validate(interactant);
+                }
+                return interactant;
+            }
+
+            protected void validate(Interactant interactant) {
+                super.validate(interactant);
+                ValidationSupport.requireChoiceElement(interactant.item, "item", Reference.class, CodeableConcept.class);
+                ValidationSupport.checkReferenceType(interactant.item, "item", "MedicinalProduct", "Medication", "Substance", "ObservationDefinition");
+                ValidationSupport.requireValueOrChildren(interactant);
             }
 
             protected Builder from(Interactant interactant) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductManufactured.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductManufactured.java
index c2f3049b2ac..7cf10f105c3 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductManufactured.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductManufactured.java
@@ -63,15 +63,13 @@ public class MedicinalProductManufactured extends DomainResource {
 
     private MedicinalProductManufactured(Builder builder) {
         super(builder);
-        manufacturedDoseForm = ValidationSupport.requireNonNull(builder.manufacturedDoseForm, "manufacturedDoseForm");
+        manufacturedDoseForm = builder.manufacturedDoseForm;
         unitOfPresentation = builder.unitOfPresentation;
-        quantity = ValidationSupport.requireNonNull(builder.quantity, "quantity");
-        manufacturer = Collections.unmodifiableList(ValidationSupport.checkList(builder.manufacturer, "manufacturer", Reference.class));
-        ingredient = Collections.unmodifiableList(ValidationSupport.checkList(builder.ingredient, "ingredient", Reference.class));
+        quantity = builder.quantity;
+        manufacturer = Collections.unmodifiableList(builder.manufacturer);
+        ingredient = Collections.unmodifiableList(builder.ingredient);
         physicalCharacteristics = builder.physicalCharacteristics;
-        otherCharacteristics = Collections.unmodifiableList(ValidationSupport.checkList(builder.otherCharacteristics, "otherCharacteristics", CodeableConcept.class));
-        ValidationSupport.checkReferenceType(manufacturer, "manufacturer", "Organization");
-        ValidationSupport.checkReferenceType(ingredient, "ingredient", "MedicinalProductIngredient");
+        otherCharacteristics = Collections.unmodifiableList(builder.otherCharacteristics);
     }
 
     /**
@@ -652,7 +650,22 @@ public Builder otherCharacteristics(Collection<CodeableConcept> otherCharacteris
          */
         @Override
         public MedicinalProductManufactured build() {
-            return new MedicinalProductManufactured(this);
+            MedicinalProductManufactured medicinalProductManufactured = new MedicinalProductManufactured(this);
+            if (validating) {
+                validate(medicinalProductManufactured);
+            }
+            return medicinalProductManufactured;
+        }
+
+        protected void validate(MedicinalProductManufactured medicinalProductManufactured) {
+            super.validate(medicinalProductManufactured);
+            ValidationSupport.requireNonNull(medicinalProductManufactured.manufacturedDoseForm, "manufacturedDoseForm");
+            ValidationSupport.requireNonNull(medicinalProductManufactured.quantity, "quantity");
+            ValidationSupport.checkList(medicinalProductManufactured.manufacturer, "manufacturer", Reference.class);
+            ValidationSupport.checkList(medicinalProductManufactured.ingredient, "ingredient", Reference.class);
+            ValidationSupport.checkList(medicinalProductManufactured.otherCharacteristics, "otherCharacteristics", CodeableConcept.class);
+            ValidationSupport.checkReferenceType(medicinalProductManufactured.manufacturer, "manufacturer", "Organization");
+            ValidationSupport.checkReferenceType(medicinalProductManufactured.ingredient, "ingredient", "MedicinalProductIngredient");
         }
 
         protected Builder from(MedicinalProductManufactured medicinalProductManufactured) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductPackaged.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductPackaged.java
index 2808e8a5296..c8665e96e56 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductPackaged.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductPackaged.java
@@ -72,18 +72,15 @@ public class MedicinalProductPackaged extends DomainResource {
 
     private MedicinalProductPackaged(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        subject = Collections.unmodifiableList(ValidationSupport.checkList(builder.subject, "subject", Reference.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        subject = Collections.unmodifiableList(builder.subject);
         description = builder.description;
         legalStatusOfSupply = builder.legalStatusOfSupply;
-        marketingStatus = Collections.unmodifiableList(ValidationSupport.checkList(builder.marketingStatus, "marketingStatus", MarketingStatus.class));
+        marketingStatus = Collections.unmodifiableList(builder.marketingStatus);
         marketingAuthorization = builder.marketingAuthorization;
-        manufacturer = Collections.unmodifiableList(ValidationSupport.checkList(builder.manufacturer, "manufacturer", Reference.class));
-        batchIdentifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.batchIdentifier, "batchIdentifier", BatchIdentifier.class));
-        packageItem = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.packageItem, "packageItem", PackageItem.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "MedicinalProduct");
-        ValidationSupport.checkReferenceType(marketingAuthorization, "marketingAuthorization", "MedicinalProductAuthorization");
-        ValidationSupport.checkReferenceType(manufacturer, "manufacturer", "Organization");
+        manufacturer = Collections.unmodifiableList(builder.manufacturer);
+        batchIdentifier = Collections.unmodifiableList(builder.batchIdentifier);
+        packageItem = Collections.unmodifiableList(builder.packageItem);
     }
 
     /**
@@ -786,7 +783,24 @@ public Builder packageItem(Collection<PackageItem> packageItem) {
          */
         @Override
         public MedicinalProductPackaged build() {
-            return new MedicinalProductPackaged(this);
+            MedicinalProductPackaged medicinalProductPackaged = new MedicinalProductPackaged(this);
+            if (validating) {
+                validate(medicinalProductPackaged);
+            }
+            return medicinalProductPackaged;
+        }
+
+        protected void validate(MedicinalProductPackaged medicinalProductPackaged) {
+            super.validate(medicinalProductPackaged);
+            ValidationSupport.checkList(medicinalProductPackaged.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(medicinalProductPackaged.subject, "subject", Reference.class);
+            ValidationSupport.checkList(medicinalProductPackaged.marketingStatus, "marketingStatus", MarketingStatus.class);
+            ValidationSupport.checkList(medicinalProductPackaged.manufacturer, "manufacturer", Reference.class);
+            ValidationSupport.checkList(medicinalProductPackaged.batchIdentifier, "batchIdentifier", BatchIdentifier.class);
+            ValidationSupport.checkNonEmptyList(medicinalProductPackaged.packageItem, "packageItem", PackageItem.class);
+            ValidationSupport.checkReferenceType(medicinalProductPackaged.subject, "subject", "MedicinalProduct");
+            ValidationSupport.checkReferenceType(medicinalProductPackaged.marketingAuthorization, "marketingAuthorization", "MedicinalProductAuthorization");
+            ValidationSupport.checkReferenceType(medicinalProductPackaged.manufacturer, "manufacturer", "Organization");
         }
 
         protected Builder from(MedicinalProductPackaged medicinalProductPackaged) {
@@ -816,9 +830,8 @@ public static class BatchIdentifier extends BackboneElement {
 
         private BatchIdentifier(Builder builder) {
             super(builder);
-            outerPackaging = ValidationSupport.requireNonNull(builder.outerPackaging, "outerPackaging");
+            outerPackaging = builder.outerPackaging;
             immediatePackaging = builder.immediatePackaging;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1061,7 +1074,17 @@ public Builder immediatePackaging(Identifier immediatePackaging) {
              */
             @Override
             public BatchIdentifier build() {
-                return new BatchIdentifier(this);
+                BatchIdentifier batchIdentifier = new BatchIdentifier(this);
+                if (validating) {
+                    validate(batchIdentifier);
+                }
+                return batchIdentifier;
+            }
+
+            protected void validate(BatchIdentifier batchIdentifier) {
+                super.validate(batchIdentifier);
+                ValidationSupport.requireNonNull(batchIdentifier.outerPackaging, "outerPackaging");
+                ValidationSupport.requireValueOrChildren(batchIdentifier);
             }
 
             protected Builder from(BatchIdentifier batchIdentifier) {
@@ -1109,22 +1132,18 @@ public static class PackageItem extends BackboneElement {
 
         private PackageItem(Builder builder) {
             super(builder);
-            identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            quantity = ValidationSupport.requireNonNull(builder.quantity, "quantity");
-            material = Collections.unmodifiableList(ValidationSupport.checkList(builder.material, "material", CodeableConcept.class));
-            alternateMaterial = Collections.unmodifiableList(ValidationSupport.checkList(builder.alternateMaterial, "alternateMaterial", CodeableConcept.class));
-            device = Collections.unmodifiableList(ValidationSupport.checkList(builder.device, "device", Reference.class));
-            manufacturedItem = Collections.unmodifiableList(ValidationSupport.checkList(builder.manufacturedItem, "manufacturedItem", Reference.class));
-            packageItem = Collections.unmodifiableList(ValidationSupport.checkList(builder.packageItem, "packageItem", MedicinalProductPackaged.PackageItem.class));
+            identifier = Collections.unmodifiableList(builder.identifier);
+            type = builder.type;
+            quantity = builder.quantity;
+            material = Collections.unmodifiableList(builder.material);
+            alternateMaterial = Collections.unmodifiableList(builder.alternateMaterial);
+            device = Collections.unmodifiableList(builder.device);
+            manufacturedItem = Collections.unmodifiableList(builder.manufacturedItem);
+            packageItem = Collections.unmodifiableList(builder.packageItem);
             physicalCharacteristics = builder.physicalCharacteristics;
-            otherCharacteristics = Collections.unmodifiableList(ValidationSupport.checkList(builder.otherCharacteristics, "otherCharacteristics", CodeableConcept.class));
-            shelfLifeStorage = Collections.unmodifiableList(ValidationSupport.checkList(builder.shelfLifeStorage, "shelfLifeStorage", ProductShelfLife.class));
-            manufacturer = Collections.unmodifiableList(ValidationSupport.checkList(builder.manufacturer, "manufacturer", Reference.class));
-            ValidationSupport.checkReferenceType(device, "device", "DeviceDefinition");
-            ValidationSupport.checkReferenceType(manufacturedItem, "manufacturedItem", "MedicinalProductManufactured");
-            ValidationSupport.checkReferenceType(manufacturer, "manufacturer", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
+            otherCharacteristics = Collections.unmodifiableList(builder.otherCharacteristics);
+            shelfLifeStorage = Collections.unmodifiableList(builder.shelfLifeStorage);
+            manufacturer = Collections.unmodifiableList(builder.manufacturer);
         }
 
         /**
@@ -1870,7 +1889,30 @@ public Builder manufacturer(Collection<Reference> manufacturer) {
              */
             @Override
             public PackageItem build() {
-                return new PackageItem(this);
+                PackageItem packageItem = new PackageItem(this);
+                if (validating) {
+                    validate(packageItem);
+                }
+                return packageItem;
+            }
+
+            protected void validate(PackageItem packageItem) {
+                super.validate(packageItem);
+                ValidationSupport.checkList(packageItem.identifier, "identifier", Identifier.class);
+                ValidationSupport.requireNonNull(packageItem.type, "type");
+                ValidationSupport.requireNonNull(packageItem.quantity, "quantity");
+                ValidationSupport.checkList(packageItem.material, "material", CodeableConcept.class);
+                ValidationSupport.checkList(packageItem.alternateMaterial, "alternateMaterial", CodeableConcept.class);
+                ValidationSupport.checkList(packageItem.device, "device", Reference.class);
+                ValidationSupport.checkList(packageItem.manufacturedItem, "manufacturedItem", Reference.class);
+                ValidationSupport.checkList(packageItem.packageItem, "packageItem", MedicinalProductPackaged.PackageItem.class);
+                ValidationSupport.checkList(packageItem.otherCharacteristics, "otherCharacteristics", CodeableConcept.class);
+                ValidationSupport.checkList(packageItem.shelfLifeStorage, "shelfLifeStorage", ProductShelfLife.class);
+                ValidationSupport.checkList(packageItem.manufacturer, "manufacturer", Reference.class);
+                ValidationSupport.checkReferenceType(packageItem.device, "device", "DeviceDefinition");
+                ValidationSupport.checkReferenceType(packageItem.manufacturedItem, "manufacturedItem", "MedicinalProductManufactured");
+                ValidationSupport.checkReferenceType(packageItem.manufacturer, "manufacturer", "Organization");
+                ValidationSupport.requireValueOrChildren(packageItem);
             }
 
             protected Builder from(PackageItem packageItem) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductPharmaceutical.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductPharmaceutical.java
index ff5f4ce15fa..a6fb1d2c59d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductPharmaceutical.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductPharmaceutical.java
@@ -67,15 +67,13 @@ public class MedicinalProductPharmaceutical extends DomainResource {
 
     private MedicinalProductPharmaceutical(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        administrableDoseForm = ValidationSupport.requireNonNull(builder.administrableDoseForm, "administrableDoseForm");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        administrableDoseForm = builder.administrableDoseForm;
         unitOfPresentation = builder.unitOfPresentation;
-        ingredient = Collections.unmodifiableList(ValidationSupport.checkList(builder.ingredient, "ingredient", Reference.class));
-        device = Collections.unmodifiableList(ValidationSupport.checkList(builder.device, "device", Reference.class));
-        characteristics = Collections.unmodifiableList(ValidationSupport.checkList(builder.characteristics, "characteristics", Characteristics.class));
-        routeOfAdministration = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.routeOfAdministration, "routeOfAdministration", RouteOfAdministration.class));
-        ValidationSupport.checkReferenceType(ingredient, "ingredient", "MedicinalProductIngredient");
-        ValidationSupport.checkReferenceType(device, "device", "DeviceDefinition");
+        ingredient = Collections.unmodifiableList(builder.ingredient);
+        device = Collections.unmodifiableList(builder.device);
+        characteristics = Collections.unmodifiableList(builder.characteristics);
+        routeOfAdministration = Collections.unmodifiableList(builder.routeOfAdministration);
     }
 
     /**
@@ -698,7 +696,23 @@ public Builder routeOfAdministration(Collection<RouteOfAdministration> routeOfAd
          */
         @Override
         public MedicinalProductPharmaceutical build() {
-            return new MedicinalProductPharmaceutical(this);
+            MedicinalProductPharmaceutical medicinalProductPharmaceutical = new MedicinalProductPharmaceutical(this);
+            if (validating) {
+                validate(medicinalProductPharmaceutical);
+            }
+            return medicinalProductPharmaceutical;
+        }
+
+        protected void validate(MedicinalProductPharmaceutical medicinalProductPharmaceutical) {
+            super.validate(medicinalProductPharmaceutical);
+            ValidationSupport.checkList(medicinalProductPharmaceutical.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(medicinalProductPharmaceutical.administrableDoseForm, "administrableDoseForm");
+            ValidationSupport.checkList(medicinalProductPharmaceutical.ingredient, "ingredient", Reference.class);
+            ValidationSupport.checkList(medicinalProductPharmaceutical.device, "device", Reference.class);
+            ValidationSupport.checkList(medicinalProductPharmaceutical.characteristics, "characteristics", Characteristics.class);
+            ValidationSupport.checkNonEmptyList(medicinalProductPharmaceutical.routeOfAdministration, "routeOfAdministration", RouteOfAdministration.class);
+            ValidationSupport.checkReferenceType(medicinalProductPharmaceutical.ingredient, "ingredient", "MedicinalProductIngredient");
+            ValidationSupport.checkReferenceType(medicinalProductPharmaceutical.device, "device", "DeviceDefinition");
         }
 
         protected Builder from(MedicinalProductPharmaceutical medicinalProductPharmaceutical) {
@@ -726,9 +740,8 @@ public static class Characteristics extends BackboneElement {
 
         private Characteristics(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            code = builder.code;
             status = builder.status;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -971,7 +984,17 @@ public Builder status(CodeableConcept status) {
              */
             @Override
             public Characteristics build() {
-                return new Characteristics(this);
+                Characteristics characteristics = new Characteristics(this);
+                if (validating) {
+                    validate(characteristics);
+                }
+                return characteristics;
+            }
+
+            protected void validate(Characteristics characteristics) {
+                super.validate(characteristics);
+                ValidationSupport.requireNonNull(characteristics.code, "code");
+                ValidationSupport.requireValueOrChildren(characteristics);
             }
 
             protected Builder from(Characteristics characteristics) {
@@ -1005,14 +1028,13 @@ public static class RouteOfAdministration extends BackboneElement {
 
         private RouteOfAdministration(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            code = builder.code;
             firstDose = builder.firstDose;
             maxSingleDose = builder.maxSingleDose;
             maxDosePerDay = builder.maxDosePerDay;
             maxDosePerTreatmentPeriod = builder.maxDosePerTreatmentPeriod;
             maxTreatmentPeriod = builder.maxTreatmentPeriod;
-            targetSpecies = Collections.unmodifiableList(ValidationSupport.checkList(builder.targetSpecies, "targetSpecies", TargetSpecies.class));
-            ValidationSupport.requireValueOrChildren(this);
+            targetSpecies = Collections.unmodifiableList(builder.targetSpecies);
         }
 
         /**
@@ -1435,7 +1457,18 @@ public Builder targetSpecies(Collection<TargetSpecies> targetSpecies) {
              */
             @Override
             public RouteOfAdministration build() {
-                return new RouteOfAdministration(this);
+                RouteOfAdministration routeOfAdministration = new RouteOfAdministration(this);
+                if (validating) {
+                    validate(routeOfAdministration);
+                }
+                return routeOfAdministration;
+            }
+
+            protected void validate(RouteOfAdministration routeOfAdministration) {
+                super.validate(routeOfAdministration);
+                ValidationSupport.requireNonNull(routeOfAdministration.code, "code");
+                ValidationSupport.checkList(routeOfAdministration.targetSpecies, "targetSpecies", TargetSpecies.class);
+                ValidationSupport.requireValueOrChildren(routeOfAdministration);
             }
 
             protected Builder from(RouteOfAdministration routeOfAdministration) {
@@ -1463,9 +1496,8 @@ public static class TargetSpecies extends BackboneElement {
 
             private TargetSpecies(Builder builder) {
                 super(builder);
-                code = ValidationSupport.requireNonNull(builder.code, "code");
-                withdrawalPeriod = Collections.unmodifiableList(ValidationSupport.checkList(builder.withdrawalPeriod, "withdrawalPeriod", WithdrawalPeriod.class));
-                ValidationSupport.requireValueOrChildren(this);
+                code = builder.code;
+                withdrawalPeriod = Collections.unmodifiableList(builder.withdrawalPeriod);
             }
 
             /**
@@ -1728,7 +1760,18 @@ public Builder withdrawalPeriod(Collection<WithdrawalPeriod> withdrawalPeriod) {
                  */
                 @Override
                 public TargetSpecies build() {
-                    return new TargetSpecies(this);
+                    TargetSpecies targetSpecies = new TargetSpecies(this);
+                    if (validating) {
+                        validate(targetSpecies);
+                    }
+                    return targetSpecies;
+                }
+
+                protected void validate(TargetSpecies targetSpecies) {
+                    super.validate(targetSpecies);
+                    ValidationSupport.requireNonNull(targetSpecies.code, "code");
+                    ValidationSupport.checkList(targetSpecies.withdrawalPeriod, "withdrawalPeriod", WithdrawalPeriod.class);
+                    ValidationSupport.requireValueOrChildren(targetSpecies);
                 }
 
                 protected Builder from(TargetSpecies targetSpecies) {
@@ -1754,10 +1797,9 @@ public static class WithdrawalPeriod extends BackboneElement {
 
                 private WithdrawalPeriod(Builder builder) {
                     super(builder);
-                    tissue = ValidationSupport.requireNonNull(builder.tissue, "tissue");
-                    value = ValidationSupport.requireNonNull(builder.value, "value");
+                    tissue = builder.tissue;
+                    value = builder.value;
                     supportingInformation = builder.supportingInformation;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -2032,7 +2074,18 @@ public Builder supportingInformation(String supportingInformation) {
                      */
                     @Override
                     public WithdrawalPeriod build() {
-                        return new WithdrawalPeriod(this);
+                        WithdrawalPeriod withdrawalPeriod = new WithdrawalPeriod(this);
+                        if (validating) {
+                            validate(withdrawalPeriod);
+                        }
+                        return withdrawalPeriod;
+                    }
+
+                    protected void validate(WithdrawalPeriod withdrawalPeriod) {
+                        super.validate(withdrawalPeriod);
+                        ValidationSupport.requireNonNull(withdrawalPeriod.tissue, "tissue");
+                        ValidationSupport.requireNonNull(withdrawalPeriod.value, "value");
+                        ValidationSupport.requireValueOrChildren(withdrawalPeriod);
                     }
 
                     protected Builder from(WithdrawalPeriod withdrawalPeriod) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductUndesirableEffect.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductUndesirableEffect.java
index cf7ee9ef19b..aaccf8c6307 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductUndesirableEffect.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MedicinalProductUndesirableEffect.java
@@ -54,12 +54,11 @@ public class MedicinalProductUndesirableEffect extends DomainResource {
 
     private MedicinalProductUndesirableEffect(Builder builder) {
         super(builder);
-        subject = Collections.unmodifiableList(ValidationSupport.checkList(builder.subject, "subject", Reference.class));
+        subject = Collections.unmodifiableList(builder.subject);
         symptomConditionEffect = builder.symptomConditionEffect;
         classification = builder.classification;
         frequencyOfOccurrence = builder.frequencyOfOccurrence;
-        population = Collections.unmodifiableList(ValidationSupport.checkList(builder.population, "population", Population.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "MedicinalProduct", "Medication");
+        population = Collections.unmodifiableList(builder.population);
     }
 
     /**
@@ -544,7 +543,18 @@ public Builder population(Collection<Population> population) {
          */
         @Override
         public MedicinalProductUndesirableEffect build() {
-            return new MedicinalProductUndesirableEffect(this);
+            MedicinalProductUndesirableEffect medicinalProductUndesirableEffect = new MedicinalProductUndesirableEffect(this);
+            if (validating) {
+                validate(medicinalProductUndesirableEffect);
+            }
+            return medicinalProductUndesirableEffect;
+        }
+
+        protected void validate(MedicinalProductUndesirableEffect medicinalProductUndesirableEffect) {
+            super.validate(medicinalProductUndesirableEffect);
+            ValidationSupport.checkList(medicinalProductUndesirableEffect.subject, "subject", Reference.class);
+            ValidationSupport.checkList(medicinalProductUndesirableEffect.population, "population", Population.class);
+            ValidationSupport.checkReferenceType(medicinalProductUndesirableEffect.subject, "subject", "MedicinalProduct", "Medication");
         }
 
         protected Builder from(MedicinalProductUndesirableEffect medicinalProductUndesirableEffect) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MessageDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MessageDefinition.java
index 4008a418557..1d355b2b369 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MessageDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MessageDefinition.java
@@ -163,29 +163,29 @@ public class MessageDefinition extends DomainResource {
     private MessageDefinition(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
-        replaces = Collections.unmodifiableList(ValidationSupport.checkList(builder.replaces, "replaces", Canonical.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        replaces = Collections.unmodifiableList(builder.replaces);
+        status = builder.status;
         experimental = builder.experimental;
-        date = ValidationSupport.requireNonNull(builder.date, "date");
+        date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         copyright = builder.copyright;
         base = builder.base;
-        parent = Collections.unmodifiableList(ValidationSupport.checkList(builder.parent, "parent", Canonical.class));
-        event = ValidationSupport.requireChoiceElement(builder.event, "event", Coding.class, Uri.class);
+        parent = Collections.unmodifiableList(builder.parent);
+        event = builder.event;
         category = builder.category;
-        focus = Collections.unmodifiableList(ValidationSupport.checkList(builder.focus, "focus", Focus.class));
+        focus = Collections.unmodifiableList(builder.focus);
         responseRequired = builder.responseRequired;
-        allowedResponse = Collections.unmodifiableList(ValidationSupport.checkList(builder.allowedResponse, "allowedResponse", AllowedResponse.class));
-        graph = Collections.unmodifiableList(ValidationSupport.checkList(builder.graph, "graph", Canonical.class));
+        allowedResponse = Collections.unmodifiableList(builder.allowedResponse);
+        graph = Collections.unmodifiableList(builder.graph);
     }
 
     /**
@@ -1404,7 +1404,27 @@ public Builder graph(Collection<Canonical> graph) {
          */
         @Override
         public MessageDefinition build() {
-            return new MessageDefinition(this);
+            MessageDefinition messageDefinition = new MessageDefinition(this);
+            if (validating) {
+                validate(messageDefinition);
+            }
+            return messageDefinition;
+        }
+
+        protected void validate(MessageDefinition messageDefinition) {
+            super.validate(messageDefinition);
+            ValidationSupport.checkList(messageDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(messageDefinition.replaces, "replaces", Canonical.class);
+            ValidationSupport.requireNonNull(messageDefinition.status, "status");
+            ValidationSupport.requireNonNull(messageDefinition.date, "date");
+            ValidationSupport.checkList(messageDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(messageDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(messageDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(messageDefinition.parent, "parent", Canonical.class);
+            ValidationSupport.requireChoiceElement(messageDefinition.event, "event", Coding.class, Uri.class);
+            ValidationSupport.checkList(messageDefinition.focus, "focus", Focus.class);
+            ValidationSupport.checkList(messageDefinition.allowedResponse, "allowedResponse", AllowedResponse.class);
+            ValidationSupport.checkList(messageDefinition.graph, "graph", Canonical.class);
         }
 
         protected Builder from(MessageDefinition messageDefinition) {
@@ -1459,11 +1479,10 @@ public static class Focus extends BackboneElement {
 
         private Focus(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            code = builder.code;
             profile = builder.profile;
-            min = ValidationSupport.requireNonNull(builder.min, "min");
+            min = builder.min;
             max = builder.max;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1771,7 +1790,18 @@ public Builder max(String max) {
              */
             @Override
             public Focus build() {
-                return new Focus(this);
+                Focus focus = new Focus(this);
+                if (validating) {
+                    validate(focus);
+                }
+                return focus;
+            }
+
+            protected void validate(Focus focus) {
+                super.validate(focus);
+                ValidationSupport.requireNonNull(focus.code, "code");
+                ValidationSupport.requireNonNull(focus.min, "min");
+                ValidationSupport.requireValueOrChildren(focus);
             }
 
             protected Builder from(Focus focus) {
@@ -1795,9 +1825,8 @@ public static class AllowedResponse extends BackboneElement {
 
         private AllowedResponse(Builder builder) {
             super(builder);
-            message = ValidationSupport.requireNonNull(builder.message, "message");
+            message = builder.message;
             situation = builder.situation;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2042,7 +2071,17 @@ public Builder situation(Markdown situation) {
              */
             @Override
             public AllowedResponse build() {
-                return new AllowedResponse(this);
+                AllowedResponse allowedResponse = new AllowedResponse(this);
+                if (validating) {
+                    validate(allowedResponse);
+                }
+                return allowedResponse;
+            }
+
+            protected void validate(AllowedResponse allowedResponse) {
+                super.validate(allowedResponse);
+                ValidationSupport.requireNonNull(allowedResponse.message, "message");
+                ValidationSupport.requireValueOrChildren(allowedResponse);
             }
 
             protected Builder from(AllowedResponse allowedResponse) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MessageHeader.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MessageHeader.java
index 6a2e13dd13a..d89fe2d7d26 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MessageHeader.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MessageHeader.java
@@ -98,21 +98,17 @@ public class MessageHeader extends DomainResource {
 
     private MessageHeader(Builder builder) {
         super(builder);
-        event = ValidationSupport.requireChoiceElement(builder.event, "event", Coding.class, Uri.class);
-        destination = Collections.unmodifiableList(ValidationSupport.checkList(builder.destination, "destination", Destination.class));
+        event = builder.event;
+        destination = Collections.unmodifiableList(builder.destination);
         sender = builder.sender;
         enterer = builder.enterer;
         author = builder.author;
-        source = ValidationSupport.requireNonNull(builder.source, "source");
+        source = builder.source;
         responsible = builder.responsible;
         reason = builder.reason;
         response = builder.response;
-        focus = Collections.unmodifiableList(ValidationSupport.checkList(builder.focus, "focus", Reference.class));
+        focus = Collections.unmodifiableList(builder.focus);
         definition = builder.definition;
-        ValidationSupport.checkReferenceType(sender, "sender", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(enterer, "enterer", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(author, "author", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(responsible, "responsible", "Practitioner", "PractitionerRole", "Organization");
     }
 
     /**
@@ -813,7 +809,23 @@ public Builder definition(Canonical definition) {
          */
         @Override
         public MessageHeader build() {
-            return new MessageHeader(this);
+            MessageHeader messageHeader = new MessageHeader(this);
+            if (validating) {
+                validate(messageHeader);
+            }
+            return messageHeader;
+        }
+
+        protected void validate(MessageHeader messageHeader) {
+            super.validate(messageHeader);
+            ValidationSupport.requireChoiceElement(messageHeader.event, "event", Coding.class, Uri.class);
+            ValidationSupport.checkList(messageHeader.destination, "destination", Destination.class);
+            ValidationSupport.requireNonNull(messageHeader.source, "source");
+            ValidationSupport.checkList(messageHeader.focus, "focus", Reference.class);
+            ValidationSupport.checkReferenceType(messageHeader.sender, "sender", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(messageHeader.enterer, "enterer", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(messageHeader.author, "author", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(messageHeader.responsible, "responsible", "Practitioner", "PractitionerRole", "Organization");
         }
 
         protected Builder from(MessageHeader messageHeader) {
@@ -853,11 +865,8 @@ private Destination(Builder builder) {
             super(builder);
             name = builder.name;
             target = builder.target;
-            endpoint = ValidationSupport.requireNonNull(builder.endpoint, "endpoint");
+            endpoint = builder.endpoint;
             receiver = builder.receiver;
-            ValidationSupport.checkReferenceType(target, "target", "Device");
-            ValidationSupport.checkReferenceType(receiver, "receiver", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1172,7 +1181,19 @@ public Builder receiver(Reference receiver) {
              */
             @Override
             public Destination build() {
-                return new Destination(this);
+                Destination destination = new Destination(this);
+                if (validating) {
+                    validate(destination);
+                }
+                return destination;
+            }
+
+            protected void validate(Destination destination) {
+                super.validate(destination);
+                ValidationSupport.requireNonNull(destination.endpoint, "endpoint");
+                ValidationSupport.checkReferenceType(destination.target, "target", "Device");
+                ValidationSupport.checkReferenceType(destination.receiver, "receiver", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.requireValueOrChildren(destination);
             }
 
             protected Builder from(Destination destination) {
@@ -1208,8 +1229,7 @@ private Source(Builder builder) {
             software = builder.software;
             version = builder.version;
             contact = builder.contact;
-            endpoint = ValidationSupport.requireNonNull(builder.endpoint, "endpoint");
-            ValidationSupport.requireValueOrChildren(this);
+            endpoint = builder.endpoint;
         }
 
         /**
@@ -1539,7 +1559,17 @@ public Builder endpoint(Url endpoint) {
              */
             @Override
             public Source build() {
-                return new Source(this);
+                Source source = new Source(this);
+                if (validating) {
+                    validate(source);
+                }
+                return source;
+            }
+
+            protected void validate(Source source) {
+                super.validate(source);
+                ValidationSupport.requireNonNull(source.endpoint, "endpoint");
+                ValidationSupport.requireValueOrChildren(source);
             }
 
             protected Builder from(Source source) {
@@ -1576,11 +1606,9 @@ public static class Response extends BackboneElement {
 
         private Response(Builder builder) {
             super(builder);
-            identifier = ValidationSupport.requireNonNull(builder.identifier, "identifier");
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            identifier = builder.identifier;
+            code = builder.code;
             details = builder.details;
-            ValidationSupport.checkReferenceType(details, "details", "OperationOutcome");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1862,7 +1890,19 @@ public Builder details(Reference details) {
              */
             @Override
             public Response build() {
-                return new Response(this);
+                Response response = new Response(this);
+                if (validating) {
+                    validate(response);
+                }
+                return response;
+            }
+
+            protected void validate(Response response) {
+                super.validate(response);
+                ValidationSupport.requireNonNull(response.identifier, "identifier");
+                ValidationSupport.requireNonNull(response.code, "code");
+                ValidationSupport.checkReferenceType(response.details, "details", "OperationOutcome");
+                ValidationSupport.requireValueOrChildren(response);
             }
 
             protected Builder from(Response response) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MolecularSequence.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MolecularSequence.java
index 2410bb43e95..8c1fac5806a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/MolecularSequence.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/MolecularSequence.java
@@ -123,27 +123,22 @@ public class MolecularSequence extends DomainResource {
 
     private MolecularSequence(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         type = builder.type;
-        coordinateSystem = ValidationSupport.requireNonNull(builder.coordinateSystem, "coordinateSystem");
+        coordinateSystem = builder.coordinateSystem;
         patient = builder.patient;
         specimen = builder.specimen;
         device = builder.device;
         performer = builder.performer;
         quantity = builder.quantity;
         referenceSeq = builder.referenceSeq;
-        variant = Collections.unmodifiableList(ValidationSupport.checkList(builder.variant, "variant", Variant.class));
+        variant = Collections.unmodifiableList(builder.variant);
         observedSeq = builder.observedSeq;
-        quality = Collections.unmodifiableList(ValidationSupport.checkList(builder.quality, "quality", Quality.class));
+        quality = Collections.unmodifiableList(builder.quality);
         readCoverage = builder.readCoverage;
-        repository = Collections.unmodifiableList(ValidationSupport.checkList(builder.repository, "repository", Repository.class));
-        pointer = Collections.unmodifiableList(ValidationSupport.checkList(builder.pointer, "pointer", Reference.class));
-        structureVariant = Collections.unmodifiableList(ValidationSupport.checkList(builder.structureVariant, "structureVariant", StructureVariant.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(specimen, "specimen", "Specimen");
-        ValidationSupport.checkReferenceType(device, "device", "Device");
-        ValidationSupport.checkReferenceType(performer, "performer", "Organization");
-        ValidationSupport.checkReferenceType(pointer, "pointer", "MolecularSequence");
+        repository = Collections.unmodifiableList(builder.repository);
+        pointer = Collections.unmodifiableList(builder.pointer);
+        structureVariant = Collections.unmodifiableList(builder.structureVariant);
     }
 
     /**
@@ -1074,7 +1069,27 @@ public Builder structureVariant(Collection<StructureVariant> structureVariant) {
          */
         @Override
         public MolecularSequence build() {
-            return new MolecularSequence(this);
+            MolecularSequence molecularSequence = new MolecularSequence(this);
+            if (validating) {
+                validate(molecularSequence);
+            }
+            return molecularSequence;
+        }
+
+        protected void validate(MolecularSequence molecularSequence) {
+            super.validate(molecularSequence);
+            ValidationSupport.checkList(molecularSequence.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(molecularSequence.coordinateSystem, "coordinateSystem");
+            ValidationSupport.checkList(molecularSequence.variant, "variant", Variant.class);
+            ValidationSupport.checkList(molecularSequence.quality, "quality", Quality.class);
+            ValidationSupport.checkList(molecularSequence.repository, "repository", Repository.class);
+            ValidationSupport.checkList(molecularSequence.pointer, "pointer", Reference.class);
+            ValidationSupport.checkList(molecularSequence.structureVariant, "structureVariant", StructureVariant.class);
+            ValidationSupport.checkReferenceType(molecularSequence.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(molecularSequence.specimen, "specimen", "Specimen");
+            ValidationSupport.checkReferenceType(molecularSequence.device, "device", "Device");
+            ValidationSupport.checkReferenceType(molecularSequence.performer, "performer", "Organization");
+            ValidationSupport.checkReferenceType(molecularSequence.pointer, "pointer", "MolecularSequence");
         }
 
         protected Builder from(MolecularSequence molecularSequence) {
@@ -1158,8 +1173,6 @@ private ReferenceSeq(Builder builder) {
             strand = builder.strand;
             windowStart = builder.windowStart;
             windowEnd = builder.windowEnd;
-            ValidationSupport.checkReferenceType(referenceSeqPointer, "referenceSeqPointer", "MolecularSequence");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1623,7 +1636,17 @@ public Builder windowEnd(Integer windowEnd) {
              */
             @Override
             public ReferenceSeq build() {
-                return new ReferenceSeq(this);
+                ReferenceSeq referenceSeq = new ReferenceSeq(this);
+                if (validating) {
+                    validate(referenceSeq);
+                }
+                return referenceSeq;
+            }
+
+            protected void validate(ReferenceSeq referenceSeq) {
+                super.validate(referenceSeq);
+                ValidationSupport.checkReferenceType(referenceSeq.referenceSeqPointer, "referenceSeqPointer", "MolecularSequence");
+                ValidationSupport.requireValueOrChildren(referenceSeq);
             }
 
             protected Builder from(ReferenceSeq referenceSeq) {
@@ -1671,8 +1694,6 @@ private Variant(Builder builder) {
             referenceAllele = builder.referenceAllele;
             cigar = builder.cigar;
             variantPointer = builder.variantPointer;
-            ValidationSupport.checkReferenceType(variantPointer, "variantPointer", "Observation");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2053,7 +2074,17 @@ public Builder variantPointer(Reference variantPointer) {
              */
             @Override
             public Variant build() {
-                return new Variant(this);
+                Variant variant = new Variant(this);
+                if (validating) {
+                    validate(variant);
+                }
+                return variant;
+            }
+
+            protected void validate(Variant variant) {
+                super.validate(variant);
+                ValidationSupport.checkReferenceType(variant.variantPointer, "variantPointer", "Observation");
+                ValidationSupport.requireValueOrChildren(variant);
             }
 
             protected Builder from(Variant variant) {
@@ -2126,7 +2157,7 @@ public static class Quality extends BackboneElement {
 
         private Quality(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            type = builder.type;
             standardSequence = builder.standardSequence;
             start = builder.start;
             end = builder.end;
@@ -2141,7 +2172,6 @@ private Quality(Builder builder) {
             recall = builder.recall;
             fScore = builder.fScore;
             roc = builder.roc;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2783,7 +2813,17 @@ public Builder roc(Roc roc) {
              */
             @Override
             public Quality build() {
-                return new Quality(this);
+                Quality quality = new Quality(this);
+                if (validating) {
+                    validate(quality);
+                }
+                return quality;
+            }
+
+            protected void validate(Quality quality) {
+                super.validate(quality);
+                ValidationSupport.requireNonNull(quality.type, "type");
+                ValidationSupport.requireValueOrChildren(quality);
             }
 
             protected Builder from(Quality quality) {
@@ -2828,14 +2868,13 @@ public static class Roc extends BackboneElement {
 
             private Roc(Builder builder) {
                 super(builder);
-                score = Collections.unmodifiableList(ValidationSupport.checkList(builder.score, "score", Integer.class));
-                numTP = Collections.unmodifiableList(ValidationSupport.checkList(builder.numTP, "numTP", Integer.class));
-                numFP = Collections.unmodifiableList(ValidationSupport.checkList(builder.numFP, "numFP", Integer.class));
-                numFN = Collections.unmodifiableList(ValidationSupport.checkList(builder.numFN, "numFN", Integer.class));
-                precision = Collections.unmodifiableList(ValidationSupport.checkList(builder.precision, "precision", Decimal.class));
-                sensitivity = Collections.unmodifiableList(ValidationSupport.checkList(builder.sensitivity, "sensitivity", Decimal.class));
-                fMeasure = Collections.unmodifiableList(ValidationSupport.checkList(builder.fMeasure, "fMeasure", Decimal.class));
-                ValidationSupport.requireValueOrChildren(this);
+                score = Collections.unmodifiableList(builder.score);
+                numTP = Collections.unmodifiableList(builder.numTP);
+                numFP = Collections.unmodifiableList(builder.numFP);
+                numFN = Collections.unmodifiableList(builder.numFN);
+                precision = Collections.unmodifiableList(builder.precision);
+                sensitivity = Collections.unmodifiableList(builder.sensitivity);
+                fMeasure = Collections.unmodifiableList(builder.fMeasure);
             }
 
             /**
@@ -3356,7 +3395,23 @@ public Builder fMeasure(Collection<Decimal> fMeasure) {
                  */
                 @Override
                 public Roc build() {
-                    return new Roc(this);
+                    Roc roc = new Roc(this);
+                    if (validating) {
+                        validate(roc);
+                    }
+                    return roc;
+                }
+
+                protected void validate(Roc roc) {
+                    super.validate(roc);
+                    ValidationSupport.checkList(roc.score, "score", Integer.class);
+                    ValidationSupport.checkList(roc.numTP, "numTP", Integer.class);
+                    ValidationSupport.checkList(roc.numFP, "numFP", Integer.class);
+                    ValidationSupport.checkList(roc.numFN, "numFN", Integer.class);
+                    ValidationSupport.checkList(roc.precision, "precision", Decimal.class);
+                    ValidationSupport.checkList(roc.sensitivity, "sensitivity", Decimal.class);
+                    ValidationSupport.checkList(roc.fMeasure, "fMeasure", Decimal.class);
+                    ValidationSupport.requireValueOrChildren(roc);
                 }
 
                 protected Builder from(Roc roc) {
@@ -3401,13 +3456,12 @@ public static class Repository extends BackboneElement {
 
         private Repository(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            type = builder.type;
             url = builder.url;
             name = builder.name;
             datasetId = builder.datasetId;
             variantsetId = builder.variantsetId;
             readsetId = builder.readsetId;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3770,7 +3824,17 @@ public Builder readsetId(String readsetId) {
              */
             @Override
             public Repository build() {
-                return new Repository(this);
+                Repository repository = new Repository(this);
+                if (validating) {
+                    validate(repository);
+                }
+                return repository;
+            }
+
+            protected void validate(Repository repository) {
+                super.validate(repository);
+                ValidationSupport.requireNonNull(repository.type, "type");
+                ValidationSupport.requireValueOrChildren(repository);
             }
 
             protected Builder from(Repository repository) {
@@ -3814,7 +3878,6 @@ private StructureVariant(Builder builder) {
             length = builder.length;
             outer = builder.outer;
             inner = builder.inner;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -4137,7 +4200,16 @@ public Builder inner(Inner inner) {
              */
             @Override
             public StructureVariant build() {
-                return new StructureVariant(this);
+                StructureVariant structureVariant = new StructureVariant(this);
+                if (validating) {
+                    validate(structureVariant);
+                }
+                return structureVariant;
+            }
+
+            protected void validate(StructureVariant structureVariant) {
+                super.validate(structureVariant);
+                ValidationSupport.requireValueOrChildren(structureVariant);
             }
 
             protected Builder from(StructureVariant structureVariant) {
@@ -4164,7 +4236,6 @@ private Outer(Builder builder) {
                 super(builder);
                 start = builder.start;
                 end = builder.end;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -4404,7 +4475,16 @@ public Builder end(Integer end) {
                  */
                 @Override
                 public Outer build() {
-                    return new Outer(this);
+                    Outer outer = new Outer(this);
+                    if (validating) {
+                        validate(outer);
+                    }
+                    return outer;
+                }
+
+                protected void validate(Outer outer) {
+                    super.validate(outer);
+                    ValidationSupport.requireValueOrChildren(outer);
                 }
 
                 protected Builder from(Outer outer) {
@@ -4429,7 +4509,6 @@ private Inner(Builder builder) {
                 super(builder);
                 start = builder.start;
                 end = builder.end;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -4669,7 +4748,16 @@ public Builder end(Integer end) {
                  */
                 @Override
                 public Inner build() {
-                    return new Inner(this);
+                    Inner inner = new Inner(this);
+                    if (validating) {
+                        validate(inner);
+                    }
+                    return inner;
+                }
+
+                protected void validate(Inner inner) {
+                    super.validate(inner);
+                    ValidationSupport.requireValueOrChildren(inner);
                 }
 
                 protected Builder from(Inner inner) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/NamingSystem.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/NamingSystem.java
index 0ff70e91f2e..cf6729aabf9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/NamingSystem.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/NamingSystem.java
@@ -144,19 +144,19 @@ public class NamingSystem extends DomainResource {
 
     private NamingSystem(Builder builder) {
         super(builder);
-        name = ValidationSupport.requireNonNull(builder.name, "name");
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        kind = ValidationSupport.requireNonNull(builder.kind, "kind");
-        date = ValidationSupport.requireNonNull(builder.date, "date");
+        name = builder.name;
+        status = builder.status;
+        kind = builder.kind;
+        date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         responsible = builder.responsible;
         type = builder.type;
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         usage = builder.usage;
-        uniqueId = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.uniqueId, "uniqueId", UniqueId.class));
+        uniqueId = Collections.unmodifiableList(builder.uniqueId);
     }
 
     /**
@@ -940,7 +940,23 @@ public Builder uniqueId(Collection<UniqueId> uniqueId) {
          */
         @Override
         public NamingSystem build() {
-            return new NamingSystem(this);
+            NamingSystem namingSystem = new NamingSystem(this);
+            if (validating) {
+                validate(namingSystem);
+            }
+            return namingSystem;
+        }
+
+        protected void validate(NamingSystem namingSystem) {
+            super.validate(namingSystem);
+            ValidationSupport.requireNonNull(namingSystem.name, "name");
+            ValidationSupport.requireNonNull(namingSystem.status, "status");
+            ValidationSupport.requireNonNull(namingSystem.kind, "kind");
+            ValidationSupport.requireNonNull(namingSystem.date, "date");
+            ValidationSupport.checkList(namingSystem.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(namingSystem.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(namingSystem.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkNonEmptyList(namingSystem.uniqueId, "uniqueId", UniqueId.class);
         }
 
         protected Builder from(NamingSystem namingSystem) {
@@ -984,12 +1000,11 @@ public static class UniqueId extends BackboneElement {
 
         private UniqueId(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            value = ValidationSupport.requireNonNull(builder.value, "value");
+            type = builder.type;
+            value = builder.value;
             preferred = builder.preferred;
             comment = builder.comment;
             period = builder.period;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1324,7 +1339,18 @@ public Builder period(Period period) {
              */
             @Override
             public UniqueId build() {
-                return new UniqueId(this);
+                UniqueId uniqueId = new UniqueId(this);
+                if (validating) {
+                    validate(uniqueId);
+                }
+                return uniqueId;
+            }
+
+            protected void validate(UniqueId uniqueId) {
+                super.validate(uniqueId);
+                ValidationSupport.requireNonNull(uniqueId.type, "type");
+                ValidationSupport.requireNonNull(uniqueId.value, "value");
+                ValidationSupport.requireValueOrChildren(uniqueId);
             }
 
             protected Builder from(UniqueId uniqueId) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/NutritionOrder.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/NutritionOrder.java
index f21fde37779..138739b4a18 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/NutritionOrder.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/NutritionOrder.java
@@ -130,27 +130,23 @@ public class NutritionOrder extends DomainResource {
 
     private NutritionOrder(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-        instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
-        instantiates = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiates, "instantiates", Uri.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        intent = ValidationSupport.requireNonNull(builder.intent, "intent");
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+        instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
+        instantiates = Collections.unmodifiableList(builder.instantiates);
+        status = builder.status;
+        intent = builder.intent;
+        patient = builder.patient;
         encounter = builder.encounter;
-        dateTime = ValidationSupport.requireNonNull(builder.dateTime, "dateTime");
+        dateTime = builder.dateTime;
         orderer = builder.orderer;
-        allergyIntolerance = Collections.unmodifiableList(ValidationSupport.checkList(builder.allergyIntolerance, "allergyIntolerance", Reference.class));
-        foodPreferenceModifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.foodPreferenceModifier, "foodPreferenceModifier", CodeableConcept.class));
-        excludeFoodModifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.excludeFoodModifier, "excludeFoodModifier", CodeableConcept.class));
+        allergyIntolerance = Collections.unmodifiableList(builder.allergyIntolerance);
+        foodPreferenceModifier = Collections.unmodifiableList(builder.foodPreferenceModifier);
+        excludeFoodModifier = Collections.unmodifiableList(builder.excludeFoodModifier);
         oralDiet = builder.oralDiet;
-        supplement = Collections.unmodifiableList(ValidationSupport.checkList(builder.supplement, "supplement", Supplement.class));
+        supplement = Collections.unmodifiableList(builder.supplement);
         enteralFormula = builder.enteralFormula;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(orderer, "orderer", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(allergyIntolerance, "allergyIntolerance", "AllergyIntolerance");
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -1189,7 +1185,32 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public NutritionOrder build() {
-            return new NutritionOrder(this);
+            NutritionOrder nutritionOrder = new NutritionOrder(this);
+            if (validating) {
+                validate(nutritionOrder);
+            }
+            return nutritionOrder;
+        }
+
+        protected void validate(NutritionOrder nutritionOrder) {
+            super.validate(nutritionOrder);
+            ValidationSupport.checkList(nutritionOrder.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(nutritionOrder.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+            ValidationSupport.checkList(nutritionOrder.instantiatesUri, "instantiatesUri", Uri.class);
+            ValidationSupport.checkList(nutritionOrder.instantiates, "instantiates", Uri.class);
+            ValidationSupport.requireNonNull(nutritionOrder.status, "status");
+            ValidationSupport.requireNonNull(nutritionOrder.intent, "intent");
+            ValidationSupport.requireNonNull(nutritionOrder.patient, "patient");
+            ValidationSupport.requireNonNull(nutritionOrder.dateTime, "dateTime");
+            ValidationSupport.checkList(nutritionOrder.allergyIntolerance, "allergyIntolerance", Reference.class);
+            ValidationSupport.checkList(nutritionOrder.foodPreferenceModifier, "foodPreferenceModifier", CodeableConcept.class);
+            ValidationSupport.checkList(nutritionOrder.excludeFoodModifier, "excludeFoodModifier", CodeableConcept.class);
+            ValidationSupport.checkList(nutritionOrder.supplement, "supplement", Supplement.class);
+            ValidationSupport.checkList(nutritionOrder.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(nutritionOrder.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(nutritionOrder.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(nutritionOrder.orderer, "orderer", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(nutritionOrder.allergyIntolerance, "allergyIntolerance", "AllergyIntolerance");
         }
 
         protected Builder from(NutritionOrder nutritionOrder) {
@@ -1242,13 +1263,12 @@ public static class OralDiet extends BackboneElement {
 
         private OralDiet(Builder builder) {
             super(builder);
-            type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
-            schedule = Collections.unmodifiableList(ValidationSupport.checkList(builder.schedule, "schedule", Timing.class));
-            nutrient = Collections.unmodifiableList(ValidationSupport.checkList(builder.nutrient, "nutrient", Nutrient.class));
-            texture = Collections.unmodifiableList(ValidationSupport.checkList(builder.texture, "texture", Texture.class));
-            fluidConsistencyType = Collections.unmodifiableList(ValidationSupport.checkList(builder.fluidConsistencyType, "fluidConsistencyType", CodeableConcept.class));
+            type = Collections.unmodifiableList(builder.type);
+            schedule = Collections.unmodifiableList(builder.schedule);
+            nutrient = Collections.unmodifiableList(builder.nutrient);
+            texture = Collections.unmodifiableList(builder.texture);
+            fluidConsistencyType = Collections.unmodifiableList(builder.fluidConsistencyType);
             instruction = builder.instruction;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1706,7 +1726,21 @@ public Builder instruction(String instruction) {
              */
             @Override
             public OralDiet build() {
-                return new OralDiet(this);
+                OralDiet oralDiet = new OralDiet(this);
+                if (validating) {
+                    validate(oralDiet);
+                }
+                return oralDiet;
+            }
+
+            protected void validate(OralDiet oralDiet) {
+                super.validate(oralDiet);
+                ValidationSupport.checkList(oralDiet.type, "type", CodeableConcept.class);
+                ValidationSupport.checkList(oralDiet.schedule, "schedule", Timing.class);
+                ValidationSupport.checkList(oralDiet.nutrient, "nutrient", Nutrient.class);
+                ValidationSupport.checkList(oralDiet.texture, "texture", Texture.class);
+                ValidationSupport.checkList(oralDiet.fluidConsistencyType, "fluidConsistencyType", CodeableConcept.class);
+                ValidationSupport.requireValueOrChildren(oralDiet);
             }
 
             protected Builder from(OralDiet oralDiet) {
@@ -1739,7 +1773,6 @@ private Nutrient(Builder builder) {
                 super(builder);
                 modifier = builder.modifier;
                 amount = builder.amount;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1975,7 +2008,16 @@ public Builder amount(SimpleQuantity amount) {
                  */
                 @Override
                 public Nutrient build() {
-                    return new Nutrient(this);
+                    Nutrient nutrient = new Nutrient(this);
+                    if (validating) {
+                        validate(nutrient);
+                    }
+                    return nutrient;
+                }
+
+                protected void validate(Nutrient nutrient) {
+                    super.validate(nutrient);
+                    ValidationSupport.requireValueOrChildren(nutrient);
                 }
 
                 protected Builder from(Nutrient nutrient) {
@@ -2010,7 +2052,6 @@ private Texture(Builder builder) {
                 super(builder);
                 modifier = builder.modifier;
                 foodType = builder.foodType;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2246,7 +2287,16 @@ public Builder foodType(CodeableConcept foodType) {
                  */
                 @Override
                 public Texture build() {
-                    return new Texture(this);
+                    Texture texture = new Texture(this);
+                    if (validating) {
+                        validate(texture);
+                    }
+                    return texture;
+                }
+
+                protected void validate(Texture texture) {
+                    super.validate(texture);
+                    ValidationSupport.requireValueOrChildren(texture);
                 }
 
                 protected Builder from(Texture texture) {
@@ -2281,10 +2331,9 @@ private Supplement(Builder builder) {
             super(builder);
             type = builder.type;
             productName = builder.productName;
-            schedule = Collections.unmodifiableList(ValidationSupport.checkList(builder.schedule, "schedule", Timing.class));
+            schedule = Collections.unmodifiableList(builder.schedule);
             quantity = builder.quantity;
             instruction = builder.instruction;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2630,7 +2679,17 @@ public Builder instruction(String instruction) {
              */
             @Override
             public Supplement build() {
-                return new Supplement(this);
+                Supplement supplement = new Supplement(this);
+                if (validating) {
+                    validate(supplement);
+                }
+                return supplement;
+            }
+
+            protected void validate(Supplement supplement) {
+                super.validate(supplement);
+                ValidationSupport.checkList(supplement.schedule, "schedule", Timing.class);
+                ValidationSupport.requireValueOrChildren(supplement);
             }
 
             protected Builder from(Supplement supplement) {
@@ -2688,10 +2747,9 @@ private EnteralFormula(Builder builder) {
             additiveProductName = builder.additiveProductName;
             caloricDensity = builder.caloricDensity;
             routeofAdministration = builder.routeofAdministration;
-            administration = Collections.unmodifiableList(ValidationSupport.checkList(builder.administration, "administration", Administration.class));
+            administration = Collections.unmodifiableList(builder.administration);
             maxVolumeToDeliver = builder.maxVolumeToDeliver;
             administrationInstruction = builder.administrationInstruction;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3166,7 +3224,17 @@ public Builder administrationInstruction(String administrationInstruction) {
              */
             @Override
             public EnteralFormula build() {
-                return new EnteralFormula(this);
+                EnteralFormula enteralFormula = new EnteralFormula(this);
+                if (validating) {
+                    validate(enteralFormula);
+                }
+                return enteralFormula;
+            }
+
+            protected void validate(EnteralFormula enteralFormula) {
+                super.validate(enteralFormula);
+                ValidationSupport.checkList(enteralFormula.administration, "administration", Administration.class);
+                ValidationSupport.requireValueOrChildren(enteralFormula);
             }
 
             protected Builder from(EnteralFormula enteralFormula) {
@@ -3199,8 +3267,7 @@ private Administration(Builder builder) {
                 super(builder);
                 schedule = builder.schedule;
                 quantity = builder.quantity;
-                rate = ValidationSupport.choiceElement(builder.rate, "rate", SimpleQuantity.class, Ratio.class);
-                ValidationSupport.requireValueOrChildren(this);
+                rate = builder.rate;
             }
 
             /**
@@ -3471,7 +3538,17 @@ public Builder rate(Element rate) {
                  */
                 @Override
                 public Administration build() {
-                    return new Administration(this);
+                    Administration administration = new Administration(this);
+                    if (validating) {
+                        validate(administration);
+                    }
+                    return administration;
+                }
+
+                protected void validate(Administration administration) {
+                    super.validate(administration);
+                    ValidationSupport.choiceElement(administration.rate, "rate", SimpleQuantity.class, Ratio.class);
+                    ValidationSupport.requireValueOrChildren(administration);
                 }
 
                 protected Builder from(Administration administration) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Observation.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Observation.java
index e60e7605709..9deafcc7861 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Observation.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Observation.java
@@ -228,39 +228,30 @@ public class Observation extends DomainResource {
 
     private Observation(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
-        code = ValidationSupport.requireNonNull(builder.code, "code");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        status = builder.status;
+        category = Collections.unmodifiableList(builder.category);
+        code = builder.code;
         subject = builder.subject;
-        focus = Collections.unmodifiableList(ValidationSupport.checkList(builder.focus, "focus", Reference.class));
+        focus = Collections.unmodifiableList(builder.focus);
         encounter = builder.encounter;
-        effective = ValidationSupport.choiceElement(builder.effective, "effective", DateTime.class, Period.class, Timing.class, Instant.class);
+        effective = builder.effective;
         issued = builder.issued;
-        performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Reference.class));
-        value = ValidationSupport.choiceElement(builder.value, "value", Quantity.class, CodeableConcept.class, String.class, Boolean.class, Integer.class, Range.class, Ratio.class, SampledData.class, Time.class, DateTime.class, Period.class);
+        performer = Collections.unmodifiableList(builder.performer);
+        value = builder.value;
         dataAbsentReason = builder.dataAbsentReason;
-        interpretation = Collections.unmodifiableList(ValidationSupport.checkList(builder.interpretation, "interpretation", CodeableConcept.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
+        interpretation = Collections.unmodifiableList(builder.interpretation);
+        note = Collections.unmodifiableList(builder.note);
         bodySite = builder.bodySite;
         method = builder.method;
         specimen = builder.specimen;
         device = builder.device;
-        referenceRange = Collections.unmodifiableList(ValidationSupport.checkList(builder.referenceRange, "referenceRange", ReferenceRange.class));
-        hasMember = Collections.unmodifiableList(ValidationSupport.checkList(builder.hasMember, "hasMember", Reference.class));
-        derivedFrom = Collections.unmodifiableList(ValidationSupport.checkList(builder.derivedFrom, "derivedFrom", Reference.class));
-        component = Collections.unmodifiableList(ValidationSupport.checkList(builder.component, "component", Component.class));
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "CarePlan", "DeviceRequest", "ImmunizationRecommendation", "MedicationRequest", "NutritionOrder", "ServiceRequest");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "MedicationAdministration", "MedicationDispense", "MedicationStatement", "Procedure", "Immunization", "ImagingStudy");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group", "Device", "Location");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(performer, "performer", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "Patient", "RelatedPerson");
-        ValidationSupport.checkReferenceType(specimen, "specimen", "Specimen");
-        ValidationSupport.checkReferenceType(device, "device", "Device", "DeviceMetric");
-        ValidationSupport.checkReferenceType(hasMember, "hasMember", "Observation", "QuestionnaireResponse", "MolecularSequence");
-        ValidationSupport.checkReferenceType(derivedFrom, "derivedFrom", "DocumentReference", "ImagingStudy", "Media", "QuestionnaireResponse", "Observation", "MolecularSequence");
+        referenceRange = Collections.unmodifiableList(builder.referenceRange);
+        hasMember = Collections.unmodifiableList(builder.hasMember);
+        derivedFrom = Collections.unmodifiableList(builder.derivedFrom);
+        component = Collections.unmodifiableList(builder.component);
     }
 
     /**
@@ -1684,7 +1675,40 @@ public Builder component(Collection<Component> component) {
          */
         @Override
         public Observation build() {
-            return new Observation(this);
+            Observation observation = new Observation(this);
+            if (validating) {
+                validate(observation);
+            }
+            return observation;
+        }
+
+        protected void validate(Observation observation) {
+            super.validate(observation);
+            ValidationSupport.checkList(observation.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(observation.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(observation.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(observation.status, "status");
+            ValidationSupport.checkList(observation.category, "category", CodeableConcept.class);
+            ValidationSupport.requireNonNull(observation.code, "code");
+            ValidationSupport.checkList(observation.focus, "focus", Reference.class);
+            ValidationSupport.choiceElement(observation.effective, "effective", DateTime.class, Period.class, Timing.class, Instant.class);
+            ValidationSupport.checkList(observation.performer, "performer", Reference.class);
+            ValidationSupport.choiceElement(observation.value, "value", Quantity.class, CodeableConcept.class, String.class, Boolean.class, Integer.class, Range.class, Ratio.class, SampledData.class, Time.class, DateTime.class, Period.class);
+            ValidationSupport.checkList(observation.interpretation, "interpretation", CodeableConcept.class);
+            ValidationSupport.checkList(observation.note, "note", Annotation.class);
+            ValidationSupport.checkList(observation.referenceRange, "referenceRange", ReferenceRange.class);
+            ValidationSupport.checkList(observation.hasMember, "hasMember", Reference.class);
+            ValidationSupport.checkList(observation.derivedFrom, "derivedFrom", Reference.class);
+            ValidationSupport.checkList(observation.component, "component", Component.class);
+            ValidationSupport.checkReferenceType(observation.basedOn, "basedOn", "CarePlan", "DeviceRequest", "ImmunizationRecommendation", "MedicationRequest", "NutritionOrder", "ServiceRequest");
+            ValidationSupport.checkReferenceType(observation.partOf, "partOf", "MedicationAdministration", "MedicationDispense", "MedicationStatement", "Procedure", "Immunization", "ImagingStudy");
+            ValidationSupport.checkReferenceType(observation.subject, "subject", "Patient", "Group", "Device", "Location");
+            ValidationSupport.checkReferenceType(observation.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(observation.performer, "performer", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "Patient", "RelatedPerson");
+            ValidationSupport.checkReferenceType(observation.specimen, "specimen", "Specimen");
+            ValidationSupport.checkReferenceType(observation.device, "device", "Device", "DeviceMetric");
+            ValidationSupport.checkReferenceType(observation.hasMember, "hasMember", "Observation", "QuestionnaireResponse", "MolecularSequence");
+            ValidationSupport.checkReferenceType(observation.derivedFrom, "derivedFrom", "DocumentReference", "ImagingStudy", "Media", "QuestionnaireResponse", "Observation", "MolecularSequence");
         }
 
         protected Builder from(Observation observation) {
@@ -1747,10 +1771,9 @@ private ReferenceRange(Builder builder) {
             low = builder.low;
             high = builder.high;
             type = builder.type;
-            appliesTo = Collections.unmodifiableList(ValidationSupport.checkList(builder.appliesTo, "appliesTo", CodeableConcept.class));
+            appliesTo = Collections.unmodifiableList(builder.appliesTo);
             age = builder.age;
             text = builder.text;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2145,7 +2168,17 @@ public Builder text(String text) {
              */
             @Override
             public ReferenceRange build() {
-                return new ReferenceRange(this);
+                ReferenceRange referenceRange = new ReferenceRange(this);
+                if (validating) {
+                    validate(referenceRange);
+                }
+                return referenceRange;
+            }
+
+            protected void validate(ReferenceRange referenceRange) {
+                super.validate(referenceRange);
+                ValidationSupport.checkList(referenceRange.appliesTo, "appliesTo", CodeableConcept.class);
+                ValidationSupport.requireValueOrChildren(referenceRange);
             }
 
             protected Builder from(ReferenceRange referenceRange) {
@@ -2197,12 +2230,11 @@ public static class Component extends BackboneElement {
 
         private Component(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            value = ValidationSupport.choiceElement(builder.value, "value", Quantity.class, CodeableConcept.class, String.class, Boolean.class, Integer.class, Range.class, Ratio.class, SampledData.class, Time.class, DateTime.class, Period.class);
+            code = builder.code;
+            value = builder.value;
             dataAbsentReason = builder.dataAbsentReason;
-            interpretation = Collections.unmodifiableList(ValidationSupport.checkList(builder.interpretation, "interpretation", CodeableConcept.class));
-            referenceRange = Collections.unmodifiableList(ValidationSupport.checkList(builder.referenceRange, "referenceRange", Observation.ReferenceRange.class));
-            ValidationSupport.requireValueOrChildren(this);
+            interpretation = Collections.unmodifiableList(builder.interpretation);
+            referenceRange = Collections.unmodifiableList(builder.referenceRange);
         }
 
         /**
@@ -2587,7 +2619,20 @@ public Builder referenceRange(Collection<Observation.ReferenceRange> referenceRa
              */
             @Override
             public Component build() {
-                return new Component(this);
+                Component component = new Component(this);
+                if (validating) {
+                    validate(component);
+                }
+                return component;
+            }
+
+            protected void validate(Component component) {
+                super.validate(component);
+                ValidationSupport.requireNonNull(component.code, "code");
+                ValidationSupport.choiceElement(component.value, "value", Quantity.class, CodeableConcept.class, String.class, Boolean.class, Integer.class, Range.class, Ratio.class, SampledData.class, Time.class, DateTime.class, Period.class);
+                ValidationSupport.checkList(component.interpretation, "interpretation", CodeableConcept.class);
+                ValidationSupport.checkList(component.referenceRange, "referenceRange", Observation.ReferenceRange.class);
+                ValidationSupport.requireValueOrChildren(component);
             }
 
             protected Builder from(Component component) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ObservationDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ObservationDefinition.java
index 2b7781ec280..5caadf943cf 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ObservationDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ObservationDefinition.java
@@ -126,23 +126,19 @@ public class ObservationDefinition extends DomainResource {
 
     private ObservationDefinition(Builder builder) {
         super(builder);
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
-        code = ValidationSupport.requireNonNull(builder.code, "code");
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        permittedDataType = Collections.unmodifiableList(ValidationSupport.checkList(builder.permittedDataType, "permittedDataType", ObservationDataType.class));
+        category = Collections.unmodifiableList(builder.category);
+        code = builder.code;
+        identifier = Collections.unmodifiableList(builder.identifier);
+        permittedDataType = Collections.unmodifiableList(builder.permittedDataType);
         multipleResultsAllowed = builder.multipleResultsAllowed;
         method = builder.method;
         preferredReportName = builder.preferredReportName;
         quantitativeDetails = builder.quantitativeDetails;
-        qualifiedInterval = Collections.unmodifiableList(ValidationSupport.checkList(builder.qualifiedInterval, "qualifiedInterval", QualifiedInterval.class));
+        qualifiedInterval = Collections.unmodifiableList(builder.qualifiedInterval);
         validCodedValueSet = builder.validCodedValueSet;
         normalCodedValueSet = builder.normalCodedValueSet;
         abnormalCodedValueSet = builder.abnormalCodedValueSet;
         criticalCodedValueSet = builder.criticalCodedValueSet;
-        ValidationSupport.checkReferenceType(validCodedValueSet, "validCodedValueSet", "ValueSet");
-        ValidationSupport.checkReferenceType(normalCodedValueSet, "normalCodedValueSet", "ValueSet");
-        ValidationSupport.checkReferenceType(abnormalCodedValueSet, "abnormalCodedValueSet", "ValueSet");
-        ValidationSupport.checkReferenceType(criticalCodedValueSet, "criticalCodedValueSet", "ValueSet");
     }
 
     /**
@@ -917,7 +913,24 @@ public Builder criticalCodedValueSet(Reference criticalCodedValueSet) {
          */
         @Override
         public ObservationDefinition build() {
-            return new ObservationDefinition(this);
+            ObservationDefinition observationDefinition = new ObservationDefinition(this);
+            if (validating) {
+                validate(observationDefinition);
+            }
+            return observationDefinition;
+        }
+
+        protected void validate(ObservationDefinition observationDefinition) {
+            super.validate(observationDefinition);
+            ValidationSupport.checkList(observationDefinition.category, "category", CodeableConcept.class);
+            ValidationSupport.requireNonNull(observationDefinition.code, "code");
+            ValidationSupport.checkList(observationDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(observationDefinition.permittedDataType, "permittedDataType", ObservationDataType.class);
+            ValidationSupport.checkList(observationDefinition.qualifiedInterval, "qualifiedInterval", QualifiedInterval.class);
+            ValidationSupport.checkReferenceType(observationDefinition.validCodedValueSet, "validCodedValueSet", "ValueSet");
+            ValidationSupport.checkReferenceType(observationDefinition.normalCodedValueSet, "normalCodedValueSet", "ValueSet");
+            ValidationSupport.checkReferenceType(observationDefinition.abnormalCodedValueSet, "abnormalCodedValueSet", "ValueSet");
+            ValidationSupport.checkReferenceType(observationDefinition.criticalCodedValueSet, "criticalCodedValueSet", "ValueSet");
         }
 
         protected Builder from(ObservationDefinition observationDefinition) {
@@ -966,7 +979,6 @@ private QuantitativeDetails(Builder builder) {
             unit = builder.unit;
             conversionFactor = builder.conversionFactor;
             decimalPrecision = builder.decimalPrecision;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1260,7 +1272,16 @@ public Builder decimalPrecision(Integer decimalPrecision) {
              */
             @Override
             public QuantitativeDetails build() {
-                return new QuantitativeDetails(this);
+                QuantitativeDetails quantitativeDetails = new QuantitativeDetails(this);
+                if (validating) {
+                    validate(quantitativeDetails);
+                }
+                return quantitativeDetails;
+            }
+
+            protected void validate(QuantitativeDetails quantitativeDetails) {
+                super.validate(quantitativeDetails);
+                ValidationSupport.requireValueOrChildren(quantitativeDetails);
             }
 
             protected Builder from(QuantitativeDetails quantitativeDetails) {
@@ -1317,12 +1338,11 @@ private QualifiedInterval(Builder builder) {
             category = builder.category;
             range = builder.range;
             context = builder.context;
-            appliesTo = Collections.unmodifiableList(ValidationSupport.checkList(builder.appliesTo, "appliesTo", CodeableConcept.class));
+            appliesTo = Collections.unmodifiableList(builder.appliesTo);
             gender = builder.gender;
             age = builder.age;
             gestationalAge = builder.gestationalAge;
             condition = builder.condition;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1754,7 +1774,17 @@ public Builder condition(String condition) {
              */
             @Override
             public QualifiedInterval build() {
-                return new QualifiedInterval(this);
+                QualifiedInterval qualifiedInterval = new QualifiedInterval(this);
+                if (validating) {
+                    validate(qualifiedInterval);
+                }
+                return qualifiedInterval;
+            }
+
+            protected void validate(QualifiedInterval qualifiedInterval) {
+                super.validate(qualifiedInterval);
+                ValidationSupport.checkList(qualifiedInterval.appliesTo, "appliesTo", CodeableConcept.class);
+                ValidationSupport.requireValueOrChildren(qualifiedInterval);
             }
 
             protected Builder from(QualifiedInterval qualifiedInterval) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/OperationDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/OperationDefinition.java
index 5ffbf1a2d08..cd1a9e80d68 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/OperationDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/OperationDefinition.java
@@ -174,30 +174,30 @@ private OperationDefinition(Builder builder) {
         super(builder);
         url = builder.url;
         version = builder.version;
-        name = ValidationSupport.requireNonNull(builder.name, "name");
+        name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        kind = ValidationSupport.requireNonNull(builder.kind, "kind");
+        status = builder.status;
+        kind = builder.kind;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         affectsState = builder.affectsState;
-        code = ValidationSupport.requireNonNull(builder.code, "code");
+        code = builder.code;
         comment = builder.comment;
         base = builder.base;
-        resource = Collections.unmodifiableList(ValidationSupport.checkList(builder.resource, "resource", ResourceType.class));
-        system = ValidationSupport.requireNonNull(builder.system, "system");
-        type = ValidationSupport.requireNonNull(builder.type, "type");
-        instance = ValidationSupport.requireNonNull(builder.instance, "instance");
+        resource = Collections.unmodifiableList(builder.resource);
+        system = builder.system;
+        type = builder.type;
+        instance = builder.instance;
         inputProfile = builder.inputProfile;
         outputProfile = builder.outputProfile;
-        parameter = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameter, "parameter", Parameter.class));
-        overload = Collections.unmodifiableList(ValidationSupport.checkList(builder.overload, "overload", Overload.class));
+        parameter = Collections.unmodifiableList(builder.parameter);
+        overload = Collections.unmodifiableList(builder.overload);
     }
 
     /**
@@ -1425,7 +1425,28 @@ public Builder overload(Collection<Overload> overload) {
          */
         @Override
         public OperationDefinition build() {
-            return new OperationDefinition(this);
+            OperationDefinition operationDefinition = new OperationDefinition(this);
+            if (validating) {
+                validate(operationDefinition);
+            }
+            return operationDefinition;
+        }
+
+        protected void validate(OperationDefinition operationDefinition) {
+            super.validate(operationDefinition);
+            ValidationSupport.requireNonNull(operationDefinition.name, "name");
+            ValidationSupport.requireNonNull(operationDefinition.status, "status");
+            ValidationSupport.requireNonNull(operationDefinition.kind, "kind");
+            ValidationSupport.checkList(operationDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(operationDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(operationDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.requireNonNull(operationDefinition.code, "code");
+            ValidationSupport.checkList(operationDefinition.resource, "resource", ResourceType.class);
+            ValidationSupport.requireNonNull(operationDefinition.system, "system");
+            ValidationSupport.requireNonNull(operationDefinition.type, "type");
+            ValidationSupport.requireNonNull(operationDefinition.instance, "instance");
+            ValidationSupport.checkList(operationDefinition.parameter, "parameter", Parameter.class);
+            ValidationSupport.checkList(operationDefinition.overload, "overload", Overload.class);
         }
 
         protected Builder from(OperationDefinition operationDefinition) {
@@ -1500,18 +1521,17 @@ public static class Parameter extends BackboneElement {
 
         private Parameter(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
-            use = ValidationSupport.requireNonNull(builder.use, "use");
-            min = ValidationSupport.requireNonNull(builder.min, "min");
-            max = ValidationSupport.requireNonNull(builder.max, "max");
+            name = builder.name;
+            use = builder.use;
+            min = builder.min;
+            max = builder.max;
             documentation = builder.documentation;
             type = builder.type;
-            targetProfile = Collections.unmodifiableList(ValidationSupport.checkList(builder.targetProfile, "targetProfile", Canonical.class));
+            targetProfile = Collections.unmodifiableList(builder.targetProfile);
             searchType = builder.searchType;
             binding = builder.binding;
-            referencedFrom = Collections.unmodifiableList(ValidationSupport.checkList(builder.referencedFrom, "referencedFrom", ReferencedFrom.class));
-            part = Collections.unmodifiableList(ValidationSupport.checkList(builder.part, "part", OperationDefinition.Parameter.class));
-            ValidationSupport.requireValueOrChildren(this);
+            referencedFrom = Collections.unmodifiableList(builder.referencedFrom);
+            part = Collections.unmodifiableList(builder.part);
         }
 
         /**
@@ -2096,7 +2116,23 @@ public Builder part(Collection<OperationDefinition.Parameter> part) {
              */
             @Override
             public Parameter build() {
-                return new Parameter(this);
+                Parameter parameter = new Parameter(this);
+                if (validating) {
+                    validate(parameter);
+                }
+                return parameter;
+            }
+
+            protected void validate(Parameter parameter) {
+                super.validate(parameter);
+                ValidationSupport.requireNonNull(parameter.name, "name");
+                ValidationSupport.requireNonNull(parameter.use, "use");
+                ValidationSupport.requireNonNull(parameter.min, "min");
+                ValidationSupport.requireNonNull(parameter.max, "max");
+                ValidationSupport.checkList(parameter.targetProfile, "targetProfile", Canonical.class);
+                ValidationSupport.checkList(parameter.referencedFrom, "referencedFrom", ReferencedFrom.class);
+                ValidationSupport.checkList(parameter.part, "part", OperationDefinition.Parameter.class);
+                ValidationSupport.requireValueOrChildren(parameter);
             }
 
             protected Builder from(Parameter parameter) {
@@ -2133,9 +2169,8 @@ public static class Binding extends BackboneElement {
 
             private Binding(Builder builder) {
                 super(builder);
-                strength = ValidationSupport.requireNonNull(builder.strength, "strength");
-                valueSet = ValidationSupport.requireNonNull(builder.valueSet, "valueSet");
-                ValidationSupport.requireValueOrChildren(this);
+                strength = builder.strength;
+                valueSet = builder.valueSet;
             }
 
             /**
@@ -2383,7 +2418,18 @@ public Builder valueSet(Canonical valueSet) {
                  */
                 @Override
                 public Binding build() {
-                    return new Binding(this);
+                    Binding binding = new Binding(this);
+                    if (validating) {
+                        validate(binding);
+                    }
+                    return binding;
+                }
+
+                protected void validate(Binding binding) {
+                    super.validate(binding);
+                    ValidationSupport.requireNonNull(binding.strength, "strength");
+                    ValidationSupport.requireNonNull(binding.valueSet, "valueSet");
+                    ValidationSupport.requireValueOrChildren(binding);
                 }
 
                 protected Builder from(Binding binding) {
@@ -2405,9 +2451,8 @@ public static class ReferencedFrom extends BackboneElement {
 
             private ReferencedFrom(Builder builder) {
                 super(builder);
-                source = ValidationSupport.requireNonNull(builder.source, "source");
+                source = builder.source;
                 sourceId = builder.sourceId;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2652,7 +2697,17 @@ public Builder sourceId(String sourceId) {
                  */
                 @Override
                 public ReferencedFrom build() {
-                    return new ReferencedFrom(this);
+                    ReferencedFrom referencedFrom = new ReferencedFrom(this);
+                    if (validating) {
+                        validate(referencedFrom);
+                    }
+                    return referencedFrom;
+                }
+
+                protected void validate(ReferencedFrom referencedFrom) {
+                    super.validate(referencedFrom);
+                    ValidationSupport.requireNonNull(referencedFrom.source, "source");
+                    ValidationSupport.requireValueOrChildren(referencedFrom);
                 }
 
                 protected Builder from(ReferencedFrom referencedFrom) {
@@ -2675,9 +2730,8 @@ public static class Overload extends BackboneElement {
 
         private Overload(Builder builder) {
             super(builder);
-            parameterName = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameterName, "parameterName", String.class));
+            parameterName = Collections.unmodifiableList(builder.parameterName);
             comment = builder.comment;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2933,7 +2987,17 @@ public Builder comment(String comment) {
              */
             @Override
             public Overload build() {
-                return new Overload(this);
+                Overload overload = new Overload(this);
+                if (validating) {
+                    validate(overload);
+                }
+                return overload;
+            }
+
+            protected void validate(Overload overload) {
+                super.validate(overload);
+                ValidationSupport.checkList(overload.parameterName, "parameterName", String.class);
+                ValidationSupport.requireValueOrChildren(overload);
             }
 
             protected Builder from(Overload overload) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/OperationOutcome.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/OperationOutcome.java
index a1a3bd1aac5..f8ddee03a14 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/OperationOutcome.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/OperationOutcome.java
@@ -50,7 +50,7 @@ public class OperationOutcome extends DomainResource {
 
     private OperationOutcome(Builder builder) {
         super(builder);
-        issue = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.issue, "issue", Issue.class));
+        issue = Collections.unmodifiableList(builder.issue);
     }
 
     /**
@@ -396,7 +396,16 @@ public Builder issue(Collection<Issue> issue) {
          */
         @Override
         public OperationOutcome build() {
-            return new OperationOutcome(this);
+            OperationOutcome operationOutcome = new OperationOutcome(this);
+            if (validating) {
+                validate(operationOutcome);
+            }
+            return operationOutcome;
+        }
+
+        protected void validate(OperationOutcome operationOutcome) {
+            super.validate(operationOutcome);
+            ValidationSupport.checkNonEmptyList(operationOutcome.issue, "issue", Issue.class);
         }
 
         protected Builder from(OperationOutcome operationOutcome) {
@@ -445,13 +454,12 @@ public static class Issue extends BackboneElement {
 
         private Issue(Builder builder) {
             super(builder);
-            severity = ValidationSupport.requireNonNull(builder.severity, "severity");
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            severity = builder.severity;
+            code = builder.code;
             details = builder.details;
             diagnostics = builder.diagnostics;
-            location = Collections.unmodifiableList(ValidationSupport.checkList(builder.location, "location", String.class));
-            expression = Collections.unmodifiableList(ValidationSupport.checkList(builder.expression, "expression", String.class));
-            ValidationSupport.requireValueOrChildren(this);
+            location = Collections.unmodifiableList(builder.location);
+            expression = Collections.unmodifiableList(builder.expression);
         }
 
         /**
@@ -875,7 +883,20 @@ public Builder expression(Collection<String> expression) {
              */
             @Override
             public Issue build() {
-                return new Issue(this);
+                Issue issue = new Issue(this);
+                if (validating) {
+                    validate(issue);
+                }
+                return issue;
+            }
+
+            protected void validate(Issue issue) {
+                super.validate(issue);
+                ValidationSupport.requireNonNull(issue.severity, "severity");
+                ValidationSupport.requireNonNull(issue.code, "code");
+                ValidationSupport.checkList(issue.location, "location", String.class);
+                ValidationSupport.checkList(issue.expression, "expression", String.class);
+                ValidationSupport.requireValueOrChildren(issue);
             }
 
             protected Builder from(Issue issue) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Organization.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Organization.java
index d82bef402ba..5e0b75526aa 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Organization.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Organization.java
@@ -106,18 +106,16 @@ public class Organization extends DomainResource {
 
     private Organization(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
-        type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
+        type = Collections.unmodifiableList(builder.type);
         name = builder.name;
-        alias = Collections.unmodifiableList(ValidationSupport.checkList(builder.alias, "alias", String.class));
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
-        address = Collections.unmodifiableList(ValidationSupport.checkList(builder.address, "address", Address.class));
+        alias = Collections.unmodifiableList(builder.alias);
+        telecom = Collections.unmodifiableList(builder.telecom);
+        address = Collections.unmodifiableList(builder.address);
         partOf = builder.partOf;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", Contact.class));
-        endpoint = Collections.unmodifiableList(ValidationSupport.checkList(builder.endpoint, "endpoint", Reference.class));
-        ValidationSupport.checkReferenceType(partOf, "partOf", "Organization");
-        ValidationSupport.checkReferenceType(endpoint, "endpoint", "Endpoint");
+        contact = Collections.unmodifiableList(builder.contact);
+        endpoint = Collections.unmodifiableList(builder.endpoint);
     }
 
     /**
@@ -850,7 +848,24 @@ public Builder endpoint(Collection<Reference> endpoint) {
          */
         @Override
         public Organization build() {
-            return new Organization(this);
+            Organization organization = new Organization(this);
+            if (validating) {
+                validate(organization);
+            }
+            return organization;
+        }
+
+        protected void validate(Organization organization) {
+            super.validate(organization);
+            ValidationSupport.checkList(organization.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(organization.type, "type", CodeableConcept.class);
+            ValidationSupport.checkList(organization.alias, "alias", String.class);
+            ValidationSupport.checkList(organization.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.checkList(organization.address, "address", Address.class);
+            ValidationSupport.checkList(organization.contact, "contact", Contact.class);
+            ValidationSupport.checkList(organization.endpoint, "endpoint", Reference.class);
+            ValidationSupport.checkReferenceType(organization.partOf, "partOf", "Organization");
+            ValidationSupport.checkReferenceType(organization.endpoint, "endpoint", "Endpoint");
         }
 
         protected Builder from(Organization organization) {
@@ -888,9 +903,8 @@ private Contact(Builder builder) {
             super(builder);
             purpose = builder.purpose;
             name = builder.name;
-            telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
+            telecom = Collections.unmodifiableList(builder.telecom);
             address = builder.address;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1204,7 +1218,17 @@ public Builder address(Address address) {
              */
             @Override
             public Contact build() {
-                return new Contact(this);
+                Contact contact = new Contact(this);
+                if (validating) {
+                    validate(contact);
+                }
+                return contact;
+            }
+
+            protected void validate(Contact contact) {
+                super.validate(contact);
+                ValidationSupport.checkList(contact.telecom, "telecom", ContactPoint.class);
+                ValidationSupport.requireValueOrChildren(contact);
             }
 
             protected Builder from(Contact contact) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/OrganizationAffiliation.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/OrganizationAffiliation.java
index 7b92f70cfe1..5d7904ef7b9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/OrganizationAffiliation.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/OrganizationAffiliation.java
@@ -98,24 +98,18 @@ public class OrganizationAffiliation extends DomainResource {
 
     private OrganizationAffiliation(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
         period = builder.period;
         organization = builder.organization;
         participatingOrganization = builder.participatingOrganization;
-        network = Collections.unmodifiableList(ValidationSupport.checkList(builder.network, "network", Reference.class));
-        code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
-        specialty = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialty, "specialty", CodeableConcept.class));
-        location = Collections.unmodifiableList(ValidationSupport.checkList(builder.location, "location", Reference.class));
-        healthcareService = Collections.unmodifiableList(ValidationSupport.checkList(builder.healthcareService, "healthcareService", Reference.class));
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
-        endpoint = Collections.unmodifiableList(ValidationSupport.checkList(builder.endpoint, "endpoint", Reference.class));
-        ValidationSupport.checkReferenceType(organization, "organization", "Organization");
-        ValidationSupport.checkReferenceType(participatingOrganization, "participatingOrganization", "Organization");
-        ValidationSupport.checkReferenceType(network, "network", "Organization");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(healthcareService, "healthcareService", "HealthcareService");
-        ValidationSupport.checkReferenceType(endpoint, "endpoint", "Endpoint");
+        network = Collections.unmodifiableList(builder.network);
+        code = Collections.unmodifiableList(builder.code);
+        specialty = Collections.unmodifiableList(builder.specialty);
+        location = Collections.unmodifiableList(builder.location);
+        healthcareService = Collections.unmodifiableList(builder.healthcareService);
+        telecom = Collections.unmodifiableList(builder.telecom);
+        endpoint = Collections.unmodifiableList(builder.endpoint);
     }
 
     /**
@@ -968,7 +962,29 @@ public Builder endpoint(Collection<Reference> endpoint) {
          */
         @Override
         public OrganizationAffiliation build() {
-            return new OrganizationAffiliation(this);
+            OrganizationAffiliation organizationAffiliation = new OrganizationAffiliation(this);
+            if (validating) {
+                validate(organizationAffiliation);
+            }
+            return organizationAffiliation;
+        }
+
+        protected void validate(OrganizationAffiliation organizationAffiliation) {
+            super.validate(organizationAffiliation);
+            ValidationSupport.checkList(organizationAffiliation.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(organizationAffiliation.network, "network", Reference.class);
+            ValidationSupport.checkList(organizationAffiliation.code, "code", CodeableConcept.class);
+            ValidationSupport.checkList(organizationAffiliation.specialty, "specialty", CodeableConcept.class);
+            ValidationSupport.checkList(organizationAffiliation.location, "location", Reference.class);
+            ValidationSupport.checkList(organizationAffiliation.healthcareService, "healthcareService", Reference.class);
+            ValidationSupport.checkList(organizationAffiliation.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.checkList(organizationAffiliation.endpoint, "endpoint", Reference.class);
+            ValidationSupport.checkReferenceType(organizationAffiliation.organization, "organization", "Organization");
+            ValidationSupport.checkReferenceType(organizationAffiliation.participatingOrganization, "participatingOrganization", "Organization");
+            ValidationSupport.checkReferenceType(organizationAffiliation.network, "network", "Organization");
+            ValidationSupport.checkReferenceType(organizationAffiliation.location, "location", "Location");
+            ValidationSupport.checkReferenceType(organizationAffiliation.healthcareService, "healthcareService", "HealthcareService");
+            ValidationSupport.checkReferenceType(organizationAffiliation.endpoint, "endpoint", "Endpoint");
         }
 
         protected Builder from(OrganizationAffiliation organizationAffiliation) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Parameters.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Parameters.java
index c023ea0b14f..7b0b8c8bdd7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Parameters.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Parameters.java
@@ -100,7 +100,7 @@ public class Parameters extends Resource {
 
     private Parameters(Builder builder) {
         super(builder);
-        parameter = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameter, "parameter", Parameter.class));
+        parameter = Collections.unmodifiableList(builder.parameter);
     }
 
     /**
@@ -288,7 +288,16 @@ public Builder parameter(Collection<Parameter> parameter) {
          */
         @Override
         public Parameters build() {
-            return new Parameters(this);
+            Parameters parameters = new Parameters(this);
+            if (validating) {
+                validate(parameters);
+            }
+            return parameters;
+        }
+
+        protected void validate(Parameters parameters) {
+            super.validate(parameters);
+            ValidationSupport.checkList(parameters.parameter, "parameter", Parameter.class);
         }
 
         protected Builder from(Parameters parameters) {
@@ -315,11 +324,10 @@ public static class Parameter extends BackboneElement {
 
         private Parameter(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
-            value = ValidationSupport.choiceElement(builder.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+            name = builder.name;
+            value = builder.value;
             resource = builder.resource;
-            part = Collections.unmodifiableList(ValidationSupport.checkList(builder.part, "part", Parameters.Parameter.class));
-            ValidationSupport.requireValueOrChildren(this);
+            part = Collections.unmodifiableList(builder.part);
         }
 
         /**
@@ -694,7 +702,19 @@ public Builder part(Collection<Parameters.Parameter> part) {
              */
             @Override
             public Parameter build() {
-                return new Parameter(this);
+                Parameter parameter = new Parameter(this);
+                if (validating) {
+                    validate(parameter);
+                }
+                return parameter;
+            }
+
+            protected void validate(Parameter parameter) {
+                super.validate(parameter);
+                ValidationSupport.requireNonNull(parameter.name, "name");
+                ValidationSupport.choiceElement(parameter.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+                ValidationSupport.checkList(parameter.part, "part", Parameters.Parameter.class);
+                ValidationSupport.requireValueOrChildren(parameter);
             }
 
             protected Builder from(Parameter parameter) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Patient.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Patient.java
index 6a23c76c22f..c64349abf24 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Patient.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Patient.java
@@ -135,24 +135,22 @@ public class Patient extends DomainResource {
 
     private Patient(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
-        name = Collections.unmodifiableList(ValidationSupport.checkList(builder.name, "name", HumanName.class));
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
+        name = Collections.unmodifiableList(builder.name);
+        telecom = Collections.unmodifiableList(builder.telecom);
         gender = builder.gender;
         birthDate = builder.birthDate;
-        deceased = ValidationSupport.choiceElement(builder.deceased, "deceased", Boolean.class, DateTime.class);
-        address = Collections.unmodifiableList(ValidationSupport.checkList(builder.address, "address", Address.class));
+        deceased = builder.deceased;
+        address = Collections.unmodifiableList(builder.address);
         maritalStatus = builder.maritalStatus;
-        multipleBirth = ValidationSupport.choiceElement(builder.multipleBirth, "multipleBirth", Boolean.class, Integer.class);
-        photo = Collections.unmodifiableList(ValidationSupport.checkList(builder.photo, "photo", Attachment.class));
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", Contact.class));
-        communication = Collections.unmodifiableList(ValidationSupport.checkList(builder.communication, "communication", Communication.class));
-        generalPractitioner = Collections.unmodifiableList(ValidationSupport.checkList(builder.generalPractitioner, "generalPractitioner", Reference.class));
+        multipleBirth = builder.multipleBirth;
+        photo = Collections.unmodifiableList(builder.photo);
+        contact = Collections.unmodifiableList(builder.contact);
+        communication = Collections.unmodifiableList(builder.communication);
+        generalPractitioner = Collections.unmodifiableList(builder.generalPractitioner);
         managingOrganization = builder.managingOrganization;
-        link = Collections.unmodifiableList(ValidationSupport.checkList(builder.link, "link", Link.class));
-        ValidationSupport.checkReferenceType(generalPractitioner, "generalPractitioner", "Organization", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(managingOrganization, "managingOrganization", "Organization");
+        link = Collections.unmodifiableList(builder.link);
     }
 
     /**
@@ -1129,7 +1127,28 @@ public Builder link(Collection<Link> link) {
          */
         @Override
         public Patient build() {
-            return new Patient(this);
+            Patient patient = new Patient(this);
+            if (validating) {
+                validate(patient);
+            }
+            return patient;
+        }
+
+        protected void validate(Patient patient) {
+            super.validate(patient);
+            ValidationSupport.checkList(patient.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(patient.name, "name", HumanName.class);
+            ValidationSupport.checkList(patient.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.choiceElement(patient.deceased, "deceased", Boolean.class, DateTime.class);
+            ValidationSupport.checkList(patient.address, "address", Address.class);
+            ValidationSupport.choiceElement(patient.multipleBirth, "multipleBirth", Boolean.class, Integer.class);
+            ValidationSupport.checkList(patient.photo, "photo", Attachment.class);
+            ValidationSupport.checkList(patient.contact, "contact", Contact.class);
+            ValidationSupport.checkList(patient.communication, "communication", Communication.class);
+            ValidationSupport.checkList(patient.generalPractitioner, "generalPractitioner", Reference.class);
+            ValidationSupport.checkList(patient.link, "link", Link.class);
+            ValidationSupport.checkReferenceType(patient.generalPractitioner, "generalPractitioner", "Organization", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(patient.managingOrganization, "managingOrganization", "Organization");
         }
 
         protected Builder from(Patient patient) {
@@ -1181,15 +1200,13 @@ public static class Contact extends BackboneElement {
 
         private Contact(Builder builder) {
             super(builder);
-            relationship = Collections.unmodifiableList(ValidationSupport.checkList(builder.relationship, "relationship", CodeableConcept.class));
+            relationship = Collections.unmodifiableList(builder.relationship);
             name = builder.name;
-            telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
+            telecom = Collections.unmodifiableList(builder.telecom);
             address = builder.address;
             gender = builder.gender;
             organization = builder.organization;
             period = builder.period;
-            ValidationSupport.checkReferenceType(organization, "organization", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1617,7 +1634,19 @@ public Builder period(Period period) {
              */
             @Override
             public Contact build() {
-                return new Contact(this);
+                Contact contact = new Contact(this);
+                if (validating) {
+                    validate(contact);
+                }
+                return contact;
+            }
+
+            protected void validate(Contact contact) {
+                super.validate(contact);
+                ValidationSupport.checkList(contact.relationship, "relationship", CodeableConcept.class);
+                ValidationSupport.checkList(contact.telecom, "telecom", ContactPoint.class);
+                ValidationSupport.checkReferenceType(contact.organization, "organization", "Organization");
+                ValidationSupport.requireValueOrChildren(contact);
             }
 
             protected Builder from(Contact contact) {
@@ -1651,10 +1680,8 @@ public static class Communication extends BackboneElement {
 
         private Communication(Builder builder) {
             super(builder);
-            language = ValidationSupport.requireNonNull(builder.language, "language");
+            language = builder.language;
             preferred = builder.preferred;
-            ValidationSupport.checkValueSetBinding(language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1901,7 +1928,18 @@ public Builder preferred(Boolean preferred) {
              */
             @Override
             public Communication build() {
-                return new Communication(this);
+                Communication communication = new Communication(this);
+                if (validating) {
+                    validate(communication);
+                }
+                return communication;
+            }
+
+            protected void validate(Communication communication) {
+                super.validate(communication);
+                ValidationSupport.requireNonNull(communication.language, "language");
+                ValidationSupport.checkValueSetBinding(communication.language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+                ValidationSupport.requireValueOrChildren(communication);
             }
 
             protected Builder from(Communication communication) {
@@ -1933,10 +1971,8 @@ public static class Link extends BackboneElement {
 
         private Link(Builder builder) {
             super(builder);
-            other = ValidationSupport.requireNonNull(builder.other, "other");
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            ValidationSupport.checkReferenceType(other, "other", "Patient", "RelatedPerson");
-            ValidationSupport.requireValueOrChildren(this);
+            other = builder.other;
+            type = builder.type;
         }
 
         /**
@@ -2188,7 +2224,19 @@ public Builder type(LinkType type) {
              */
             @Override
             public Link build() {
-                return new Link(this);
+                Link link = new Link(this);
+                if (validating) {
+                    validate(link);
+                }
+                return link;
+            }
+
+            protected void validate(Link link) {
+                super.validate(link);
+                ValidationSupport.requireNonNull(link.other, "other");
+                ValidationSupport.requireNonNull(link.type, "type");
+                ValidationSupport.checkReferenceType(link.other, "other", "Patient", "RelatedPerson");
+                ValidationSupport.requireValueOrChildren(link);
             }
 
             protected Builder from(Link link) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/PaymentNotice.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/PaymentNotice.java
index c281fb58816..2c9552aa4cb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/PaymentNotice.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/PaymentNotice.java
@@ -89,22 +89,18 @@ public class PaymentNotice extends DomainResource {
 
     private PaymentNotice(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         request = builder.request;
         response = builder.response;
-        created = ValidationSupport.requireNonNull(builder.created, "created");
+        created = builder.created;
         provider = builder.provider;
-        payment = ValidationSupport.requireNonNull(builder.payment, "payment");
+        payment = builder.payment;
         paymentDate = builder.paymentDate;
         payee = builder.payee;
-        recipient = ValidationSupport.requireNonNull(builder.recipient, "recipient");
-        amount = ValidationSupport.requireNonNull(builder.amount, "amount");
+        recipient = builder.recipient;
+        amount = builder.amount;
         paymentStatus = builder.paymentStatus;
-        ValidationSupport.checkReferenceType(provider, "provider", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(payment, "payment", "PaymentReconciliation");
-        ValidationSupport.checkReferenceType(payee, "payee", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(recipient, "recipient", "Organization");
     }
 
     /**
@@ -803,7 +799,25 @@ public Builder paymentStatus(CodeableConcept paymentStatus) {
          */
         @Override
         public PaymentNotice build() {
-            return new PaymentNotice(this);
+            PaymentNotice paymentNotice = new PaymentNotice(this);
+            if (validating) {
+                validate(paymentNotice);
+            }
+            return paymentNotice;
+        }
+
+        protected void validate(PaymentNotice paymentNotice) {
+            super.validate(paymentNotice);
+            ValidationSupport.checkList(paymentNotice.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(paymentNotice.status, "status");
+            ValidationSupport.requireNonNull(paymentNotice.created, "created");
+            ValidationSupport.requireNonNull(paymentNotice.payment, "payment");
+            ValidationSupport.requireNonNull(paymentNotice.recipient, "recipient");
+            ValidationSupport.requireNonNull(paymentNotice.amount, "amount");
+            ValidationSupport.checkReferenceType(paymentNotice.provider, "provider", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(paymentNotice.payment, "payment", "PaymentReconciliation");
+            ValidationSupport.checkReferenceType(paymentNotice.payee, "payee", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(paymentNotice.recipient, "recipient", "Organization");
         }
 
         protected Builder from(PaymentNotice paymentNotice) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/PaymentReconciliation.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/PaymentReconciliation.java
index a473c9acd80..78f9eb4f52e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/PaymentReconciliation.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/PaymentReconciliation.java
@@ -101,24 +101,21 @@ public class PaymentReconciliation extends DomainResource {
 
     private PaymentReconciliation(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         period = builder.period;
-        created = ValidationSupport.requireNonNull(builder.created, "created");
+        created = builder.created;
         paymentIssuer = builder.paymentIssuer;
         request = builder.request;
         requestor = builder.requestor;
         outcome = builder.outcome;
         disposition = builder.disposition;
-        paymentDate = ValidationSupport.requireNonNull(builder.paymentDate, "paymentDate");
-        paymentAmount = ValidationSupport.requireNonNull(builder.paymentAmount, "paymentAmount");
+        paymentDate = builder.paymentDate;
+        paymentAmount = builder.paymentAmount;
         paymentIdentifier = builder.paymentIdentifier;
-        detail = Collections.unmodifiableList(ValidationSupport.checkList(builder.detail, "detail", Detail.class));
+        detail = Collections.unmodifiableList(builder.detail);
         formCode = builder.formCode;
-        processNote = Collections.unmodifiableList(ValidationSupport.checkList(builder.processNote, "processNote", ProcessNote.class));
-        ValidationSupport.checkReferenceType(paymentIssuer, "paymentIssuer", "Organization");
-        ValidationSupport.checkReferenceType(request, "request", "Task");
-        ValidationSupport.checkReferenceType(requestor, "requestor", "Practitioner", "PractitionerRole", "Organization");
+        processNote = Collections.unmodifiableList(builder.processNote);
     }
 
     /**
@@ -934,7 +931,25 @@ public Builder processNote(Collection<ProcessNote> processNote) {
          */
         @Override
         public PaymentReconciliation build() {
-            return new PaymentReconciliation(this);
+            PaymentReconciliation paymentReconciliation = new PaymentReconciliation(this);
+            if (validating) {
+                validate(paymentReconciliation);
+            }
+            return paymentReconciliation;
+        }
+
+        protected void validate(PaymentReconciliation paymentReconciliation) {
+            super.validate(paymentReconciliation);
+            ValidationSupport.checkList(paymentReconciliation.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(paymentReconciliation.status, "status");
+            ValidationSupport.requireNonNull(paymentReconciliation.created, "created");
+            ValidationSupport.requireNonNull(paymentReconciliation.paymentDate, "paymentDate");
+            ValidationSupport.requireNonNull(paymentReconciliation.paymentAmount, "paymentAmount");
+            ValidationSupport.checkList(paymentReconciliation.detail, "detail", Detail.class);
+            ValidationSupport.checkList(paymentReconciliation.processNote, "processNote", ProcessNote.class);
+            ValidationSupport.checkReferenceType(paymentReconciliation.paymentIssuer, "paymentIssuer", "Organization");
+            ValidationSupport.checkReferenceType(paymentReconciliation.request, "request", "Task");
+            ValidationSupport.checkReferenceType(paymentReconciliation.requestor, "requestor", "Practitioner", "PractitionerRole", "Organization");
         }
 
         protected Builder from(PaymentReconciliation paymentReconciliation) {
@@ -987,7 +1002,7 @@ private Detail(Builder builder) {
             super(builder);
             identifier = builder.identifier;
             predecessor = builder.predecessor;
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            type = builder.type;
             request = builder.request;
             submitter = builder.submitter;
             response = builder.response;
@@ -995,10 +1010,6 @@ private Detail(Builder builder) {
             responsible = builder.responsible;
             payee = builder.payee;
             amount = builder.amount;
-            ValidationSupport.checkReferenceType(submitter, "submitter", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.checkReferenceType(responsible, "responsible", "PractitionerRole");
-            ValidationSupport.checkReferenceType(payee, "payee", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1492,7 +1503,20 @@ public Builder amount(Money amount) {
              */
             @Override
             public Detail build() {
-                return new Detail(this);
+                Detail detail = new Detail(this);
+                if (validating) {
+                    validate(detail);
+                }
+                return detail;
+            }
+
+            protected void validate(Detail detail) {
+                super.validate(detail);
+                ValidationSupport.requireNonNull(detail.type, "type");
+                ValidationSupport.checkReferenceType(detail.submitter, "submitter", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.checkReferenceType(detail.responsible, "responsible", "PractitionerRole");
+                ValidationSupport.checkReferenceType(detail.payee, "payee", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.requireValueOrChildren(detail);
             }
 
             protected Builder from(Detail detail) {
@@ -1529,7 +1553,6 @@ private ProcessNote(Builder builder) {
             super(builder);
             type = builder.type;
             text = builder.text;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1765,7 +1788,16 @@ public Builder text(String text) {
              */
             @Override
             public ProcessNote build() {
-                return new ProcessNote(this);
+                ProcessNote processNote = new ProcessNote(this);
+                if (validating) {
+                    validate(processNote);
+                }
+                return processNote;
+            }
+
+            protected void validate(ProcessNote processNote) {
+                super.validate(processNote);
+                ValidationSupport.requireValueOrChildren(processNote);
             }
 
             protected Builder from(ProcessNote processNote) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Person.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Person.java
index 324da2ac24e..ed9005bbf3f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Person.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Person.java
@@ -77,17 +77,16 @@ public class Person extends DomainResource {
 
     private Person(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        name = Collections.unmodifiableList(ValidationSupport.checkList(builder.name, "name", HumanName.class));
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        name = Collections.unmodifiableList(builder.name);
+        telecom = Collections.unmodifiableList(builder.telecom);
         gender = builder.gender;
         birthDate = builder.birthDate;
-        address = Collections.unmodifiableList(ValidationSupport.checkList(builder.address, "address", Address.class));
+        address = Collections.unmodifiableList(builder.address);
         photo = builder.photo;
         managingOrganization = builder.managingOrganization;
         active = builder.active;
-        link = Collections.unmodifiableList(ValidationSupport.checkList(builder.link, "link", Link.class));
-        ValidationSupport.checkReferenceType(managingOrganization, "managingOrganization", "Organization");
+        link = Collections.unmodifiableList(builder.link);
     }
 
     /**
@@ -770,7 +769,21 @@ public Builder link(Collection<Link> link) {
          */
         @Override
         public Person build() {
-            return new Person(this);
+            Person person = new Person(this);
+            if (validating) {
+                validate(person);
+            }
+            return person;
+        }
+
+        protected void validate(Person person) {
+            super.validate(person);
+            ValidationSupport.checkList(person.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(person.name, "name", HumanName.class);
+            ValidationSupport.checkList(person.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.checkList(person.address, "address", Address.class);
+            ValidationSupport.checkList(person.link, "link", Link.class);
+            ValidationSupport.checkReferenceType(person.managingOrganization, "managingOrganization", "Organization");
         }
 
         protected Builder from(Person person) {
@@ -806,10 +819,8 @@ public static class Link extends BackboneElement {
 
         private Link(Builder builder) {
             super(builder);
-            target = ValidationSupport.requireNonNull(builder.target, "target");
+            target = builder.target;
             assurance = builder.assurance;
-            ValidationSupport.checkReferenceType(target, "target", "Patient", "Practitioner", "RelatedPerson", "Person");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1060,7 +1071,18 @@ public Builder assurance(IdentityAssuranceLevel assurance) {
              */
             @Override
             public Link build() {
-                return new Link(this);
+                Link link = new Link(this);
+                if (validating) {
+                    validate(link);
+                }
+                return link;
+            }
+
+            protected void validate(Link link) {
+                super.validate(link);
+                ValidationSupport.requireNonNull(link.target, "target");
+                ValidationSupport.checkReferenceType(link.target, "target", "Patient", "Practitioner", "RelatedPerson", "Person");
+                ValidationSupport.requireValueOrChildren(link);
             }
 
             protected Builder from(Link link) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/PlanDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/PlanDefinition.java
index daaea57258f..0a73a99e613 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/PlanDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/PlanDefinition.java
@@ -216,37 +216,36 @@ public class PlanDefinition extends DomainResource {
     private PlanDefinition(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
         subtitle = builder.subtitle;
         type = builder.type;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
-        subject = ValidationSupport.choiceElement(builder.subject, "subject", CodeableConcept.class, Reference.class);
+        subject = builder.subject;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         usage = builder.usage;
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
-        library = Collections.unmodifiableList(ValidationSupport.checkList(builder.library, "library", Canonical.class));
-        goal = Collections.unmodifiableList(ValidationSupport.checkList(builder.goal, "goal", Goal.class));
-        action = Collections.unmodifiableList(ValidationSupport.checkList(builder.action, "action", Action.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Group");
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
+        library = Collections.unmodifiableList(builder.library);
+        goal = Collections.unmodifiableList(builder.goal);
+        action = Collections.unmodifiableList(builder.action);
     }
 
     /**
@@ -1760,7 +1759,31 @@ public Builder action(Collection<Action> action) {
          */
         @Override
         public PlanDefinition build() {
-            return new PlanDefinition(this);
+            PlanDefinition planDefinition = new PlanDefinition(this);
+            if (validating) {
+                validate(planDefinition);
+            }
+            return planDefinition;
+        }
+
+        protected void validate(PlanDefinition planDefinition) {
+            super.validate(planDefinition);
+            ValidationSupport.checkList(planDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(planDefinition.status, "status");
+            ValidationSupport.choiceElement(planDefinition.subject, "subject", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(planDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(planDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(planDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(planDefinition.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(planDefinition.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(planDefinition.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(planDefinition.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(planDefinition.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(planDefinition.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.checkList(planDefinition.library, "library", Canonical.class);
+            ValidationSupport.checkList(planDefinition.goal, "goal", Goal.class);
+            ValidationSupport.checkList(planDefinition.action, "action", Action.class);
+            ValidationSupport.checkReferenceType(planDefinition.subject, "subject", "Group");
         }
 
         protected Builder from(PlanDefinition planDefinition) {
@@ -1847,13 +1870,12 @@ public static class Goal extends BackboneElement {
         private Goal(Builder builder) {
             super(builder);
             category = builder.category;
-            description = ValidationSupport.requireNonNull(builder.description, "description");
+            description = builder.description;
             priority = builder.priority;
             start = builder.start;
-            addresses = Collections.unmodifiableList(ValidationSupport.checkList(builder.addresses, "addresses", CodeableConcept.class));
-            documentation = Collections.unmodifiableList(ValidationSupport.checkList(builder.documentation, "documentation", RelatedArtifact.class));
-            target = Collections.unmodifiableList(ValidationSupport.checkList(builder.target, "target", Target.class));
-            ValidationSupport.requireValueOrChildren(this);
+            addresses = Collections.unmodifiableList(builder.addresses);
+            documentation = Collections.unmodifiableList(builder.documentation);
+            target = Collections.unmodifiableList(builder.target);
         }
 
         /**
@@ -2306,7 +2328,20 @@ public Builder target(Collection<Target> target) {
              */
             @Override
             public Goal build() {
-                return new Goal(this);
+                Goal goal = new Goal(this);
+                if (validating) {
+                    validate(goal);
+                }
+                return goal;
+            }
+
+            protected void validate(Goal goal) {
+                super.validate(goal);
+                ValidationSupport.requireNonNull(goal.description, "description");
+                ValidationSupport.checkList(goal.addresses, "addresses", CodeableConcept.class);
+                ValidationSupport.checkList(goal.documentation, "documentation", RelatedArtifact.class);
+                ValidationSupport.checkList(goal.target, "target", Target.class);
+                ValidationSupport.requireValueOrChildren(goal);
             }
 
             protected Builder from(Goal goal) {
@@ -2340,9 +2375,8 @@ public static class Target extends BackboneElement {
             private Target(Builder builder) {
                 super(builder);
                 measure = builder.measure;
-                detail = ValidationSupport.choiceElement(builder.detail, "detail", Quantity.class, Range.class, CodeableConcept.class);
+                detail = builder.detail;
                 due = builder.due;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2620,7 +2654,17 @@ public Builder due(Duration due) {
                  */
                 @Override
                 public Target build() {
-                    return new Target(this);
+                    Target target = new Target(this);
+                    if (validating) {
+                        validate(target);
+                    }
+                    return target;
+                }
+
+                protected void validate(Target target) {
+                    super.validate(target);
+                    ValidationSupport.choiceElement(target.detail, "detail", Quantity.class, Range.class, CodeableConcept.class);
+                    ValidationSupport.requireValueOrChildren(target);
                 }
 
                 protected Builder from(Target target) {
@@ -2725,30 +2769,28 @@ private Action(Builder builder) {
             description = builder.description;
             textEquivalent = builder.textEquivalent;
             priority = builder.priority;
-            code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
-            reason = Collections.unmodifiableList(ValidationSupport.checkList(builder.reason, "reason", CodeableConcept.class));
-            documentation = Collections.unmodifiableList(ValidationSupport.checkList(builder.documentation, "documentation", RelatedArtifact.class));
-            goalId = Collections.unmodifiableList(ValidationSupport.checkList(builder.goalId, "goalId", Id.class));
-            subject = ValidationSupport.choiceElement(builder.subject, "subject", CodeableConcept.class, Reference.class);
-            trigger = Collections.unmodifiableList(ValidationSupport.checkList(builder.trigger, "trigger", TriggerDefinition.class));
-            condition = Collections.unmodifiableList(ValidationSupport.checkList(builder.condition, "condition", Condition.class));
-            input = Collections.unmodifiableList(ValidationSupport.checkList(builder.input, "input", DataRequirement.class));
-            output = Collections.unmodifiableList(ValidationSupport.checkList(builder.output, "output", DataRequirement.class));
-            relatedAction = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedAction, "relatedAction", RelatedAction.class));
-            timing = ValidationSupport.choiceElement(builder.timing, "timing", DateTime.class, Age.class, Period.class, Duration.class, Range.class, Timing.class);
-            participant = Collections.unmodifiableList(ValidationSupport.checkList(builder.participant, "participant", Participant.class));
+            code = Collections.unmodifiableList(builder.code);
+            reason = Collections.unmodifiableList(builder.reason);
+            documentation = Collections.unmodifiableList(builder.documentation);
+            goalId = Collections.unmodifiableList(builder.goalId);
+            subject = builder.subject;
+            trigger = Collections.unmodifiableList(builder.trigger);
+            condition = Collections.unmodifiableList(builder.condition);
+            input = Collections.unmodifiableList(builder.input);
+            output = Collections.unmodifiableList(builder.output);
+            relatedAction = Collections.unmodifiableList(builder.relatedAction);
+            timing = builder.timing;
+            participant = Collections.unmodifiableList(builder.participant);
             type = builder.type;
             groupingBehavior = builder.groupingBehavior;
             selectionBehavior = builder.selectionBehavior;
             requiredBehavior = builder.requiredBehavior;
             precheckBehavior = builder.precheckBehavior;
             cardinalityBehavior = builder.cardinalityBehavior;
-            definition = ValidationSupport.choiceElement(builder.definition, "definition", Canonical.class, Uri.class);
+            definition = builder.definition;
             transform = builder.transform;
-            dynamicValue = Collections.unmodifiableList(ValidationSupport.checkList(builder.dynamicValue, "dynamicValue", DynamicValue.class));
-            action = Collections.unmodifiableList(ValidationSupport.checkList(builder.action, "action", PlanDefinition.Action.class));
-            ValidationSupport.checkReferenceType(subject, "subject", "Group");
-            ValidationSupport.requireValueOrChildren(this);
+            dynamicValue = Collections.unmodifiableList(builder.dynamicValue);
+            action = Collections.unmodifiableList(builder.action);
         }
 
         /**
@@ -4003,7 +4045,32 @@ public Builder action(Collection<PlanDefinition.Action> action) {
              */
             @Override
             public Action build() {
-                return new Action(this);
+                Action action = new Action(this);
+                if (validating) {
+                    validate(action);
+                }
+                return action;
+            }
+
+            protected void validate(Action action) {
+                super.validate(action);
+                ValidationSupport.checkList(action.code, "code", CodeableConcept.class);
+                ValidationSupport.checkList(action.reason, "reason", CodeableConcept.class);
+                ValidationSupport.checkList(action.documentation, "documentation", RelatedArtifact.class);
+                ValidationSupport.checkList(action.goalId, "goalId", Id.class);
+                ValidationSupport.choiceElement(action.subject, "subject", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkList(action.trigger, "trigger", TriggerDefinition.class);
+                ValidationSupport.checkList(action.condition, "condition", Condition.class);
+                ValidationSupport.checkList(action.input, "input", DataRequirement.class);
+                ValidationSupport.checkList(action.output, "output", DataRequirement.class);
+                ValidationSupport.checkList(action.relatedAction, "relatedAction", RelatedAction.class);
+                ValidationSupport.choiceElement(action.timing, "timing", DateTime.class, Age.class, Period.class, Duration.class, Range.class, Timing.class);
+                ValidationSupport.checkList(action.participant, "participant", Participant.class);
+                ValidationSupport.choiceElement(action.definition, "definition", Canonical.class, Uri.class);
+                ValidationSupport.checkList(action.dynamicValue, "dynamicValue", DynamicValue.class);
+                ValidationSupport.checkList(action.action, "action", PlanDefinition.Action.class);
+                ValidationSupport.checkReferenceType(action.subject, "subject", "Group");
+                ValidationSupport.requireValueOrChildren(action);
             }
 
             protected Builder from(Action action) {
@@ -4055,9 +4122,8 @@ public static class Condition extends BackboneElement {
 
             private Condition(Builder builder) {
                 super(builder);
-                kind = ValidationSupport.requireNonNull(builder.kind, "kind");
+                kind = builder.kind;
                 expression = builder.expression;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -4300,7 +4366,17 @@ public Builder expression(Expression expression) {
                  */
                 @Override
                 public Condition build() {
-                    return new Condition(this);
+                    Condition condition = new Condition(this);
+                    if (validating) {
+                        validate(condition);
+                    }
+                    return condition;
+                }
+
+                protected void validate(Condition condition) {
+                    super.validate(condition);
+                    ValidationSupport.requireNonNull(condition.kind, "kind");
+                    ValidationSupport.requireValueOrChildren(condition);
                 }
 
                 protected Builder from(Condition condition) {
@@ -4331,10 +4407,9 @@ public static class RelatedAction extends BackboneElement {
 
             private RelatedAction(Builder builder) {
                 super(builder);
-                actionId = ValidationSupport.requireNonNull(builder.actionId, "actionId");
-                relationship = ValidationSupport.requireNonNull(builder.relationship, "relationship");
-                offset = ValidationSupport.choiceElement(builder.offset, "offset", Duration.class, Range.class);
-                ValidationSupport.requireValueOrChildren(this);
+                actionId = builder.actionId;
+                relationship = builder.relationship;
+                offset = builder.offset;
             }
 
             /**
@@ -4616,7 +4691,19 @@ public Builder offset(Element offset) {
                  */
                 @Override
                 public RelatedAction build() {
-                    return new RelatedAction(this);
+                    RelatedAction relatedAction = new RelatedAction(this);
+                    if (validating) {
+                        validate(relatedAction);
+                    }
+                    return relatedAction;
+                }
+
+                protected void validate(RelatedAction relatedAction) {
+                    super.validate(relatedAction);
+                    ValidationSupport.requireNonNull(relatedAction.actionId, "actionId");
+                    ValidationSupport.requireNonNull(relatedAction.relationship, "relationship");
+                    ValidationSupport.choiceElement(relatedAction.offset, "offset", Duration.class, Range.class);
+                    ValidationSupport.requireValueOrChildren(relatedAction);
                 }
 
                 protected Builder from(RelatedAction relatedAction) {
@@ -4651,9 +4738,8 @@ public static class Participant extends BackboneElement {
 
             private Participant(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
+                type = builder.type;
                 role = builder.role;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -4896,7 +4982,17 @@ public Builder role(CodeableConcept role) {
                  */
                 @Override
                 public Participant build() {
-                    return new Participant(this);
+                    Participant participant = new Participant(this);
+                    if (validating) {
+                        validate(participant);
+                    }
+                    return participant;
+                }
+
+                protected void validate(Participant participant) {
+                    super.validate(participant);
+                    ValidationSupport.requireNonNull(participant.type, "type");
+                    ValidationSupport.requireValueOrChildren(participant);
                 }
 
                 protected Builder from(Participant participant) {
@@ -4921,7 +5017,6 @@ private DynamicValue(Builder builder) {
                 super(builder);
                 path = builder.path;
                 expression = builder.expression;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -5165,7 +5260,16 @@ public Builder expression(Expression expression) {
                  */
                 @Override
                 public DynamicValue build() {
-                    return new DynamicValue(this);
+                    DynamicValue dynamicValue = new DynamicValue(this);
+                    if (validating) {
+                        validate(dynamicValue);
+                    }
+                    return dynamicValue;
+                }
+
+                protected void validate(DynamicValue dynamicValue) {
+                    super.validate(dynamicValue);
+                    ValidationSupport.requireValueOrChildren(dynamicValue);
                 }
 
                 protected Builder from(DynamicValue dynamicValue) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Practitioner.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Practitioner.java
index 3e37756de6c..c7ea98344f7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Practitioner.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Practitioner.java
@@ -94,17 +94,16 @@ public class Practitioner extends DomainResource {
 
     private Practitioner(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
-        name = Collections.unmodifiableList(ValidationSupport.checkList(builder.name, "name", HumanName.class));
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
-        address = Collections.unmodifiableList(ValidationSupport.checkList(builder.address, "address", Address.class));
+        name = Collections.unmodifiableList(builder.name);
+        telecom = Collections.unmodifiableList(builder.telecom);
+        address = Collections.unmodifiableList(builder.address);
         gender = builder.gender;
         birthDate = builder.birthDate;
-        photo = Collections.unmodifiableList(ValidationSupport.checkList(builder.photo, "photo", Attachment.class));
-        qualification = Collections.unmodifiableList(ValidationSupport.checkList(builder.qualification, "qualification", Qualification.class));
-        communication = Collections.unmodifiableList(ValidationSupport.checkList(builder.communication, "communication", CodeableConcept.class));
-        ValidationSupport.checkValueSetBinding(communication, "communication", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+        photo = Collections.unmodifiableList(builder.photo);
+        qualification = Collections.unmodifiableList(builder.qualification);
+        communication = Collections.unmodifiableList(builder.communication);
     }
 
     /**
@@ -833,7 +832,23 @@ public Builder communication(Collection<CodeableConcept> communication) {
          */
         @Override
         public Practitioner build() {
-            return new Practitioner(this);
+            Practitioner practitioner = new Practitioner(this);
+            if (validating) {
+                validate(practitioner);
+            }
+            return practitioner;
+        }
+
+        protected void validate(Practitioner practitioner) {
+            super.validate(practitioner);
+            ValidationSupport.checkList(practitioner.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(practitioner.name, "name", HumanName.class);
+            ValidationSupport.checkList(practitioner.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.checkList(practitioner.address, "address", Address.class);
+            ValidationSupport.checkList(practitioner.photo, "photo", Attachment.class);
+            ValidationSupport.checkList(practitioner.qualification, "qualification", Qualification.class);
+            ValidationSupport.checkList(practitioner.communication, "communication", CodeableConcept.class);
+            ValidationSupport.checkValueSetBinding(practitioner.communication, "communication", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
         }
 
         protected Builder from(Practitioner practitioner) {
@@ -873,12 +888,10 @@ public static class Qualification extends BackboneElement {
 
         private Qualification(Builder builder) {
             super(builder);
-            identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-            code = ValidationSupport.requireNonNull(builder.code, "code");
+            identifier = Collections.unmodifiableList(builder.identifier);
+            code = builder.code;
             period = builder.period;
             issuer = builder.issuer;
-            ValidationSupport.checkReferenceType(issuer, "issuer", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1204,7 +1217,19 @@ public Builder issuer(Reference issuer) {
              */
             @Override
             public Qualification build() {
-                return new Qualification(this);
+                Qualification qualification = new Qualification(this);
+                if (validating) {
+                    validate(qualification);
+                }
+                return qualification;
+            }
+
+            protected void validate(Qualification qualification) {
+                super.validate(qualification);
+                ValidationSupport.checkList(qualification.identifier, "identifier", Identifier.class);
+                ValidationSupport.requireNonNull(qualification.code, "code");
+                ValidationSupport.checkReferenceType(qualification.issuer, "issuer", "Organization");
+                ValidationSupport.requireValueOrChildren(qualification);
             }
 
             protected Builder from(Qualification qualification) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/PractitionerRole.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/PractitionerRole.java
index f7870022462..d6fc5dbf7b6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/PractitionerRole.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/PractitionerRole.java
@@ -103,25 +103,20 @@ public class PractitionerRole extends DomainResource {
 
     private PractitionerRole(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
         period = builder.period;
         practitioner = builder.practitioner;
         organization = builder.organization;
-        code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
-        specialty = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialty, "specialty", CodeableConcept.class));
-        location = Collections.unmodifiableList(ValidationSupport.checkList(builder.location, "location", Reference.class));
-        healthcareService = Collections.unmodifiableList(ValidationSupport.checkList(builder.healthcareService, "healthcareService", Reference.class));
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
-        availableTime = Collections.unmodifiableList(ValidationSupport.checkList(builder.availableTime, "availableTime", AvailableTime.class));
-        notAvailable = Collections.unmodifiableList(ValidationSupport.checkList(builder.notAvailable, "notAvailable", NotAvailable.class));
+        code = Collections.unmodifiableList(builder.code);
+        specialty = Collections.unmodifiableList(builder.specialty);
+        location = Collections.unmodifiableList(builder.location);
+        healthcareService = Collections.unmodifiableList(builder.healthcareService);
+        telecom = Collections.unmodifiableList(builder.telecom);
+        availableTime = Collections.unmodifiableList(builder.availableTime);
+        notAvailable = Collections.unmodifiableList(builder.notAvailable);
         availabilityExceptions = builder.availabilityExceptions;
-        endpoint = Collections.unmodifiableList(ValidationSupport.checkList(builder.endpoint, "endpoint", Reference.class));
-        ValidationSupport.checkReferenceType(practitioner, "practitioner", "Practitioner");
-        ValidationSupport.checkReferenceType(organization, "organization", "Organization");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(healthcareService, "healthcareService", "HealthcareService");
-        ValidationSupport.checkReferenceType(endpoint, "endpoint", "Endpoint");
+        endpoint = Collections.unmodifiableList(builder.endpoint);
     }
 
     /**
@@ -1037,7 +1032,29 @@ public Builder endpoint(Collection<Reference> endpoint) {
          */
         @Override
         public PractitionerRole build() {
-            return new PractitionerRole(this);
+            PractitionerRole practitionerRole = new PractitionerRole(this);
+            if (validating) {
+                validate(practitionerRole);
+            }
+            return practitionerRole;
+        }
+
+        protected void validate(PractitionerRole practitionerRole) {
+            super.validate(practitionerRole);
+            ValidationSupport.checkList(practitionerRole.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(practitionerRole.code, "code", CodeableConcept.class);
+            ValidationSupport.checkList(practitionerRole.specialty, "specialty", CodeableConcept.class);
+            ValidationSupport.checkList(practitionerRole.location, "location", Reference.class);
+            ValidationSupport.checkList(practitionerRole.healthcareService, "healthcareService", Reference.class);
+            ValidationSupport.checkList(practitionerRole.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.checkList(practitionerRole.availableTime, "availableTime", AvailableTime.class);
+            ValidationSupport.checkList(practitionerRole.notAvailable, "notAvailable", NotAvailable.class);
+            ValidationSupport.checkList(practitionerRole.endpoint, "endpoint", Reference.class);
+            ValidationSupport.checkReferenceType(practitionerRole.practitioner, "practitioner", "Practitioner");
+            ValidationSupport.checkReferenceType(practitionerRole.organization, "organization", "Organization");
+            ValidationSupport.checkReferenceType(practitionerRole.location, "location", "Location");
+            ValidationSupport.checkReferenceType(practitionerRole.healthcareService, "healthcareService", "HealthcareService");
+            ValidationSupport.checkReferenceType(practitionerRole.endpoint, "endpoint", "Endpoint");
         }
 
         protected Builder from(PractitionerRole practitionerRole) {
@@ -1077,11 +1094,10 @@ public static class AvailableTime extends BackboneElement {
 
         private AvailableTime(Builder builder) {
             super(builder);
-            daysOfWeek = Collections.unmodifiableList(ValidationSupport.checkList(builder.daysOfWeek, "daysOfWeek", DaysOfWeek.class));
+            daysOfWeek = Collections.unmodifiableList(builder.daysOfWeek);
             allDay = builder.allDay;
             availableStartTime = builder.availableStartTime;
             availableEndTime = builder.availableEndTime;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1395,7 +1411,17 @@ public Builder availableEndTime(Time availableEndTime) {
              */
             @Override
             public AvailableTime build() {
-                return new AvailableTime(this);
+                AvailableTime availableTime = new AvailableTime(this);
+                if (validating) {
+                    validate(availableTime);
+                }
+                return availableTime;
+            }
+
+            protected void validate(AvailableTime availableTime) {
+                super.validate(availableTime);
+                ValidationSupport.checkList(availableTime.daysOfWeek, "daysOfWeek", DaysOfWeek.class);
+                ValidationSupport.requireValueOrChildren(availableTime);
             }
 
             protected Builder from(AvailableTime availableTime) {
@@ -1419,9 +1445,8 @@ public static class NotAvailable extends BackboneElement {
 
         private NotAvailable(Builder builder) {
             super(builder);
-            description = ValidationSupport.requireNonNull(builder.description, "description");
+            description = builder.description;
             during = builder.during;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1664,7 +1689,17 @@ public Builder during(Period during) {
              */
             @Override
             public NotAvailable build() {
-                return new NotAvailable(this);
+                NotAvailable notAvailable = new NotAvailable(this);
+                if (validating) {
+                    validate(notAvailable);
+                }
+                return notAvailable;
+            }
+
+            protected void validate(NotAvailable notAvailable) {
+                super.validate(notAvailable);
+                ValidationSupport.requireNonNull(notAvailable.description, "description");
+                ValidationSupport.requireValueOrChildren(notAvailable);
             }
 
             protected Builder from(NotAvailable notAvailable) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Procedure.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Procedure.java
index 8059950503d..6f401571677 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Procedure.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Procedure.java
@@ -189,45 +189,34 @@ public class Procedure extends DomainResource {
 
     private Procedure(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-        instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+        instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        status = builder.status;
         statusReason = builder.statusReason;
         category = builder.category;
         code = builder.code;
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        subject = builder.subject;
         encounter = builder.encounter;
-        performed = ValidationSupport.choiceElement(builder.performed, "performed", DateTime.class, Period.class, String.class, Age.class, Range.class);
+        performed = builder.performed;
         recorder = builder.recorder;
         asserter = builder.asserter;
-        performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Performer.class));
+        performer = Collections.unmodifiableList(builder.performer);
         location = builder.location;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        bodySite = Collections.unmodifiableList(ValidationSupport.checkList(builder.bodySite, "bodySite", CodeableConcept.class));
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        bodySite = Collections.unmodifiableList(builder.bodySite);
         outcome = builder.outcome;
-        report = Collections.unmodifiableList(ValidationSupport.checkList(builder.report, "report", Reference.class));
-        complication = Collections.unmodifiableList(ValidationSupport.checkList(builder.complication, "complication", CodeableConcept.class));
-        complicationDetail = Collections.unmodifiableList(ValidationSupport.checkList(builder.complicationDetail, "complicationDetail", Reference.class));
-        followUp = Collections.unmodifiableList(ValidationSupport.checkList(builder.followUp, "followUp", CodeableConcept.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        focalDevice = Collections.unmodifiableList(ValidationSupport.checkList(builder.focalDevice, "focalDevice", FocalDevice.class));
-        usedReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.usedReference, "usedReference", Reference.class));
-        usedCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.usedCode, "usedCode", CodeableConcept.class));
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "CarePlan", "ServiceRequest");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "Procedure", "Observation", "MedicationAdministration");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(recorder, "recorder", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(asserter, "asserter", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "Procedure", "DiagnosticReport", "DocumentReference");
-        ValidationSupport.checkReferenceType(report, "report", "DiagnosticReport", "DocumentReference", "Composition");
-        ValidationSupport.checkReferenceType(complicationDetail, "complicationDetail", "Condition");
-        ValidationSupport.checkReferenceType(usedReference, "usedReference", "Device", "Medication", "Substance");
+        report = Collections.unmodifiableList(builder.report);
+        complication = Collections.unmodifiableList(builder.complication);
+        complicationDetail = Collections.unmodifiableList(builder.complicationDetail);
+        followUp = Collections.unmodifiableList(builder.followUp);
+        note = Collections.unmodifiableList(builder.note);
+        focalDevice = Collections.unmodifiableList(builder.focalDevice);
+        usedReference = Collections.unmodifiableList(builder.usedReference);
+        usedCode = Collections.unmodifiableList(builder.usedCode);
     }
 
     /**
@@ -1833,7 +1822,46 @@ public Builder usedCode(Collection<CodeableConcept> usedCode) {
          */
         @Override
         public Procedure build() {
-            return new Procedure(this);
+            Procedure procedure = new Procedure(this);
+            if (validating) {
+                validate(procedure);
+            }
+            return procedure;
+        }
+
+        protected void validate(Procedure procedure) {
+            super.validate(procedure);
+            ValidationSupport.checkList(procedure.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(procedure.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+            ValidationSupport.checkList(procedure.instantiatesUri, "instantiatesUri", Uri.class);
+            ValidationSupport.checkList(procedure.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(procedure.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(procedure.status, "status");
+            ValidationSupport.requireNonNull(procedure.subject, "subject");
+            ValidationSupport.choiceElement(procedure.performed, "performed", DateTime.class, Period.class, String.class, Age.class, Range.class);
+            ValidationSupport.checkList(procedure.performer, "performer", Performer.class);
+            ValidationSupport.checkList(procedure.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(procedure.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(procedure.bodySite, "bodySite", CodeableConcept.class);
+            ValidationSupport.checkList(procedure.report, "report", Reference.class);
+            ValidationSupport.checkList(procedure.complication, "complication", CodeableConcept.class);
+            ValidationSupport.checkList(procedure.complicationDetail, "complicationDetail", Reference.class);
+            ValidationSupport.checkList(procedure.followUp, "followUp", CodeableConcept.class);
+            ValidationSupport.checkList(procedure.note, "note", Annotation.class);
+            ValidationSupport.checkList(procedure.focalDevice, "focalDevice", FocalDevice.class);
+            ValidationSupport.checkList(procedure.usedReference, "usedReference", Reference.class);
+            ValidationSupport.checkList(procedure.usedCode, "usedCode", CodeableConcept.class);
+            ValidationSupport.checkReferenceType(procedure.basedOn, "basedOn", "CarePlan", "ServiceRequest");
+            ValidationSupport.checkReferenceType(procedure.partOf, "partOf", "Procedure", "Observation", "MedicationAdministration");
+            ValidationSupport.checkReferenceType(procedure.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(procedure.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(procedure.recorder, "recorder", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(procedure.asserter, "asserter", "Patient", "RelatedPerson", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(procedure.location, "location", "Location");
+            ValidationSupport.checkReferenceType(procedure.reasonReference, "reasonReference", "Condition", "Observation", "Procedure", "DiagnosticReport", "DocumentReference");
+            ValidationSupport.checkReferenceType(procedure.report, "report", "DiagnosticReport", "DocumentReference", "Composition");
+            ValidationSupport.checkReferenceType(procedure.complicationDetail, "complicationDetail", "Condition");
+            ValidationSupport.checkReferenceType(procedure.usedReference, "usedReference", "Device", "Medication", "Substance");
         }
 
         protected Builder from(Procedure procedure) {
@@ -1892,11 +1920,8 @@ public static class Performer extends BackboneElement {
         private Performer(Builder builder) {
             super(builder);
             function = builder.function;
-            actor = ValidationSupport.requireNonNull(builder.actor, "actor");
+            actor = builder.actor;
             onBehalfOf = builder.onBehalfOf;
-            ValidationSupport.checkReferenceType(actor, "actor", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
-            ValidationSupport.checkReferenceType(onBehalfOf, "onBehalfOf", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2185,7 +2210,19 @@ public Builder onBehalfOf(Reference onBehalfOf) {
              */
             @Override
             public Performer build() {
-                return new Performer(this);
+                Performer performer = new Performer(this);
+                if (validating) {
+                    validate(performer);
+                }
+                return performer;
+            }
+
+            protected void validate(Performer performer) {
+                super.validate(performer);
+                ValidationSupport.requireNonNull(performer.actor, "actor");
+                ValidationSupport.checkReferenceType(performer.actor, "actor", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
+                ValidationSupport.checkReferenceType(performer.onBehalfOf, "onBehalfOf", "Organization");
+                ValidationSupport.requireValueOrChildren(performer);
             }
 
             protected Builder from(Performer performer) {
@@ -2217,9 +2254,7 @@ public static class FocalDevice extends BackboneElement {
         private FocalDevice(Builder builder) {
             super(builder);
             action = builder.action;
-            manipulated = ValidationSupport.requireNonNull(builder.manipulated, "manipulated");
-            ValidationSupport.checkReferenceType(manipulated, "manipulated", "Device");
-            ValidationSupport.requireValueOrChildren(this);
+            manipulated = builder.manipulated;
         }
 
         /**
@@ -2467,7 +2502,18 @@ public Builder manipulated(Reference manipulated) {
              */
             @Override
             public FocalDevice build() {
-                return new FocalDevice(this);
+                FocalDevice focalDevice = new FocalDevice(this);
+                if (validating) {
+                    validate(focalDevice);
+                }
+                return focalDevice;
+            }
+
+            protected void validate(FocalDevice focalDevice) {
+                super.validate(focalDevice);
+                ValidationSupport.requireNonNull(focalDevice.manipulated, "manipulated");
+                ValidationSupport.checkReferenceType(focalDevice.manipulated, "manipulated", "Device");
+                ValidationSupport.requireValueOrChildren(focalDevice);
             }
 
             protected Builder from(FocalDevice focalDevice) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Provenance.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Provenance.java
index 1ef4c21aa75..6753e23c34d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Provenance.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Provenance.java
@@ -113,17 +113,16 @@ public class Provenance extends DomainResource {
 
     private Provenance(Builder builder) {
         super(builder);
-        target = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.target, "target", Reference.class));
-        occurred = ValidationSupport.choiceElement(builder.occurred, "occurred", Period.class, DateTime.class);
-        recorded = ValidationSupport.requireNonNull(builder.recorded, "recorded");
-        policy = Collections.unmodifiableList(ValidationSupport.checkList(builder.policy, "policy", Uri.class));
+        target = Collections.unmodifiableList(builder.target);
+        occurred = builder.occurred;
+        recorded = builder.recorded;
+        policy = Collections.unmodifiableList(builder.policy);
         location = builder.location;
-        reason = Collections.unmodifiableList(ValidationSupport.checkList(builder.reason, "reason", CodeableConcept.class));
+        reason = Collections.unmodifiableList(builder.reason);
         activity = builder.activity;
-        agent = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.agent, "agent", Agent.class));
-        entity = Collections.unmodifiableList(ValidationSupport.checkList(builder.entity, "entity", Entity.class));
-        signature = Collections.unmodifiableList(ValidationSupport.checkList(builder.signature, "signature", Signature.class));
-        ValidationSupport.checkReferenceType(location, "location", "Location");
+        agent = Collections.unmodifiableList(builder.agent);
+        entity = Collections.unmodifiableList(builder.entity);
+        signature = Collections.unmodifiableList(builder.signature);
     }
 
     /**
@@ -863,7 +862,24 @@ public Builder signature(Collection<Signature> signature) {
          */
         @Override
         public Provenance build() {
-            return new Provenance(this);
+            Provenance provenance = new Provenance(this);
+            if (validating) {
+                validate(provenance);
+            }
+            return provenance;
+        }
+
+        protected void validate(Provenance provenance) {
+            super.validate(provenance);
+            ValidationSupport.checkNonEmptyList(provenance.target, "target", Reference.class);
+            ValidationSupport.choiceElement(provenance.occurred, "occurred", Period.class, DateTime.class);
+            ValidationSupport.requireNonNull(provenance.recorded, "recorded");
+            ValidationSupport.checkList(provenance.policy, "policy", Uri.class);
+            ValidationSupport.checkList(provenance.reason, "reason", CodeableConcept.class);
+            ValidationSupport.checkNonEmptyList(provenance.agent, "agent", Agent.class);
+            ValidationSupport.checkList(provenance.entity, "entity", Entity.class);
+            ValidationSupport.checkList(provenance.signature, "signature", Signature.class);
+            ValidationSupport.checkReferenceType(provenance.location, "location", "Location");
         }
 
         protected Builder from(Provenance provenance) {
@@ -912,12 +928,9 @@ public static class Agent extends BackboneElement {
         private Agent(Builder builder) {
             super(builder);
             type = builder.type;
-            role = Collections.unmodifiableList(ValidationSupport.checkList(builder.role, "role", CodeableConcept.class));
-            who = ValidationSupport.requireNonNull(builder.who, "who");
+            role = Collections.unmodifiableList(builder.role);
+            who = builder.who;
             onBehalfOf = builder.onBehalfOf;
-            ValidationSupport.checkReferenceType(who, "who", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Device", "Organization");
-            ValidationSupport.checkReferenceType(onBehalfOf, "onBehalfOf", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Device", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1261,7 +1274,20 @@ public Builder onBehalfOf(Reference onBehalfOf) {
              */
             @Override
             public Agent build() {
-                return new Agent(this);
+                Agent agent = new Agent(this);
+                if (validating) {
+                    validate(agent);
+                }
+                return agent;
+            }
+
+            protected void validate(Agent agent) {
+                super.validate(agent);
+                ValidationSupport.checkList(agent.role, "role", CodeableConcept.class);
+                ValidationSupport.requireNonNull(agent.who, "who");
+                ValidationSupport.checkReferenceType(agent.who, "who", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Device", "Organization");
+                ValidationSupport.checkReferenceType(agent.onBehalfOf, "onBehalfOf", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Device", "Organization");
+                ValidationSupport.requireValueOrChildren(agent);
             }
 
             protected Builder from(Agent agent) {
@@ -1295,10 +1321,9 @@ public static class Entity extends BackboneElement {
 
         private Entity(Builder builder) {
             super(builder);
-            role = ValidationSupport.requireNonNull(builder.role, "role");
-            what = ValidationSupport.requireNonNull(builder.what, "what");
-            agent = Collections.unmodifiableList(ValidationSupport.checkList(builder.agent, "agent", Provenance.Agent.class));
-            ValidationSupport.requireValueOrChildren(this);
+            role = builder.role;
+            what = builder.what;
+            agent = Collections.unmodifiableList(builder.agent);
         }
 
         /**
@@ -1599,7 +1624,19 @@ public Builder agent(Collection<Provenance.Agent> agent) {
              */
             @Override
             public Entity build() {
-                return new Entity(this);
+                Entity entity = new Entity(this);
+                if (validating) {
+                    validate(entity);
+                }
+                return entity;
+            }
+
+            protected void validate(Entity entity) {
+                super.validate(entity);
+                ValidationSupport.requireNonNull(entity.role, "role");
+                ValidationSupport.requireNonNull(entity.what, "what");
+                ValidationSupport.checkList(entity.agent, "agent", Provenance.Agent.class);
+                ValidationSupport.requireValueOrChildren(entity);
             }
 
             protected Builder from(Entity entity) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Questionnaire.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Questionnaire.java
index 689037a18b3..57b853a1dec 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Questionnaire.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Questionnaire.java
@@ -239,27 +239,27 @@ public class Questionnaire extends DomainResource {
     private Questionnaire(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
-        derivedFrom = Collections.unmodifiableList(ValidationSupport.checkList(builder.derivedFrom, "derivedFrom", Canonical.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        derivedFrom = Collections.unmodifiableList(builder.derivedFrom);
+        status = builder.status;
         experimental = builder.experimental;
-        subjectType = Collections.unmodifiableList(ValidationSupport.checkList(builder.subjectType, "subjectType", ResourceType.class));
+        subjectType = Collections.unmodifiableList(builder.subjectType);
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", Coding.class));
-        item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", Item.class));
+        code = Collections.unmodifiableList(builder.code);
+        item = Collections.unmodifiableList(builder.item);
     }
 
     /**
@@ -1387,7 +1387,24 @@ public Builder item(Collection<Item> item) {
          */
         @Override
         public Questionnaire build() {
-            return new Questionnaire(this);
+            Questionnaire questionnaire = new Questionnaire(this);
+            if (validating) {
+                validate(questionnaire);
+            }
+            return questionnaire;
+        }
+
+        protected void validate(Questionnaire questionnaire) {
+            super.validate(questionnaire);
+            ValidationSupport.checkList(questionnaire.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(questionnaire.derivedFrom, "derivedFrom", Canonical.class);
+            ValidationSupport.requireNonNull(questionnaire.status, "status");
+            ValidationSupport.checkList(questionnaire.subjectType, "subjectType", ResourceType.class);
+            ValidationSupport.checkList(questionnaire.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(questionnaire.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(questionnaire.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(questionnaire.code, "code", Coding.class);
+            ValidationSupport.checkList(questionnaire.item, "item", Item.class);
         }
 
         protected Builder from(Questionnaire questionnaire) {
@@ -1461,23 +1478,22 @@ public static class Item extends BackboneElement {
 
         private Item(Builder builder) {
             super(builder);
-            linkId = ValidationSupport.requireNonNull(builder.linkId, "linkId");
+            linkId = builder.linkId;
             definition = builder.definition;
-            code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", Coding.class));
+            code = Collections.unmodifiableList(builder.code);
             prefix = builder.prefix;
             text = builder.text;
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            enableWhen = Collections.unmodifiableList(ValidationSupport.checkList(builder.enableWhen, "enableWhen", EnableWhen.class));
+            type = builder.type;
+            enableWhen = Collections.unmodifiableList(builder.enableWhen);
             enableBehavior = builder.enableBehavior;
             required = builder.required;
             repeats = builder.repeats;
             readOnly = builder.readOnly;
             maxLength = builder.maxLength;
             answerValueSet = builder.answerValueSet;
-            answerOption = Collections.unmodifiableList(ValidationSupport.checkList(builder.answerOption, "answerOption", AnswerOption.class));
-            initial = Collections.unmodifiableList(ValidationSupport.checkList(builder.initial, "initial", Initial.class));
-            item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", Questionnaire.Item.class));
-            ValidationSupport.requireValueOrChildren(this);
+            answerOption = Collections.unmodifiableList(builder.answerOption);
+            initial = Collections.unmodifiableList(builder.initial);
+            item = Collections.unmodifiableList(builder.item);
         }
 
         /**
@@ -2274,7 +2290,23 @@ public Builder item(Collection<Questionnaire.Item> item) {
              */
             @Override
             public Item build() {
-                return new Item(this);
+                Item item = new Item(this);
+                if (validating) {
+                    validate(item);
+                }
+                return item;
+            }
+
+            protected void validate(Item item) {
+                super.validate(item);
+                ValidationSupport.requireNonNull(item.linkId, "linkId");
+                ValidationSupport.checkList(item.code, "code", Coding.class);
+                ValidationSupport.requireNonNull(item.type, "type");
+                ValidationSupport.checkList(item.enableWhen, "enableWhen", EnableWhen.class);
+                ValidationSupport.checkList(item.answerOption, "answerOption", AnswerOption.class);
+                ValidationSupport.checkList(item.initial, "initial", Initial.class);
+                ValidationSupport.checkList(item.item, "item", Questionnaire.Item.class);
+                ValidationSupport.requireValueOrChildren(item);
             }
 
             protected Builder from(Item item) {
@@ -2326,10 +2358,9 @@ public static class EnableWhen extends BackboneElement {
 
             private EnableWhen(Builder builder) {
                 super(builder);
-                question = ValidationSupport.requireNonNull(builder.question, "question");
-                operator = ValidationSupport.requireNonNull(builder.operator, "operator");
-                answer = ValidationSupport.requireChoiceElement(builder.answer, "answer", Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Coding.class, Quantity.class, Reference.class);
-                ValidationSupport.requireValueOrChildren(this);
+                question = builder.question;
+                operator = builder.operator;
+                answer = builder.answer;
             }
 
             /**
@@ -2621,7 +2652,19 @@ public Builder answer(Element answer) {
                  */
                 @Override
                 public EnableWhen build() {
-                    return new EnableWhen(this);
+                    EnableWhen enableWhen = new EnableWhen(this);
+                    if (validating) {
+                        validate(enableWhen);
+                    }
+                    return enableWhen;
+                }
+
+                protected void validate(EnableWhen enableWhen) {
+                    super.validate(enableWhen);
+                    ValidationSupport.requireNonNull(enableWhen.question, "question");
+                    ValidationSupport.requireNonNull(enableWhen.operator, "operator");
+                    ValidationSupport.requireChoiceElement(enableWhen.answer, "answer", Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Coding.class, Quantity.class, Reference.class);
+                    ValidationSupport.requireValueOrChildren(enableWhen);
                 }
 
                 protected Builder from(EnableWhen enableWhen) {
@@ -2651,9 +2694,8 @@ public static class AnswerOption extends BackboneElement {
 
             private AnswerOption(Builder builder) {
                 super(builder);
-                value = ValidationSupport.requireChoiceElement(builder.value, "value", Integer.class, Date.class, Time.class, String.class, Coding.class, Reference.class);
+                value = builder.value;
                 initialSelected = builder.initialSelected;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2906,7 +2948,17 @@ public Builder initialSelected(Boolean initialSelected) {
                  */
                 @Override
                 public AnswerOption build() {
-                    return new AnswerOption(this);
+                    AnswerOption answerOption = new AnswerOption(this);
+                    if (validating) {
+                        validate(answerOption);
+                    }
+                    return answerOption;
+                }
+
+                protected void validate(AnswerOption answerOption) {
+                    super.validate(answerOption);
+                    ValidationSupport.requireChoiceElement(answerOption.value, "value", Integer.class, Date.class, Time.class, String.class, Coding.class, Reference.class);
+                    ValidationSupport.requireValueOrChildren(answerOption);
                 }
 
                 protected Builder from(AnswerOption answerOption) {
@@ -2935,8 +2987,7 @@ public static class Initial extends BackboneElement {
 
             private Initial(Builder builder) {
                 super(builder);
-                value = ValidationSupport.requireChoiceElement(builder.value, "value", Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Uri.class, Attachment.class, Coding.class, Quantity.class, Reference.class);
-                ValidationSupport.requireValueOrChildren(this);
+                value = builder.value;
             }
 
             /**
@@ -3166,7 +3217,17 @@ public Builder value(Element value) {
                  */
                 @Override
                 public Initial build() {
-                    return new Initial(this);
+                    Initial initial = new Initial(this);
+                    if (validating) {
+                        validate(initial);
+                    }
+                    return initial;
+                }
+
+                protected void validate(Initial initial) {
+                    super.validate(initial);
+                    ValidationSupport.requireChoiceElement(initial.value, "value", Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Uri.class, Attachment.class, Coding.class, Quantity.class, Reference.class);
+                    ValidationSupport.requireValueOrChildren(initial);
                 }
 
                 protected Builder from(Initial initial) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/QuestionnaireResponse.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/QuestionnaireResponse.java
index f72747fb49b..6f9b24ce84e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/QuestionnaireResponse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/QuestionnaireResponse.java
@@ -103,21 +103,16 @@ public class QuestionnaireResponse extends DomainResource {
     private QuestionnaireResponse(Builder builder) {
         super(builder);
         identifier = builder.identifier;
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        partOf = Collections.unmodifiableList(builder.partOf);
         questionnaire = builder.questionnaire;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         subject = builder.subject;
         encounter = builder.encounter;
         authored = builder.authored;
         author = builder.author;
         source = builder.source;
-        item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", Item.class));
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "CarePlan", "ServiceRequest");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "Observation", "Procedure");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(author, "author", "Device", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson", "Organization");
-        ValidationSupport.checkReferenceType(source, "source", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
+        item = Collections.unmodifiableList(builder.item);
     }
 
     /**
@@ -848,7 +843,24 @@ public Builder item(Collection<Item> item) {
          */
         @Override
         public QuestionnaireResponse build() {
-            return new QuestionnaireResponse(this);
+            QuestionnaireResponse questionnaireResponse = new QuestionnaireResponse(this);
+            if (validating) {
+                validate(questionnaireResponse);
+            }
+            return questionnaireResponse;
+        }
+
+        protected void validate(QuestionnaireResponse questionnaireResponse) {
+            super.validate(questionnaireResponse);
+            ValidationSupport.checkList(questionnaireResponse.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(questionnaireResponse.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(questionnaireResponse.status, "status");
+            ValidationSupport.checkList(questionnaireResponse.item, "item", Item.class);
+            ValidationSupport.checkReferenceType(questionnaireResponse.basedOn, "basedOn", "CarePlan", "ServiceRequest");
+            ValidationSupport.checkReferenceType(questionnaireResponse.partOf, "partOf", "Observation", "Procedure");
+            ValidationSupport.checkReferenceType(questionnaireResponse.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(questionnaireResponse.author, "author", "Device", "Practitioner", "PractitionerRole", "Patient", "RelatedPerson", "Organization");
+            ValidationSupport.checkReferenceType(questionnaireResponse.source, "source", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
         }
 
         protected Builder from(QuestionnaireResponse questionnaireResponse) {
@@ -881,12 +893,11 @@ public static class Item extends BackboneElement {
 
         private Item(Builder builder) {
             super(builder);
-            linkId = ValidationSupport.requireNonNull(builder.linkId, "linkId");
+            linkId = builder.linkId;
             definition = builder.definition;
             text = builder.text;
-            answer = Collections.unmodifiableList(ValidationSupport.checkList(builder.answer, "answer", Answer.class));
-            item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", QuestionnaireResponse.Item.class));
-            ValidationSupport.requireValueOrChildren(this);
+            answer = Collections.unmodifiableList(builder.answer);
+            item = Collections.unmodifiableList(builder.item);
         }
 
         /**
@@ -1256,7 +1267,19 @@ public Builder item(Collection<QuestionnaireResponse.Item> item) {
              */
             @Override
             public Item build() {
-                return new Item(this);
+                Item item = new Item(this);
+                if (validating) {
+                    validate(item);
+                }
+                return item;
+            }
+
+            protected void validate(Item item) {
+                super.validate(item);
+                ValidationSupport.requireNonNull(item.linkId, "linkId");
+                ValidationSupport.checkList(item.answer, "answer", Answer.class);
+                ValidationSupport.checkList(item.item, "item", QuestionnaireResponse.Item.class);
+                ValidationSupport.requireValueOrChildren(item);
             }
 
             protected Builder from(Item item) {
@@ -1286,9 +1309,8 @@ public static class Answer extends BackboneElement {
 
             private Answer(Builder builder) {
                 super(builder);
-                value = ValidationSupport.choiceElement(builder.value, "value", Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Uri.class, Attachment.class, Coding.class, Quantity.class, Reference.class);
-                item = Collections.unmodifiableList(ValidationSupport.checkList(builder.item, "item", QuestionnaireResponse.Item.class));
-                ValidationSupport.requireValueOrChildren(this);
+                value = builder.value;
+                item = Collections.unmodifiableList(builder.item);
             }
 
             /**
@@ -1560,7 +1582,18 @@ public Builder item(Collection<QuestionnaireResponse.Item> item) {
                  */
                 @Override
                 public Answer build() {
-                    return new Answer(this);
+                    Answer answer = new Answer(this);
+                    if (validating) {
+                        validate(answer);
+                    }
+                    return answer;
+                }
+
+                protected void validate(Answer answer) {
+                    super.validate(answer);
+                    ValidationSupport.choiceElement(answer.value, "value", Boolean.class, Decimal.class, Integer.class, Date.class, DateTime.class, Time.class, String.class, Uri.class, Attachment.class, Coding.class, Quantity.class, Reference.class);
+                    ValidationSupport.checkList(answer.item, "item", QuestionnaireResponse.Item.class);
+                    ValidationSupport.requireValueOrChildren(answer);
                 }
 
                 protected Builder from(Answer answer) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/RelatedPerson.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/RelatedPerson.java
index 0af4ddaee82..3f9debe3970 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/RelatedPerson.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/RelatedPerson.java
@@ -108,19 +108,18 @@ public class RelatedPerson extends DomainResource {
 
     private RelatedPerson(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
-        relationship = Collections.unmodifiableList(ValidationSupport.checkList(builder.relationship, "relationship", CodeableConcept.class));
-        name = Collections.unmodifiableList(ValidationSupport.checkList(builder.name, "name", HumanName.class));
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
+        patient = builder.patient;
+        relationship = Collections.unmodifiableList(builder.relationship);
+        name = Collections.unmodifiableList(builder.name);
+        telecom = Collections.unmodifiableList(builder.telecom);
         gender = builder.gender;
         birthDate = builder.birthDate;
-        address = Collections.unmodifiableList(ValidationSupport.checkList(builder.address, "address", Address.class));
-        photo = Collections.unmodifiableList(ValidationSupport.checkList(builder.photo, "photo", Attachment.class));
+        address = Collections.unmodifiableList(builder.address);
+        photo = Collections.unmodifiableList(builder.photo);
         period = builder.period;
-        communication = Collections.unmodifiableList(ValidationSupport.checkList(builder.communication, "communication", Communication.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
+        communication = Collections.unmodifiableList(builder.communication);
     }
 
     /**
@@ -912,7 +911,24 @@ public Builder communication(Collection<Communication> communication) {
          */
         @Override
         public RelatedPerson build() {
-            return new RelatedPerson(this);
+            RelatedPerson relatedPerson = new RelatedPerson(this);
+            if (validating) {
+                validate(relatedPerson);
+            }
+            return relatedPerson;
+        }
+
+        protected void validate(RelatedPerson relatedPerson) {
+            super.validate(relatedPerson);
+            ValidationSupport.checkList(relatedPerson.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(relatedPerson.patient, "patient");
+            ValidationSupport.checkList(relatedPerson.relationship, "relationship", CodeableConcept.class);
+            ValidationSupport.checkList(relatedPerson.name, "name", HumanName.class);
+            ValidationSupport.checkList(relatedPerson.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.checkList(relatedPerson.address, "address", Address.class);
+            ValidationSupport.checkList(relatedPerson.photo, "photo", Attachment.class);
+            ValidationSupport.checkList(relatedPerson.communication, "communication", Communication.class);
+            ValidationSupport.checkReferenceType(relatedPerson.patient, "patient", "Patient");
         }
 
         protected Builder from(RelatedPerson relatedPerson) {
@@ -950,10 +966,8 @@ public static class Communication extends BackboneElement {
 
         private Communication(Builder builder) {
             super(builder);
-            language = ValidationSupport.requireNonNull(builder.language, "language");
+            language = builder.language;
             preferred = builder.preferred;
-            ValidationSupport.checkValueSetBinding(language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1200,7 +1214,18 @@ public Builder preferred(Boolean preferred) {
              */
             @Override
             public Communication build() {
-                return new Communication(this);
+                Communication communication = new Communication(this);
+                if (validating) {
+                    validate(communication);
+                }
+                return communication;
+            }
+
+            protected void validate(Communication communication) {
+                super.validate(communication);
+                ValidationSupport.requireNonNull(communication.language, "language");
+                ValidationSupport.checkValueSetBinding(communication.language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+                ValidationSupport.requireValueOrChildren(communication);
             }
 
             protected Builder from(Communication communication) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/RequestGroup.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/RequestGroup.java
index 4b1b7cab65e..2f642ed8e34 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/RequestGroup.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/RequestGroup.java
@@ -138,28 +138,24 @@ public class RequestGroup extends DomainResource {
 
     private RequestGroup(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-        instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        replaces = Collections.unmodifiableList(ValidationSupport.checkList(builder.replaces, "replaces", Reference.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+        instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        replaces = Collections.unmodifiableList(builder.replaces);
         groupIdentifier = builder.groupIdentifier;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        intent = ValidationSupport.requireNonNull(builder.intent, "intent");
+        status = builder.status;
+        intent = builder.intent;
         priority = builder.priority;
         code = builder.code;
         subject = builder.subject;
         encounter = builder.encounter;
         authoredOn = builder.authoredOn;
         author = builder.author;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        action = Collections.unmodifiableList(ValidationSupport.checkList(builder.action, "action", Action.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(author, "author", "Device", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        note = Collections.unmodifiableList(builder.note);
+        action = Collections.unmodifiableList(builder.action);
     }
 
     /**
@@ -1203,7 +1199,30 @@ public Builder action(Collection<Action> action) {
          */
         @Override
         public RequestGroup build() {
-            return new RequestGroup(this);
+            RequestGroup requestGroup = new RequestGroup(this);
+            if (validating) {
+                validate(requestGroup);
+            }
+            return requestGroup;
+        }
+
+        protected void validate(RequestGroup requestGroup) {
+            super.validate(requestGroup);
+            ValidationSupport.checkList(requestGroup.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(requestGroup.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+            ValidationSupport.checkList(requestGroup.instantiatesUri, "instantiatesUri", Uri.class);
+            ValidationSupport.checkList(requestGroup.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(requestGroup.replaces, "replaces", Reference.class);
+            ValidationSupport.requireNonNull(requestGroup.status, "status");
+            ValidationSupport.requireNonNull(requestGroup.intent, "intent");
+            ValidationSupport.checkList(requestGroup.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(requestGroup.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(requestGroup.note, "note", Annotation.class);
+            ValidationSupport.checkList(requestGroup.action, "action", Action.class);
+            ValidationSupport.checkReferenceType(requestGroup.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(requestGroup.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(requestGroup.author, "author", "Device", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(requestGroup.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
         }
 
         protected Builder from(RequestGroup requestGroup) {
@@ -1307,12 +1326,12 @@ private Action(Builder builder) {
             description = builder.description;
             textEquivalent = builder.textEquivalent;
             priority = builder.priority;
-            code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", CodeableConcept.class));
-            documentation = Collections.unmodifiableList(ValidationSupport.checkList(builder.documentation, "documentation", RelatedArtifact.class));
-            condition = Collections.unmodifiableList(ValidationSupport.checkList(builder.condition, "condition", Condition.class));
-            relatedAction = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedAction, "relatedAction", RelatedAction.class));
-            timing = ValidationSupport.choiceElement(builder.timing, "timing", DateTime.class, Age.class, Period.class, Duration.class, Range.class, Timing.class);
-            participant = Collections.unmodifiableList(ValidationSupport.checkList(builder.participant, "participant", Reference.class));
+            code = Collections.unmodifiableList(builder.code);
+            documentation = Collections.unmodifiableList(builder.documentation);
+            condition = Collections.unmodifiableList(builder.condition);
+            relatedAction = Collections.unmodifiableList(builder.relatedAction);
+            timing = builder.timing;
+            participant = Collections.unmodifiableList(builder.participant);
             type = builder.type;
             groupingBehavior = builder.groupingBehavior;
             selectionBehavior = builder.selectionBehavior;
@@ -1320,9 +1339,7 @@ private Action(Builder builder) {
             precheckBehavior = builder.precheckBehavior;
             cardinalityBehavior = builder.cardinalityBehavior;
             resource = builder.resource;
-            action = Collections.unmodifiableList(ValidationSupport.checkList(builder.action, "action", RequestGroup.Action.class));
-            ValidationSupport.checkReferenceType(participant, "participant", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Device");
-            ValidationSupport.requireValueOrChildren(this);
+            action = Collections.unmodifiableList(builder.action);
         }
 
         /**
@@ -2207,7 +2224,24 @@ public Builder action(Collection<RequestGroup.Action> action) {
              */
             @Override
             public Action build() {
-                return new Action(this);
+                Action action = new Action(this);
+                if (validating) {
+                    validate(action);
+                }
+                return action;
+            }
+
+            protected void validate(Action action) {
+                super.validate(action);
+                ValidationSupport.checkList(action.code, "code", CodeableConcept.class);
+                ValidationSupport.checkList(action.documentation, "documentation", RelatedArtifact.class);
+                ValidationSupport.checkList(action.condition, "condition", Condition.class);
+                ValidationSupport.checkList(action.relatedAction, "relatedAction", RelatedAction.class);
+                ValidationSupport.choiceElement(action.timing, "timing", DateTime.class, Age.class, Period.class, Duration.class, Range.class, Timing.class);
+                ValidationSupport.checkList(action.participant, "participant", Reference.class);
+                ValidationSupport.checkList(action.action, "action", RequestGroup.Action.class);
+                ValidationSupport.checkReferenceType(action.participant, "participant", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Device");
+                ValidationSupport.requireValueOrChildren(action);
             }
 
             protected Builder from(Action action) {
@@ -2251,9 +2285,8 @@ public static class Condition extends BackboneElement {
 
             private Condition(Builder builder) {
                 super(builder);
-                kind = ValidationSupport.requireNonNull(builder.kind, "kind");
+                kind = builder.kind;
                 expression = builder.expression;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2496,7 +2529,17 @@ public Builder expression(Expression expression) {
                  */
                 @Override
                 public Condition build() {
-                    return new Condition(this);
+                    Condition condition = new Condition(this);
+                    if (validating) {
+                        validate(condition);
+                    }
+                    return condition;
+                }
+
+                protected void validate(Condition condition) {
+                    super.validate(condition);
+                    ValidationSupport.requireNonNull(condition.kind, "kind");
+                    ValidationSupport.requireValueOrChildren(condition);
                 }
 
                 protected Builder from(Condition condition) {
@@ -2527,10 +2570,9 @@ public static class RelatedAction extends BackboneElement {
 
             private RelatedAction(Builder builder) {
                 super(builder);
-                actionId = ValidationSupport.requireNonNull(builder.actionId, "actionId");
-                relationship = ValidationSupport.requireNonNull(builder.relationship, "relationship");
-                offset = ValidationSupport.choiceElement(builder.offset, "offset", Duration.class, Range.class);
-                ValidationSupport.requireValueOrChildren(this);
+                actionId = builder.actionId;
+                relationship = builder.relationship;
+                offset = builder.offset;
             }
 
             /**
@@ -2812,7 +2854,19 @@ public Builder offset(Element offset) {
                  */
                 @Override
                 public RelatedAction build() {
-                    return new RelatedAction(this);
+                    RelatedAction relatedAction = new RelatedAction(this);
+                    if (validating) {
+                        validate(relatedAction);
+                    }
+                    return relatedAction;
+                }
+
+                protected void validate(RelatedAction relatedAction) {
+                    super.validate(relatedAction);
+                    ValidationSupport.requireNonNull(relatedAction.actionId, "actionId");
+                    ValidationSupport.requireNonNull(relatedAction.relationship, "relationship");
+                    ValidationSupport.choiceElement(relatedAction.offset, "offset", Duration.class, Range.class);
+                    ValidationSupport.requireValueOrChildren(relatedAction);
                 }
 
                 protected Builder from(RelatedAction relatedAction) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchDefinition.java
index cc97f9b1095..d8566dd7880 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchDefinition.java
@@ -169,44 +169,39 @@ public class ResearchDefinition extends DomainResource {
     private ResearchDefinition(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
         shortTitle = builder.shortTitle;
         subtitle = builder.subtitle;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
-        subject = ValidationSupport.choiceElement(builder.subject, "subject", CodeableConcept.class, Reference.class);
+        subject = builder.subject;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        comment = Collections.unmodifiableList(ValidationSupport.checkList(builder.comment, "comment", String.class));
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        comment = Collections.unmodifiableList(builder.comment);
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         usage = builder.usage;
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
-        library = Collections.unmodifiableList(ValidationSupport.checkList(builder.library, "library", Canonical.class));
-        population = ValidationSupport.requireNonNull(builder.population, "population");
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
+        library = Collections.unmodifiableList(builder.library);
+        population = builder.population;
         exposure = builder.exposure;
         exposureAlternative = builder.exposureAlternative;
         outcome = builder.outcome;
-        ValidationSupport.checkReferenceType(subject, "subject", "Group");
-        ValidationSupport.checkReferenceType(population, "population", "ResearchElementDefinition");
-        ValidationSupport.checkReferenceType(exposure, "exposure", "ResearchElementDefinition");
-        ValidationSupport.checkReferenceType(exposureAlternative, "exposureAlternative", "ResearchElementDefinition");
-        ValidationSupport.checkReferenceType(outcome, "outcome", "ResearchElementDefinition");
     }
 
     /**
@@ -1811,7 +1806,35 @@ public Builder outcome(Reference outcome) {
          */
         @Override
         public ResearchDefinition build() {
-            return new ResearchDefinition(this);
+            ResearchDefinition researchDefinition = new ResearchDefinition(this);
+            if (validating) {
+                validate(researchDefinition);
+            }
+            return researchDefinition;
+        }
+
+        protected void validate(ResearchDefinition researchDefinition) {
+            super.validate(researchDefinition);
+            ValidationSupport.checkList(researchDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(researchDefinition.status, "status");
+            ValidationSupport.choiceElement(researchDefinition.subject, "subject", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(researchDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(researchDefinition.comment, "comment", String.class);
+            ValidationSupport.checkList(researchDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(researchDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(researchDefinition.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(researchDefinition.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(researchDefinition.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(researchDefinition.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(researchDefinition.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(researchDefinition.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.checkList(researchDefinition.library, "library", Canonical.class);
+            ValidationSupport.requireNonNull(researchDefinition.population, "population");
+            ValidationSupport.checkReferenceType(researchDefinition.subject, "subject", "Group");
+            ValidationSupport.checkReferenceType(researchDefinition.population, "population", "ResearchElementDefinition");
+            ValidationSupport.checkReferenceType(researchDefinition.exposure, "exposure", "ResearchElementDefinition");
+            ValidationSupport.checkReferenceType(researchDefinition.exposureAlternative, "exposureAlternative", "ResearchElementDefinition");
+            ValidationSupport.checkReferenceType(researchDefinition.outcome, "outcome", "ResearchElementDefinition");
         }
 
         protected Builder from(ResearchDefinition researchDefinition) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchElementDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchElementDefinition.java
index c6fc217cc72..ae1eed02e92 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchElementDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchElementDefinition.java
@@ -184,39 +184,38 @@ public class ResearchElementDefinition extends DomainResource {
     private ResearchElementDefinition(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
         shortTitle = builder.shortTitle;
         subtitle = builder.subtitle;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
-        subject = ValidationSupport.choiceElement(builder.subject, "subject", CodeableConcept.class, Reference.class);
+        subject = builder.subject;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        comment = Collections.unmodifiableList(ValidationSupport.checkList(builder.comment, "comment", String.class));
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        comment = Collections.unmodifiableList(builder.comment);
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         usage = builder.usage;
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
-        library = Collections.unmodifiableList(ValidationSupport.checkList(builder.library, "library", Canonical.class));
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
+        library = Collections.unmodifiableList(builder.library);
+        type = builder.type;
         variableType = builder.variableType;
-        characteristic = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.characteristic, "characteristic", Characteristic.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Group");
+        characteristic = Collections.unmodifiableList(builder.characteristic);
     }
 
     /**
@@ -1800,7 +1799,32 @@ public Builder characteristic(Collection<Characteristic> characteristic) {
          */
         @Override
         public ResearchElementDefinition build() {
-            return new ResearchElementDefinition(this);
+            ResearchElementDefinition researchElementDefinition = new ResearchElementDefinition(this);
+            if (validating) {
+                validate(researchElementDefinition);
+            }
+            return researchElementDefinition;
+        }
+
+        protected void validate(ResearchElementDefinition researchElementDefinition) {
+            super.validate(researchElementDefinition);
+            ValidationSupport.checkList(researchElementDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(researchElementDefinition.status, "status");
+            ValidationSupport.choiceElement(researchElementDefinition.subject, "subject", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(researchElementDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(researchElementDefinition.comment, "comment", String.class);
+            ValidationSupport.checkList(researchElementDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(researchElementDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(researchElementDefinition.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(researchElementDefinition.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(researchElementDefinition.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(researchElementDefinition.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(researchElementDefinition.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(researchElementDefinition.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.checkList(researchElementDefinition.library, "library", Canonical.class);
+            ValidationSupport.requireNonNull(researchElementDefinition.type, "type");
+            ValidationSupport.checkNonEmptyList(researchElementDefinition.characteristic, "characteristic", Characteristic.class);
+            ValidationSupport.checkReferenceType(researchElementDefinition.subject, "subject", "Group");
         }
 
         protected Builder from(ResearchElementDefinition researchElementDefinition) {
@@ -1885,20 +1909,18 @@ public static class Characteristic extends BackboneElement {
 
         private Characteristic(Builder builder) {
             super(builder);
-            definition = ValidationSupport.requireChoiceElement(builder.definition, "definition", CodeableConcept.class, Canonical.class, Expression.class, DataRequirement.class);
-            usageContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.usageContext, "usageContext", UsageContext.class));
+            definition = builder.definition;
+            usageContext = Collections.unmodifiableList(builder.usageContext);
             exclude = builder.exclude;
             unitOfMeasure = builder.unitOfMeasure;
             studyEffectiveDescription = builder.studyEffectiveDescription;
-            studyEffective = ValidationSupport.choiceElement(builder.studyEffective, "studyEffective", DateTime.class, Period.class, Duration.class, Timing.class);
+            studyEffective = builder.studyEffective;
             studyEffectiveTimeFromStart = builder.studyEffectiveTimeFromStart;
             studyEffectiveGroupMeasure = builder.studyEffectiveGroupMeasure;
             participantEffectiveDescription = builder.participantEffectiveDescription;
-            participantEffective = ValidationSupport.choiceElement(builder.participantEffective, "participantEffective", DateTime.class, Period.class, Duration.class, Timing.class);
+            participantEffective = builder.participantEffective;
             participantEffectiveTimeFromStart = builder.participantEffectiveTimeFromStart;
             participantEffectiveGroupMeasure = builder.participantEffectiveGroupMeasure;
-            ValidationSupport.checkValueSetBinding(unitOfMeasure, "unitOfMeasure", "http://hl7.org/fhir/ValueSet/ucum-units", "http://unitsofmeasure.org");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2479,7 +2501,21 @@ public Builder participantEffectiveGroupMeasure(GroupMeasure participantEffectiv
              */
             @Override
             public Characteristic build() {
-                return new Characteristic(this);
+                Characteristic characteristic = new Characteristic(this);
+                if (validating) {
+                    validate(characteristic);
+                }
+                return characteristic;
+            }
+
+            protected void validate(Characteristic characteristic) {
+                super.validate(characteristic);
+                ValidationSupport.requireChoiceElement(characteristic.definition, "definition", CodeableConcept.class, Canonical.class, Expression.class, DataRequirement.class);
+                ValidationSupport.checkList(characteristic.usageContext, "usageContext", UsageContext.class);
+                ValidationSupport.choiceElement(characteristic.studyEffective, "studyEffective", DateTime.class, Period.class, Duration.class, Timing.class);
+                ValidationSupport.choiceElement(characteristic.participantEffective, "participantEffective", DateTime.class, Period.class, Duration.class, Timing.class);
+                ValidationSupport.checkValueSetBinding(characteristic.unitOfMeasure, "unitOfMeasure", "http://hl7.org/fhir/ValueSet/ucum-units", "http://unitsofmeasure.org");
+                ValidationSupport.requireValueOrChildren(characteristic);
             }
 
             protected Builder from(Characteristic characteristic) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchStudy.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchStudy.java
index 7d5b5df09fc..f9b47498c85 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchStudy.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchStudy.java
@@ -183,36 +183,30 @@ public class ResearchStudy extends DomainResource {
 
     private ResearchStudy(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         title = builder.title;
-        protocol = Collections.unmodifiableList(ValidationSupport.checkList(builder.protocol, "protocol", Reference.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        protocol = Collections.unmodifiableList(builder.protocol);
+        partOf = Collections.unmodifiableList(builder.partOf);
+        status = builder.status;
         primaryPurposeType = builder.primaryPurposeType;
         phase = builder.phase;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
-        focus = Collections.unmodifiableList(ValidationSupport.checkList(builder.focus, "focus", CodeableConcept.class));
-        condition = Collections.unmodifiableList(ValidationSupport.checkList(builder.condition, "condition", CodeableConcept.class));
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
-        keyword = Collections.unmodifiableList(ValidationSupport.checkList(builder.keyword, "keyword", CodeableConcept.class));
-        location = Collections.unmodifiableList(ValidationSupport.checkList(builder.location, "location", CodeableConcept.class));
+        category = Collections.unmodifiableList(builder.category);
+        focus = Collections.unmodifiableList(builder.focus);
+        condition = Collections.unmodifiableList(builder.condition);
+        contact = Collections.unmodifiableList(builder.contact);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
+        keyword = Collections.unmodifiableList(builder.keyword);
+        location = Collections.unmodifiableList(builder.location);
         description = builder.description;
-        enrollment = Collections.unmodifiableList(ValidationSupport.checkList(builder.enrollment, "enrollment", Reference.class));
+        enrollment = Collections.unmodifiableList(builder.enrollment);
         period = builder.period;
         sponsor = builder.sponsor;
         principalInvestigator = builder.principalInvestigator;
-        site = Collections.unmodifiableList(ValidationSupport.checkList(builder.site, "site", Reference.class));
+        site = Collections.unmodifiableList(builder.site);
         reasonStopped = builder.reasonStopped;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        arm = Collections.unmodifiableList(ValidationSupport.checkList(builder.arm, "arm", Arm.class));
-        objective = Collections.unmodifiableList(ValidationSupport.checkList(builder.objective, "objective", Objective.class));
-        ValidationSupport.checkReferenceType(protocol, "protocol", "PlanDefinition");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "ResearchStudy");
-        ValidationSupport.checkReferenceType(enrollment, "enrollment", "Group");
-        ValidationSupport.checkReferenceType(sponsor, "sponsor", "Organization");
-        ValidationSupport.checkReferenceType(principalInvestigator, "principalInvestigator", "Practitioner", "PractitionerRole");
-        ValidationSupport.checkReferenceType(site, "site", "Location");
+        note = Collections.unmodifiableList(builder.note);
+        arm = Collections.unmodifiableList(builder.arm);
+        objective = Collections.unmodifiableList(builder.objective);
     }
 
     /**
@@ -1580,7 +1574,37 @@ public Builder objective(Collection<Objective> objective) {
          */
         @Override
         public ResearchStudy build() {
-            return new ResearchStudy(this);
+            ResearchStudy researchStudy = new ResearchStudy(this);
+            if (validating) {
+                validate(researchStudy);
+            }
+            return researchStudy;
+        }
+
+        protected void validate(ResearchStudy researchStudy) {
+            super.validate(researchStudy);
+            ValidationSupport.checkList(researchStudy.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(researchStudy.protocol, "protocol", Reference.class);
+            ValidationSupport.checkList(researchStudy.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(researchStudy.status, "status");
+            ValidationSupport.checkList(researchStudy.category, "category", CodeableConcept.class);
+            ValidationSupport.checkList(researchStudy.focus, "focus", CodeableConcept.class);
+            ValidationSupport.checkList(researchStudy.condition, "condition", CodeableConcept.class);
+            ValidationSupport.checkList(researchStudy.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(researchStudy.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.checkList(researchStudy.keyword, "keyword", CodeableConcept.class);
+            ValidationSupport.checkList(researchStudy.location, "location", CodeableConcept.class);
+            ValidationSupport.checkList(researchStudy.enrollment, "enrollment", Reference.class);
+            ValidationSupport.checkList(researchStudy.site, "site", Reference.class);
+            ValidationSupport.checkList(researchStudy.note, "note", Annotation.class);
+            ValidationSupport.checkList(researchStudy.arm, "arm", Arm.class);
+            ValidationSupport.checkList(researchStudy.objective, "objective", Objective.class);
+            ValidationSupport.checkReferenceType(researchStudy.protocol, "protocol", "PlanDefinition");
+            ValidationSupport.checkReferenceType(researchStudy.partOf, "partOf", "ResearchStudy");
+            ValidationSupport.checkReferenceType(researchStudy.enrollment, "enrollment", "Group");
+            ValidationSupport.checkReferenceType(researchStudy.sponsor, "sponsor", "Organization");
+            ValidationSupport.checkReferenceType(researchStudy.principalInvestigator, "principalInvestigator", "Practitioner", "PractitionerRole");
+            ValidationSupport.checkReferenceType(researchStudy.site, "site", "Location");
         }
 
         protected Builder from(ResearchStudy researchStudy) {
@@ -1625,10 +1649,9 @@ public static class Arm extends BackboneElement {
 
         private Arm(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
+            name = builder.name;
             type = builder.type;
             description = builder.description;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1900,7 +1923,17 @@ public Builder description(String description) {
              */
             @Override
             public Arm build() {
-                return new Arm(this);
+                Arm arm = new Arm(this);
+                if (validating) {
+                    validate(arm);
+                }
+                return arm;
+            }
+
+            protected void validate(Arm arm) {
+                super.validate(arm);
+                ValidationSupport.requireNonNull(arm.name, "name");
+                ValidationSupport.requireValueOrChildren(arm);
             }
 
             protected Builder from(Arm arm) {
@@ -1931,7 +1964,6 @@ private Objective(Builder builder) {
             super(builder);
             name = builder.name;
             type = builder.type;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2167,7 +2199,16 @@ public Builder type(CodeableConcept type) {
              */
             @Override
             public Objective build() {
-                return new Objective(this);
+                Objective objective = new Objective(this);
+                if (validating) {
+                    validate(objective);
+                }
+                return objective;
+            }
+
+            protected void validate(Objective objective) {
+                super.validate(objective);
+                ValidationSupport.requireValueOrChildren(objective);
             }
 
             protected Builder from(Objective objective) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchSubject.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchSubject.java
index ae7226d572c..b7aa9b1f090 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchSubject.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ResearchSubject.java
@@ -73,17 +73,14 @@ public class ResearchSubject extends DomainResource {
 
     private ResearchSubject(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
         period = builder.period;
-        study = ValidationSupport.requireNonNull(builder.study, "study");
-        individual = ValidationSupport.requireNonNull(builder.individual, "individual");
+        study = builder.study;
+        individual = builder.individual;
         assignedArm = builder.assignedArm;
         actualArm = builder.actualArm;
         consent = builder.consent;
-        ValidationSupport.checkReferenceType(study, "study", "ResearchStudy");
-        ValidationSupport.checkReferenceType(individual, "individual", "Patient");
-        ValidationSupport.checkReferenceType(consent, "consent", "Consent");
     }
 
     /**
@@ -652,7 +649,22 @@ public Builder consent(Reference consent) {
          */
         @Override
         public ResearchSubject build() {
-            return new ResearchSubject(this);
+            ResearchSubject researchSubject = new ResearchSubject(this);
+            if (validating) {
+                validate(researchSubject);
+            }
+            return researchSubject;
+        }
+
+        protected void validate(ResearchSubject researchSubject) {
+            super.validate(researchSubject);
+            ValidationSupport.checkList(researchSubject.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(researchSubject.status, "status");
+            ValidationSupport.requireNonNull(researchSubject.study, "study");
+            ValidationSupport.requireNonNull(researchSubject.individual, "individual");
+            ValidationSupport.checkReferenceType(researchSubject.study, "study", "ResearchStudy");
+            ValidationSupport.checkReferenceType(researchSubject.individual, "individual", "Patient");
+            ValidationSupport.checkReferenceType(researchSubject.consent, "consent", "Consent");
         }
 
         protected Builder from(ResearchSubject researchSubject) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Resource.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Resource.java
index 1f065fd56f7..b8184eb252a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Resource.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Resource.java
@@ -62,8 +62,6 @@ protected Resource(Builder builder) {
         meta = builder.meta;
         implicitRules = builder.implicitRules;
         language = builder.language;
-        ValidationSupport.checkId(id);
-        ValidationSupport.checkValueSetBinding(language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
     }
 
     /**
@@ -209,6 +207,11 @@ public Builder language(Code language) {
         @Override
         public abstract Resource build();
 
+        protected void validate(Resource resource) {
+            ValidationSupport.checkId(resource.id);
+            ValidationSupport.checkValueSetBinding(resource.language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+        }
+
         protected Builder from(Resource resource) {
             id = resource.id;
             meta = resource.meta;
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/RiskAssessment.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/RiskAssessment.java
index 65ee9d92a20..ae07bec8eba 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/RiskAssessment.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/RiskAssessment.java
@@ -116,28 +116,23 @@ public class RiskAssessment extends DomainResource {
 
     private RiskAssessment(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         basedOn = builder.basedOn;
         parent = builder.parent;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         method = builder.method;
         code = builder.code;
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        subject = builder.subject;
         encounter = builder.encounter;
-        occurrence = ValidationSupport.choiceElement(builder.occurrence, "occurrence", DateTime.class, Period.class);
+        occurrence = builder.occurrence;
         condition = builder.condition;
         performer = builder.performer;
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        basis = Collections.unmodifiableList(ValidationSupport.checkList(builder.basis, "basis", Reference.class));
-        prediction = Collections.unmodifiableList(ValidationSupport.checkList(builder.prediction, "prediction", Prediction.class));
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        basis = Collections.unmodifiableList(builder.basis);
+        prediction = Collections.unmodifiableList(builder.prediction);
         mitigation = builder.mitigation;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(condition, "condition", "Condition");
-        ValidationSupport.checkReferenceType(performer, "performer", "Practitioner", "PractitionerRole", "Device");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -1096,7 +1091,29 @@ public Builder note(Collection<Annotation> note) {
          */
         @Override
         public RiskAssessment build() {
-            return new RiskAssessment(this);
+            RiskAssessment riskAssessment = new RiskAssessment(this);
+            if (validating) {
+                validate(riskAssessment);
+            }
+            return riskAssessment;
+        }
+
+        protected void validate(RiskAssessment riskAssessment) {
+            super.validate(riskAssessment);
+            ValidationSupport.checkList(riskAssessment.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(riskAssessment.status, "status");
+            ValidationSupport.requireNonNull(riskAssessment.subject, "subject");
+            ValidationSupport.choiceElement(riskAssessment.occurrence, "occurrence", DateTime.class, Period.class);
+            ValidationSupport.checkList(riskAssessment.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(riskAssessment.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(riskAssessment.basis, "basis", Reference.class);
+            ValidationSupport.checkList(riskAssessment.prediction, "prediction", Prediction.class);
+            ValidationSupport.checkList(riskAssessment.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(riskAssessment.subject, "subject", "Patient", "Group");
+            ValidationSupport.checkReferenceType(riskAssessment.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(riskAssessment.condition, "condition", "Condition");
+            ValidationSupport.checkReferenceType(riskAssessment.performer, "performer", "Practitioner", "PractitionerRole", "Device");
+            ValidationSupport.checkReferenceType(riskAssessment.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
         }
 
         protected Builder from(RiskAssessment riskAssessment) {
@@ -1149,12 +1166,11 @@ public static class Prediction extends BackboneElement {
         private Prediction(Builder builder) {
             super(builder);
             outcome = builder.outcome;
-            probability = ValidationSupport.choiceElement(builder.probability, "probability", Decimal.class, Range.class);
+            probability = builder.probability;
             qualitativeRisk = builder.qualitativeRisk;
             relativeRisk = builder.relativeRisk;
-            when = ValidationSupport.choiceElement(builder.when, "when", Period.class, Range.class);
+            when = builder.when;
             rationale = builder.rationale;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1522,7 +1538,18 @@ public Builder rationale(String rationale) {
              */
             @Override
             public Prediction build() {
-                return new Prediction(this);
+                Prediction prediction = new Prediction(this);
+                if (validating) {
+                    validate(prediction);
+                }
+                return prediction;
+            }
+
+            protected void validate(Prediction prediction) {
+                super.validate(prediction);
+                ValidationSupport.choiceElement(prediction.probability, "probability", Decimal.class, Range.class);
+                ValidationSupport.choiceElement(prediction.when, "when", Period.class, Range.class);
+                ValidationSupport.requireValueOrChildren(prediction);
             }
 
             protected Builder from(Prediction prediction) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/RiskEvidenceSynthesis.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/RiskEvidenceSynthesis.java
index 875b38ec5e8..69ddf5655fa 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/RiskEvidenceSynthesis.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/RiskEvidenceSynthesis.java
@@ -217,39 +217,36 @@ public class RiskEvidenceSynthesis extends DomainResource {
     private RiskEvidenceSynthesis(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        note = Collections.unmodifiableList(builder.note);
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         copyright = builder.copyright;
         approvalDate = builder.approvalDate;
         lastReviewDate = builder.lastReviewDate;
         effectivePeriod = builder.effectivePeriod;
-        topic = Collections.unmodifiableList(ValidationSupport.checkList(builder.topic, "topic", CodeableConcept.class));
-        author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", ContactDetail.class));
-        editor = Collections.unmodifiableList(ValidationSupport.checkList(builder.editor, "editor", ContactDetail.class));
-        reviewer = Collections.unmodifiableList(ValidationSupport.checkList(builder.reviewer, "reviewer", ContactDetail.class));
-        endorser = Collections.unmodifiableList(ValidationSupport.checkList(builder.endorser, "endorser", ContactDetail.class));
-        relatedArtifact = Collections.unmodifiableList(ValidationSupport.checkList(builder.relatedArtifact, "relatedArtifact", RelatedArtifact.class));
+        topic = Collections.unmodifiableList(builder.topic);
+        author = Collections.unmodifiableList(builder.author);
+        editor = Collections.unmodifiableList(builder.editor);
+        reviewer = Collections.unmodifiableList(builder.reviewer);
+        endorser = Collections.unmodifiableList(builder.endorser);
+        relatedArtifact = Collections.unmodifiableList(builder.relatedArtifact);
         synthesisType = builder.synthesisType;
         studyType = builder.studyType;
-        population = ValidationSupport.requireNonNull(builder.population, "population");
+        population = builder.population;
         exposure = builder.exposure;
-        outcome = ValidationSupport.requireNonNull(builder.outcome, "outcome");
+        outcome = builder.outcome;
         sampleSize = builder.sampleSize;
         riskEstimate = builder.riskEstimate;
-        certainty = Collections.unmodifiableList(ValidationSupport.checkList(builder.certainty, "certainty", Certainty.class));
-        ValidationSupport.checkReferenceType(population, "population", "EvidenceVariable");
-        ValidationSupport.checkReferenceType(exposure, "exposure", "EvidenceVariable");
-        ValidationSupport.checkReferenceType(outcome, "outcome", "EvidenceVariable");
+        certainty = Collections.unmodifiableList(builder.certainty);
     }
 
     /**
@@ -1742,7 +1739,33 @@ public Builder certainty(Collection<Certainty> certainty) {
          */
         @Override
         public RiskEvidenceSynthesis build() {
-            return new RiskEvidenceSynthesis(this);
+            RiskEvidenceSynthesis riskEvidenceSynthesis = new RiskEvidenceSynthesis(this);
+            if (validating) {
+                validate(riskEvidenceSynthesis);
+            }
+            return riskEvidenceSynthesis;
+        }
+
+        protected void validate(RiskEvidenceSynthesis riskEvidenceSynthesis) {
+            super.validate(riskEvidenceSynthesis);
+            ValidationSupport.checkList(riskEvidenceSynthesis.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(riskEvidenceSynthesis.status, "status");
+            ValidationSupport.checkList(riskEvidenceSynthesis.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(riskEvidenceSynthesis.note, "note", Annotation.class);
+            ValidationSupport.checkList(riskEvidenceSynthesis.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(riskEvidenceSynthesis.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(riskEvidenceSynthesis.topic, "topic", CodeableConcept.class);
+            ValidationSupport.checkList(riskEvidenceSynthesis.author, "author", ContactDetail.class);
+            ValidationSupport.checkList(riskEvidenceSynthesis.editor, "editor", ContactDetail.class);
+            ValidationSupport.checkList(riskEvidenceSynthesis.reviewer, "reviewer", ContactDetail.class);
+            ValidationSupport.checkList(riskEvidenceSynthesis.endorser, "endorser", ContactDetail.class);
+            ValidationSupport.checkList(riskEvidenceSynthesis.relatedArtifact, "relatedArtifact", RelatedArtifact.class);
+            ValidationSupport.requireNonNull(riskEvidenceSynthesis.population, "population");
+            ValidationSupport.requireNonNull(riskEvidenceSynthesis.outcome, "outcome");
+            ValidationSupport.checkList(riskEvidenceSynthesis.certainty, "certainty", Certainty.class);
+            ValidationSupport.checkReferenceType(riskEvidenceSynthesis.population, "population", "EvidenceVariable");
+            ValidationSupport.checkReferenceType(riskEvidenceSynthesis.exposure, "exposure", "EvidenceVariable");
+            ValidationSupport.checkReferenceType(riskEvidenceSynthesis.outcome, "outcome", "EvidenceVariable");
         }
 
         protected Builder from(RiskEvidenceSynthesis riskEvidenceSynthesis) {
@@ -1795,7 +1818,6 @@ private SampleSize(Builder builder) {
             description = builder.description;
             numberOfStudies = builder.numberOfStudies;
             numberOfParticipants = builder.numberOfParticipants;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2060,7 +2082,16 @@ public Builder numberOfParticipants(Integer numberOfParticipants) {
              */
             @Override
             public SampleSize build() {
-                return new SampleSize(this);
+                SampleSize sampleSize = new SampleSize(this);
+                if (validating) {
+                    validate(sampleSize);
+                }
+                return sampleSize;
+            }
+
+            protected void validate(SampleSize sampleSize) {
+                super.validate(sampleSize);
+                ValidationSupport.requireValueOrChildren(sampleSize);
             }
 
             protected Builder from(SampleSize sampleSize) {
@@ -2105,9 +2136,7 @@ private RiskEstimate(Builder builder) {
             unitOfMeasure = builder.unitOfMeasure;
             denominatorCount = builder.denominatorCount;
             numeratorCount = builder.numeratorCount;
-            precisionEstimate = Collections.unmodifiableList(ValidationSupport.checkList(builder.precisionEstimate, "precisionEstimate", PrecisionEstimate.class));
-            ValidationSupport.checkValueSetBinding(unitOfMeasure, "unitOfMeasure", "http://hl7.org/fhir/ValueSet/ucum-units", "http://unitsofmeasure.org");
-            ValidationSupport.requireValueOrChildren(this);
+            precisionEstimate = Collections.unmodifiableList(builder.precisionEstimate);
         }
 
         /**
@@ -2508,7 +2537,18 @@ public Builder precisionEstimate(Collection<PrecisionEstimate> precisionEstimate
              */
             @Override
             public RiskEstimate build() {
-                return new RiskEstimate(this);
+                RiskEstimate riskEstimate = new RiskEstimate(this);
+                if (validating) {
+                    validate(riskEstimate);
+                }
+                return riskEstimate;
+            }
+
+            protected void validate(RiskEstimate riskEstimate) {
+                super.validate(riskEstimate);
+                ValidationSupport.checkList(riskEstimate.precisionEstimate, "precisionEstimate", PrecisionEstimate.class);
+                ValidationSupport.checkValueSetBinding(riskEstimate.unitOfMeasure, "unitOfMeasure", "http://hl7.org/fhir/ValueSet/ucum-units", "http://unitsofmeasure.org");
+                ValidationSupport.requireValueOrChildren(riskEstimate);
             }
 
             protected Builder from(RiskEstimate riskEstimate) {
@@ -2545,7 +2585,6 @@ private PrecisionEstimate(Builder builder) {
                 level = builder.level;
                 from = builder.from;
                 to = builder.to;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2839,7 +2878,16 @@ public Builder to(Decimal to) {
                  */
                 @Override
                 public PrecisionEstimate build() {
-                    return new PrecisionEstimate(this);
+                    PrecisionEstimate precisionEstimate = new PrecisionEstimate(this);
+                    if (validating) {
+                        validate(precisionEstimate);
+                    }
+                    return precisionEstimate;
+                }
+
+                protected void validate(PrecisionEstimate precisionEstimate) {
+                    super.validate(precisionEstimate);
+                    ValidationSupport.requireValueOrChildren(precisionEstimate);
                 }
 
                 protected Builder from(PrecisionEstimate precisionEstimate) {
@@ -2870,10 +2918,9 @@ public static class Certainty extends BackboneElement {
 
         private Certainty(Builder builder) {
             super(builder);
-            rating = Collections.unmodifiableList(ValidationSupport.checkList(builder.rating, "rating", CodeableConcept.class));
-            note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-            certaintySubcomponent = Collections.unmodifiableList(ValidationSupport.checkList(builder.certaintySubcomponent, "certaintySubcomponent", CertaintySubcomponent.class));
-            ValidationSupport.requireValueOrChildren(this);
+            rating = Collections.unmodifiableList(builder.rating);
+            note = Collections.unmodifiableList(builder.note);
+            certaintySubcomponent = Collections.unmodifiableList(builder.certaintySubcomponent);
         }
 
         /**
@@ -3198,7 +3245,19 @@ public Builder certaintySubcomponent(Collection<CertaintySubcomponent> certainty
              */
             @Override
             public Certainty build() {
-                return new Certainty(this);
+                Certainty certainty = new Certainty(this);
+                if (validating) {
+                    validate(certainty);
+                }
+                return certainty;
+            }
+
+            protected void validate(Certainty certainty) {
+                super.validate(certainty);
+                ValidationSupport.checkList(certainty.rating, "rating", CodeableConcept.class);
+                ValidationSupport.checkList(certainty.note, "note", Annotation.class);
+                ValidationSupport.checkList(certainty.certaintySubcomponent, "certaintySubcomponent", CertaintySubcomponent.class);
+                ValidationSupport.requireValueOrChildren(certainty);
             }
 
             protected Builder from(Certainty certainty) {
@@ -3233,9 +3292,8 @@ public static class CertaintySubcomponent extends BackboneElement {
             private CertaintySubcomponent(Builder builder) {
                 super(builder);
                 type = builder.type;
-                rating = Collections.unmodifiableList(ValidationSupport.checkList(builder.rating, "rating", CodeableConcept.class));
-                note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-                ValidationSupport.requireValueOrChildren(this);
+                rating = Collections.unmodifiableList(builder.rating);
+                note = Collections.unmodifiableList(builder.note);
             }
 
             /**
@@ -3540,7 +3598,18 @@ public Builder note(Collection<Annotation> note) {
                  */
                 @Override
                 public CertaintySubcomponent build() {
-                    return new CertaintySubcomponent(this);
+                    CertaintySubcomponent certaintySubcomponent = new CertaintySubcomponent(this);
+                    if (validating) {
+                        validate(certaintySubcomponent);
+                    }
+                    return certaintySubcomponent;
+                }
+
+                protected void validate(CertaintySubcomponent certaintySubcomponent) {
+                    super.validate(certaintySubcomponent);
+                    ValidationSupport.checkList(certaintySubcomponent.rating, "rating", CodeableConcept.class);
+                    ValidationSupport.checkList(certaintySubcomponent.note, "note", Annotation.class);
+                    ValidationSupport.requireValueOrChildren(certaintySubcomponent);
                 }
 
                 protected Builder from(CertaintySubcomponent certaintySubcomponent) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Schedule.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Schedule.java
index 79f950282d5..c64294bc5a6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Schedule.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Schedule.java
@@ -91,15 +91,14 @@ public class Schedule extends DomainResource {
 
     private Schedule(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         active = builder.active;
-        serviceCategory = Collections.unmodifiableList(ValidationSupport.checkList(builder.serviceCategory, "serviceCategory", CodeableConcept.class));
-        serviceType = Collections.unmodifiableList(ValidationSupport.checkList(builder.serviceType, "serviceType", CodeableConcept.class));
-        specialty = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialty, "specialty", CodeableConcept.class));
-        actor = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.actor, "actor", Reference.class));
+        serviceCategory = Collections.unmodifiableList(builder.serviceCategory);
+        serviceType = Collections.unmodifiableList(builder.serviceType);
+        specialty = Collections.unmodifiableList(builder.specialty);
+        actor = Collections.unmodifiableList(builder.actor);
         planningHorizon = builder.planningHorizon;
         comment = builder.comment;
-        ValidationSupport.checkReferenceType(actor, "actor", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Device", "HealthcareService", "Location");
     }
 
     /**
@@ -756,7 +755,21 @@ public Builder comment(String comment) {
          */
         @Override
         public Schedule build() {
-            return new Schedule(this);
+            Schedule schedule = new Schedule(this);
+            if (validating) {
+                validate(schedule);
+            }
+            return schedule;
+        }
+
+        protected void validate(Schedule schedule) {
+            super.validate(schedule);
+            ValidationSupport.checkList(schedule.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(schedule.serviceCategory, "serviceCategory", CodeableConcept.class);
+            ValidationSupport.checkList(schedule.serviceType, "serviceType", CodeableConcept.class);
+            ValidationSupport.checkList(schedule.specialty, "specialty", CodeableConcept.class);
+            ValidationSupport.checkNonEmptyList(schedule.actor, "actor", Reference.class);
+            ValidationSupport.checkReferenceType(schedule.actor, "actor", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Device", "HealthcareService", "Location");
         }
 
         protected Builder from(Schedule schedule) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SearchParameter.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SearchParameter.java
index 25f2088befa..65160ed2aee 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SearchParameter.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SearchParameter.java
@@ -182,32 +182,32 @@ public class SearchParameter extends DomainResource {
 
     private SearchParameter(Builder builder) {
         super(builder);
-        url = ValidationSupport.requireNonNull(builder.url, "url");
+        url = builder.url;
         version = builder.version;
-        name = ValidationSupport.requireNonNull(builder.name, "name");
+        name = builder.name;
         derivedFrom = builder.derivedFrom;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
-        description = ValidationSupport.requireNonNull(builder.description, "description");
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        contact = Collections.unmodifiableList(builder.contact);
+        description = builder.description;
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
-        code = ValidationSupport.requireNonNull(builder.code, "code");
-        base = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.base, "base", ResourceType.class));
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        code = builder.code;
+        base = Collections.unmodifiableList(builder.base);
+        type = builder.type;
         expression = builder.expression;
         xpath = builder.xpath;
         xpathUsage = builder.xpathUsage;
-        target = Collections.unmodifiableList(ValidationSupport.checkList(builder.target, "target", ResourceType.class));
+        target = Collections.unmodifiableList(builder.target);
         multipleOr = builder.multipleOr;
         multipleAnd = builder.multipleAnd;
-        comparator = Collections.unmodifiableList(ValidationSupport.checkList(builder.comparator, "comparator", SearchComparator.class));
-        modifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifier, "modifier", SearchModifierCode.class));
-        chain = Collections.unmodifiableList(ValidationSupport.checkList(builder.chain, "chain", String.class));
-        component = Collections.unmodifiableList(ValidationSupport.checkList(builder.component, "component", Component.class));
+        comparator = Collections.unmodifiableList(builder.comparator);
+        modifier = Collections.unmodifiableList(builder.modifier);
+        chain = Collections.unmodifiableList(builder.chain);
+        component = Collections.unmodifiableList(builder.component);
     }
 
     /**
@@ -1499,7 +1499,30 @@ public Builder component(Collection<Component> component) {
          */
         @Override
         public SearchParameter build() {
-            return new SearchParameter(this);
+            SearchParameter searchParameter = new SearchParameter(this);
+            if (validating) {
+                validate(searchParameter);
+            }
+            return searchParameter;
+        }
+
+        protected void validate(SearchParameter searchParameter) {
+            super.validate(searchParameter);
+            ValidationSupport.requireNonNull(searchParameter.url, "url");
+            ValidationSupport.requireNonNull(searchParameter.name, "name");
+            ValidationSupport.requireNonNull(searchParameter.status, "status");
+            ValidationSupport.checkList(searchParameter.contact, "contact", ContactDetail.class);
+            ValidationSupport.requireNonNull(searchParameter.description, "description");
+            ValidationSupport.checkList(searchParameter.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(searchParameter.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.requireNonNull(searchParameter.code, "code");
+            ValidationSupport.checkNonEmptyList(searchParameter.base, "base", ResourceType.class);
+            ValidationSupport.requireNonNull(searchParameter.type, "type");
+            ValidationSupport.checkList(searchParameter.target, "target", ResourceType.class);
+            ValidationSupport.checkList(searchParameter.comparator, "comparator", SearchComparator.class);
+            ValidationSupport.checkList(searchParameter.modifier, "modifier", SearchModifierCode.class);
+            ValidationSupport.checkList(searchParameter.chain, "chain", String.class);
+            ValidationSupport.checkList(searchParameter.component, "component", Component.class);
         }
 
         protected Builder from(SearchParameter searchParameter) {
@@ -1545,9 +1568,8 @@ public static class Component extends BackboneElement {
 
         private Component(Builder builder) {
             super(builder);
-            definition = ValidationSupport.requireNonNull(builder.definition, "definition");
-            expression = ValidationSupport.requireNonNull(builder.expression, "expression");
-            ValidationSupport.requireValueOrChildren(this);
+            definition = builder.definition;
+            expression = builder.expression;
         }
 
         /**
@@ -1795,7 +1817,18 @@ public Builder expression(String expression) {
              */
             @Override
             public Component build() {
-                return new Component(this);
+                Component component = new Component(this);
+                if (validating) {
+                    validate(component);
+                }
+                return component;
+            }
+
+            protected void validate(Component component) {
+                super.validate(component);
+                ValidationSupport.requireNonNull(component.definition, "definition");
+                ValidationSupport.requireNonNull(component.expression, "expression");
+                ValidationSupport.requireValueOrChildren(component);
             }
 
             protected Builder from(Component component) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ServiceRequest.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ServiceRequest.java
index b7914c63292..63f43586448 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ServiceRequest.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ServiceRequest.java
@@ -214,50 +214,39 @@ public class ServiceRequest extends DomainResource {
 
     private ServiceRequest(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        instantiatesCanonical = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesCanonical, "instantiatesCanonical", Canonical.class));
-        instantiatesUri = Collections.unmodifiableList(ValidationSupport.checkList(builder.instantiatesUri, "instantiatesUri", Uri.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        replaces = Collections.unmodifiableList(ValidationSupport.checkList(builder.replaces, "replaces", Reference.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        instantiatesCanonical = Collections.unmodifiableList(builder.instantiatesCanonical);
+        instantiatesUri = Collections.unmodifiableList(builder.instantiatesUri);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        replaces = Collections.unmodifiableList(builder.replaces);
         requisition = builder.requisition;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        intent = ValidationSupport.requireNonNull(builder.intent, "intent");
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
+        status = builder.status;
+        intent = builder.intent;
+        category = Collections.unmodifiableList(builder.category);
         priority = builder.priority;
         doNotPerform = builder.doNotPerform;
         code = builder.code;
-        orderDetail = Collections.unmodifiableList(ValidationSupport.checkList(builder.orderDetail, "orderDetail", CodeableConcept.class));
-        quantity = ValidationSupport.choiceElement(builder.quantity, "quantity", Quantity.class, Ratio.class, Range.class);
-        subject = ValidationSupport.requireNonNull(builder.subject, "subject");
+        orderDetail = Collections.unmodifiableList(builder.orderDetail);
+        quantity = builder.quantity;
+        subject = builder.subject;
         encounter = builder.encounter;
-        occurrence = ValidationSupport.choiceElement(builder.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
-        asNeeded = ValidationSupport.choiceElement(builder.asNeeded, "asNeeded", Boolean.class, CodeableConcept.class);
+        occurrence = builder.occurrence;
+        asNeeded = builder.asNeeded;
         authoredOn = builder.authoredOn;
         requester = builder.requester;
         performerType = builder.performerType;
-        performer = Collections.unmodifiableList(ValidationSupport.checkList(builder.performer, "performer", Reference.class));
-        locationCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.locationCode, "locationCode", CodeableConcept.class));
-        locationReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.locationReference, "locationReference", Reference.class));
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
-        insurance = Collections.unmodifiableList(ValidationSupport.checkList(builder.insurance, "insurance", Reference.class));
-        supportingInfo = Collections.unmodifiableList(ValidationSupport.checkList(builder.supportingInfo, "supportingInfo", Reference.class));
-        specimen = Collections.unmodifiableList(ValidationSupport.checkList(builder.specimen, "specimen", Reference.class));
-        bodySite = Collections.unmodifiableList(ValidationSupport.checkList(builder.bodySite, "bodySite", CodeableConcept.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
+        performer = Collections.unmodifiableList(builder.performer);
+        locationCode = Collections.unmodifiableList(builder.locationCode);
+        locationReference = Collections.unmodifiableList(builder.locationReference);
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
+        insurance = Collections.unmodifiableList(builder.insurance);
+        supportingInfo = Collections.unmodifiableList(builder.supportingInfo);
+        specimen = Collections.unmodifiableList(builder.specimen);
+        bodySite = Collections.unmodifiableList(builder.bodySite);
+        note = Collections.unmodifiableList(builder.note);
         patientInstruction = builder.patientInstruction;
-        relevantHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.relevantHistory, "relevantHistory", Reference.class));
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "CarePlan", "ServiceRequest", "MedicationRequest");
-        ValidationSupport.checkReferenceType(replaces, "replaces", "ServiceRequest");
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group", "Location", "Device");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(requester, "requester", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
-        ValidationSupport.checkReferenceType(performer, "performer", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "HealthcareService", "Patient", "Device", "RelatedPerson");
-        ValidationSupport.checkReferenceType(locationReference, "locationReference", "Location");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
-        ValidationSupport.checkReferenceType(insurance, "insurance", "Coverage", "ClaimResponse");
-        ValidationSupport.checkReferenceType(specimen, "specimen", "Specimen");
-        ValidationSupport.checkReferenceType(relevantHistory, "relevantHistory", "Provenance");
+        relevantHistory = Collections.unmodifiableList(builder.relevantHistory);
     }
 
     /**
@@ -2073,7 +2062,50 @@ public Builder relevantHistory(Collection<Reference> relevantHistory) {
          */
         @Override
         public ServiceRequest build() {
-            return new ServiceRequest(this);
+            ServiceRequest serviceRequest = new ServiceRequest(this);
+            if (validating) {
+                validate(serviceRequest);
+            }
+            return serviceRequest;
+        }
+
+        protected void validate(ServiceRequest serviceRequest) {
+            super.validate(serviceRequest);
+            ValidationSupport.checkList(serviceRequest.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(serviceRequest.instantiatesCanonical, "instantiatesCanonical", Canonical.class);
+            ValidationSupport.checkList(serviceRequest.instantiatesUri, "instantiatesUri", Uri.class);
+            ValidationSupport.checkList(serviceRequest.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(serviceRequest.replaces, "replaces", Reference.class);
+            ValidationSupport.requireNonNull(serviceRequest.status, "status");
+            ValidationSupport.requireNonNull(serviceRequest.intent, "intent");
+            ValidationSupport.checkList(serviceRequest.category, "category", CodeableConcept.class);
+            ValidationSupport.checkList(serviceRequest.orderDetail, "orderDetail", CodeableConcept.class);
+            ValidationSupport.choiceElement(serviceRequest.quantity, "quantity", Quantity.class, Ratio.class, Range.class);
+            ValidationSupport.requireNonNull(serviceRequest.subject, "subject");
+            ValidationSupport.choiceElement(serviceRequest.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
+            ValidationSupport.choiceElement(serviceRequest.asNeeded, "asNeeded", Boolean.class, CodeableConcept.class);
+            ValidationSupport.checkList(serviceRequest.performer, "performer", Reference.class);
+            ValidationSupport.checkList(serviceRequest.locationCode, "locationCode", CodeableConcept.class);
+            ValidationSupport.checkList(serviceRequest.locationReference, "locationReference", Reference.class);
+            ValidationSupport.checkList(serviceRequest.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(serviceRequest.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkList(serviceRequest.insurance, "insurance", Reference.class);
+            ValidationSupport.checkList(serviceRequest.supportingInfo, "supportingInfo", Reference.class);
+            ValidationSupport.checkList(serviceRequest.specimen, "specimen", Reference.class);
+            ValidationSupport.checkList(serviceRequest.bodySite, "bodySite", CodeableConcept.class);
+            ValidationSupport.checkList(serviceRequest.note, "note", Annotation.class);
+            ValidationSupport.checkList(serviceRequest.relevantHistory, "relevantHistory", Reference.class);
+            ValidationSupport.checkReferenceType(serviceRequest.basedOn, "basedOn", "CarePlan", "ServiceRequest", "MedicationRequest");
+            ValidationSupport.checkReferenceType(serviceRequest.replaces, "replaces", "ServiceRequest");
+            ValidationSupport.checkReferenceType(serviceRequest.subject, "subject", "Patient", "Group", "Location", "Device");
+            ValidationSupport.checkReferenceType(serviceRequest.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(serviceRequest.requester, "requester", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
+            ValidationSupport.checkReferenceType(serviceRequest.performer, "performer", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "HealthcareService", "Patient", "Device", "RelatedPerson");
+            ValidationSupport.checkReferenceType(serviceRequest.locationReference, "locationReference", "Location");
+            ValidationSupport.checkReferenceType(serviceRequest.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
+            ValidationSupport.checkReferenceType(serviceRequest.insurance, "insurance", "Coverage", "ClaimResponse");
+            ValidationSupport.checkReferenceType(serviceRequest.specimen, "specimen", "Specimen");
+            ValidationSupport.checkReferenceType(serviceRequest.relevantHistory, "relevantHistory", "Provenance");
         }
 
         protected Builder from(ServiceRequest serviceRequest) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Slot.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Slot.java
index af324354d24..75bf4a3034e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Slot.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Slot.java
@@ -119,18 +119,17 @@ public class Slot extends DomainResource {
 
     private Slot(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        serviceCategory = Collections.unmodifiableList(ValidationSupport.checkList(builder.serviceCategory, "serviceCategory", CodeableConcept.class));
-        serviceType = Collections.unmodifiableList(ValidationSupport.checkList(builder.serviceType, "serviceType", CodeableConcept.class));
-        specialty = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialty, "specialty", CodeableConcept.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        serviceCategory = Collections.unmodifiableList(builder.serviceCategory);
+        serviceType = Collections.unmodifiableList(builder.serviceType);
+        specialty = Collections.unmodifiableList(builder.specialty);
         appointmentType = builder.appointmentType;
-        schedule = ValidationSupport.requireNonNull(builder.schedule, "schedule");
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        start = ValidationSupport.requireNonNull(builder.start, "start");
-        end = ValidationSupport.requireNonNull(builder.end, "end");
+        schedule = builder.schedule;
+        status = builder.status;
+        start = builder.start;
+        end = builder.end;
         overbooked = builder.overbooked;
         comment = builder.comment;
-        ValidationSupport.checkReferenceType(schedule, "schedule", "Schedule");
     }
 
     /**
@@ -848,7 +847,24 @@ public Builder comment(String comment) {
          */
         @Override
         public Slot build() {
-            return new Slot(this);
+            Slot slot = new Slot(this);
+            if (validating) {
+                validate(slot);
+            }
+            return slot;
+        }
+
+        protected void validate(Slot slot) {
+            super.validate(slot);
+            ValidationSupport.checkList(slot.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(slot.serviceCategory, "serviceCategory", CodeableConcept.class);
+            ValidationSupport.checkList(slot.serviceType, "serviceType", CodeableConcept.class);
+            ValidationSupport.checkList(slot.specialty, "specialty", CodeableConcept.class);
+            ValidationSupport.requireNonNull(slot.schedule, "schedule");
+            ValidationSupport.requireNonNull(slot.status, "status");
+            ValidationSupport.requireNonNull(slot.start, "start");
+            ValidationSupport.requireNonNull(slot.end, "end");
+            ValidationSupport.checkReferenceType(slot.schedule, "schedule", "Schedule");
         }
 
         protected Builder from(Slot slot) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Specimen.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Specimen.java
index 78c07fcd0a3..eb570a3537e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Specimen.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Specimen.java
@@ -112,22 +112,19 @@ public class Specimen extends DomainResource {
 
     private Specimen(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         accessionIdentifier = builder.accessionIdentifier;
         status = builder.status;
         type = builder.type;
         subject = builder.subject;
         receivedTime = builder.receivedTime;
-        parent = Collections.unmodifiableList(ValidationSupport.checkList(builder.parent, "parent", Reference.class));
-        request = Collections.unmodifiableList(ValidationSupport.checkList(builder.request, "request", Reference.class));
+        parent = Collections.unmodifiableList(builder.parent);
+        request = Collections.unmodifiableList(builder.request);
         collection = builder.collection;
-        processing = Collections.unmodifiableList(ValidationSupport.checkList(builder.processing, "processing", Processing.class));
-        container = Collections.unmodifiableList(ValidationSupport.checkList(builder.container, "container", Container.class));
-        condition = Collections.unmodifiableList(ValidationSupport.checkList(builder.condition, "condition", CodeableConcept.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Patient", "Group", "Device", "Substance", "Location");
-        ValidationSupport.checkReferenceType(parent, "parent", "Specimen");
-        ValidationSupport.checkReferenceType(request, "request", "ServiceRequest");
+        processing = Collections.unmodifiableList(builder.processing);
+        container = Collections.unmodifiableList(builder.container);
+        condition = Collections.unmodifiableList(builder.condition);
+        note = Collections.unmodifiableList(builder.note);
     }
 
     /**
@@ -975,7 +972,25 @@ public Builder note(java.util.Collection<Annotation> note) {
          */
         @Override
         public Specimen build() {
-            return new Specimen(this);
+            Specimen specimen = new Specimen(this);
+            if (validating) {
+                validate(specimen);
+            }
+            return specimen;
+        }
+
+        protected void validate(Specimen specimen) {
+            super.validate(specimen);
+            ValidationSupport.checkList(specimen.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(specimen.parent, "parent", Reference.class);
+            ValidationSupport.checkList(specimen.request, "request", Reference.class);
+            ValidationSupport.checkList(specimen.processing, "processing", Processing.class);
+            ValidationSupport.checkList(specimen.container, "container", Container.class);
+            ValidationSupport.checkList(specimen.condition, "condition", CodeableConcept.class);
+            ValidationSupport.checkList(specimen.note, "note", Annotation.class);
+            ValidationSupport.checkReferenceType(specimen.subject, "subject", "Patient", "Group", "Device", "Substance", "Location");
+            ValidationSupport.checkReferenceType(specimen.parent, "parent", "Specimen");
+            ValidationSupport.checkReferenceType(specimen.request, "request", "ServiceRequest");
         }
 
         protected Builder from(Specimen specimen) {
@@ -1037,14 +1052,12 @@ public static class Collection extends BackboneElement {
         private Collection(Builder builder) {
             super(builder);
             collector = builder.collector;
-            collected = ValidationSupport.choiceElement(builder.collected, "collected", DateTime.class, Period.class);
+            collected = builder.collected;
             duration = builder.duration;
             quantity = builder.quantity;
             method = builder.method;
             bodySite = builder.bodySite;
-            fastingStatus = ValidationSupport.choiceElement(builder.fastingStatus, "fastingStatus", CodeableConcept.class, Duration.class);
-            ValidationSupport.checkReferenceType(collector, "collector", "Practitioner", "PractitionerRole");
-            ValidationSupport.requireValueOrChildren(this);
+            fastingStatus = builder.fastingStatus;
         }
 
         /**
@@ -1447,7 +1460,19 @@ public Builder fastingStatus(Element fastingStatus) {
              */
             @Override
             public Collection build() {
-                return new Collection(this);
+                Collection collection = new Collection(this);
+                if (validating) {
+                    validate(collection);
+                }
+                return collection;
+            }
+
+            protected void validate(Collection collection) {
+                super.validate(collection);
+                ValidationSupport.choiceElement(collection.collected, "collected", DateTime.class, Period.class);
+                ValidationSupport.choiceElement(collection.fastingStatus, "fastingStatus", CodeableConcept.class, Duration.class);
+                ValidationSupport.checkReferenceType(collection.collector, "collector", "Practitioner", "PractitionerRole");
+                ValidationSupport.requireValueOrChildren(collection);
             }
 
             protected Builder from(Collection collection) {
@@ -1485,10 +1510,8 @@ private Processing(Builder builder) {
             super(builder);
             description = builder.description;
             procedure = builder.procedure;
-            additive = Collections.unmodifiableList(ValidationSupport.checkList(builder.additive, "additive", Reference.class));
-            time = ValidationSupport.choiceElement(builder.time, "time", DateTime.class, Period.class);
-            ValidationSupport.checkReferenceType(additive, "additive", "Substance");
-            ValidationSupport.requireValueOrChildren(this);
+            additive = Collections.unmodifiableList(builder.additive);
+            time = builder.time;
         }
 
         /**
@@ -1820,7 +1843,19 @@ public Builder time(Element time) {
              */
             @Override
             public Processing build() {
-                return new Processing(this);
+                Processing processing = new Processing(this);
+                if (validating) {
+                    validate(processing);
+                }
+                return processing;
+            }
+
+            protected void validate(Processing processing) {
+                super.validate(processing);
+                ValidationSupport.checkList(processing.additive, "additive", Reference.class);
+                ValidationSupport.choiceElement(processing.time, "time", DateTime.class, Period.class);
+                ValidationSupport.checkReferenceType(processing.additive, "additive", "Substance");
+                ValidationSupport.requireValueOrChildren(processing);
             }
 
             protected Builder from(Processing processing) {
@@ -1863,14 +1898,12 @@ public static class Container extends BackboneElement {
 
         private Container(Builder builder) {
             super(builder);
-            identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+            identifier = Collections.unmodifiableList(builder.identifier);
             description = builder.description;
             type = builder.type;
             capacity = builder.capacity;
             specimenQuantity = builder.specimenQuantity;
-            additive = ValidationSupport.choiceElement(builder.additive, "additive", CodeableConcept.class, Reference.class);
-            ValidationSupport.checkReferenceType(additive, "additive", "Substance");
-            ValidationSupport.requireValueOrChildren(this);
+            additive = builder.additive;
         }
 
         /**
@@ -2258,7 +2291,19 @@ public Builder additive(Element additive) {
              */
             @Override
             public Container build() {
-                return new Container(this);
+                Container container = new Container(this);
+                if (validating) {
+                    validate(container);
+                }
+                return container;
+            }
+
+            protected void validate(Container container) {
+                super.validate(container);
+                ValidationSupport.checkList(container.identifier, "identifier", Identifier.class);
+                ValidationSupport.choiceElement(container.additive, "additive", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkReferenceType(container.additive, "additive", "Substance");
+                ValidationSupport.requireValueOrChildren(container);
             }
 
             protected Builder from(Container container) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SpecimenDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SpecimenDefinition.java
index 84bee4ee801..96c4275ee95 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SpecimenDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SpecimenDefinition.java
@@ -86,10 +86,10 @@ private SpecimenDefinition(Builder builder) {
         super(builder);
         identifier = builder.identifier;
         typeCollected = builder.typeCollected;
-        patientPreparation = Collections.unmodifiableList(ValidationSupport.checkList(builder.patientPreparation, "patientPreparation", CodeableConcept.class));
+        patientPreparation = Collections.unmodifiableList(builder.patientPreparation);
         timeAspect = builder.timeAspect;
-        collection = Collections.unmodifiableList(ValidationSupport.checkList(builder.collection, "collection", CodeableConcept.class));
-        typeTested = Collections.unmodifiableList(ValidationSupport.checkList(builder.typeTested, "typeTested", TypeTested.class));
+        collection = Collections.unmodifiableList(builder.collection);
+        typeTested = Collections.unmodifiableList(builder.typeTested);
     }
 
     /**
@@ -611,7 +611,18 @@ public Builder typeTested(Collection<TypeTested> typeTested) {
          */
         @Override
         public SpecimenDefinition build() {
-            return new SpecimenDefinition(this);
+            SpecimenDefinition specimenDefinition = new SpecimenDefinition(this);
+            if (validating) {
+                validate(specimenDefinition);
+            }
+            return specimenDefinition;
+        }
+
+        protected void validate(SpecimenDefinition specimenDefinition) {
+            super.validate(specimenDefinition);
+            ValidationSupport.checkList(specimenDefinition.patientPreparation, "patientPreparation", CodeableConcept.class);
+            ValidationSupport.checkList(specimenDefinition.collection, "collection", CodeableConcept.class);
+            ValidationSupport.checkList(specimenDefinition.typeTested, "typeTested", TypeTested.class);
         }
 
         protected Builder from(SpecimenDefinition specimenDefinition) {
@@ -662,13 +673,12 @@ private TypeTested(Builder builder) {
             super(builder);
             isDerived = builder.isDerived;
             type = builder.type;
-            preference = ValidationSupport.requireNonNull(builder.preference, "preference");
+            preference = builder.preference;
             container = builder.container;
             requirement = builder.requirement;
             retentionTime = builder.retentionTime;
-            rejectionCriterion = Collections.unmodifiableList(ValidationSupport.checkList(builder.rejectionCriterion, "rejectionCriterion", CodeableConcept.class));
-            handling = Collections.unmodifiableList(ValidationSupport.checkList(builder.handling, "handling", Handling.class));
-            ValidationSupport.requireValueOrChildren(this);
+            rejectionCriterion = Collections.unmodifiableList(builder.rejectionCriterion);
+            handling = Collections.unmodifiableList(builder.handling);
         }
 
         /**
@@ -1130,7 +1140,19 @@ public Builder handling(Collection<Handling> handling) {
              */
             @Override
             public TypeTested build() {
-                return new TypeTested(this);
+                TypeTested typeTested = new TypeTested(this);
+                if (validating) {
+                    validate(typeTested);
+                }
+                return typeTested;
+            }
+
+            protected void validate(TypeTested typeTested) {
+                super.validate(typeTested);
+                ValidationSupport.requireNonNull(typeTested.preference, "preference");
+                ValidationSupport.checkList(typeTested.rejectionCriterion, "rejectionCriterion", CodeableConcept.class);
+                ValidationSupport.checkList(typeTested.handling, "handling", Handling.class);
+                ValidationSupport.requireValueOrChildren(typeTested);
             }
 
             protected Builder from(TypeTested typeTested) {
@@ -1186,10 +1208,9 @@ private Container(Builder builder) {
                 cap = builder.cap;
                 description = builder.description;
                 capacity = builder.capacity;
-                minimumVolume = ValidationSupport.choiceElement(builder.minimumVolume, "minimumVolume", SimpleQuantity.class, String.class);
-                additive = Collections.unmodifiableList(ValidationSupport.checkList(builder.additive, "additive", Additive.class));
+                minimumVolume = builder.minimumVolume;
+                additive = Collections.unmodifiableList(builder.additive);
                 preparation = builder.preparation;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1628,7 +1649,18 @@ public Builder preparation(String preparation) {
                  */
                 @Override
                 public Container build() {
-                    return new Container(this);
+                    Container container = new Container(this);
+                    if (validating) {
+                        validate(container);
+                    }
+                    return container;
+                }
+
+                protected void validate(Container container) {
+                    super.validate(container);
+                    ValidationSupport.choiceElement(container.minimumVolume, "minimumVolume", SimpleQuantity.class, String.class);
+                    ValidationSupport.checkList(container.additive, "additive", Additive.class);
+                    ValidationSupport.requireValueOrChildren(container);
                 }
 
                 protected Builder from(Container container) {
@@ -1663,9 +1695,7 @@ public static class Additive extends BackboneElement {
 
                 private Additive(Builder builder) {
                     super(builder);
-                    additive = ValidationSupport.requireChoiceElement(builder.additive, "additive", CodeableConcept.class, Reference.class);
-                    ValidationSupport.checkReferenceType(additive, "additive", "Substance");
-                    ValidationSupport.requireValueOrChildren(this);
+                    additive = builder.additive;
                 }
 
                 /**
@@ -1892,7 +1922,18 @@ public Builder additive(Element additive) {
                      */
                     @Override
                     public Additive build() {
-                        return new Additive(this);
+                        Additive additive = new Additive(this);
+                        if (validating) {
+                            validate(additive);
+                        }
+                        return additive;
+                    }
+
+                    protected void validate(Additive additive) {
+                        super.validate(additive);
+                        ValidationSupport.requireChoiceElement(additive.additive, "additive", CodeableConcept.class, Reference.class);
+                        ValidationSupport.checkReferenceType(additive.additive, "additive", "Substance");
+                        ValidationSupport.requireValueOrChildren(additive);
                     }
 
                     protected Builder from(Additive additive) {
@@ -1926,7 +1967,6 @@ private Handling(Builder builder) {
                 temperatureRange = builder.temperatureRange;
                 maxDuration = builder.maxDuration;
                 instruction = builder.instruction;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2224,7 +2264,16 @@ public Builder instruction(String instruction) {
                  */
                 @Override
                 public Handling build() {
-                    return new Handling(this);
+                    Handling handling = new Handling(this);
+                    if (validating) {
+                        validate(handling);
+                    }
+                    return handling;
+                }
+
+                protected void validate(Handling handling) {
+                    super.validate(handling);
+                    ValidationSupport.requireValueOrChildren(handling);
                 }
 
                 protected Builder from(Handling handling) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/StructureDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/StructureDefinition.java
index ae2220b7ad7..7f1c1f5ca25 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/StructureDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/StructureDefinition.java
@@ -350,29 +350,29 @@ public class StructureDefinition extends DomainResource {
 
     private StructureDefinition(Builder builder) {
         super(builder);
-        url = ValidationSupport.requireNonNull(builder.url, "url");
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        url = builder.url;
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
-        name = ValidationSupport.requireNonNull(builder.name, "name");
+        name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         copyright = builder.copyright;
-        keyword = Collections.unmodifiableList(ValidationSupport.checkList(builder.keyword, "keyword", Coding.class));
+        keyword = Collections.unmodifiableList(builder.keyword);
         fhirVersion = builder.fhirVersion;
-        mapping = Collections.unmodifiableList(ValidationSupport.checkList(builder.mapping, "mapping", Mapping.class));
-        kind = ValidationSupport.requireNonNull(builder.kind, "kind");
-        _abstract = ValidationSupport.requireNonNull(builder._abstract, "abstract");
-        context = Collections.unmodifiableList(ValidationSupport.checkList(builder.context, "context", Context.class));
-        contextInvariant = Collections.unmodifiableList(ValidationSupport.checkList(builder.contextInvariant, "contextInvariant", String.class));
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        mapping = Collections.unmodifiableList(builder.mapping);
+        kind = builder.kind;
+        _abstract = builder._abstract;
+        context = Collections.unmodifiableList(builder.context);
+        contextInvariant = Collections.unmodifiableList(builder.contextInvariant);
+        type = builder.type;
         baseDefinition = builder.baseDefinition;
         derivation = builder.derivation;
         snapshot = builder.snapshot;
@@ -1682,7 +1682,29 @@ public Builder differential(Differential differential) {
          */
         @Override
         public StructureDefinition build() {
-            return new StructureDefinition(this);
+            StructureDefinition structureDefinition = new StructureDefinition(this);
+            if (validating) {
+                validate(structureDefinition);
+            }
+            return structureDefinition;
+        }
+
+        protected void validate(StructureDefinition structureDefinition) {
+            super.validate(structureDefinition);
+            ValidationSupport.requireNonNull(structureDefinition.url, "url");
+            ValidationSupport.checkList(structureDefinition.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(structureDefinition.name, "name");
+            ValidationSupport.requireNonNull(structureDefinition.status, "status");
+            ValidationSupport.checkList(structureDefinition.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(structureDefinition.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(structureDefinition.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(structureDefinition.keyword, "keyword", Coding.class);
+            ValidationSupport.checkList(structureDefinition.mapping, "mapping", Mapping.class);
+            ValidationSupport.requireNonNull(structureDefinition.kind, "kind");
+            ValidationSupport.requireNonNull(structureDefinition._abstract, "abstract");
+            ValidationSupport.checkList(structureDefinition.context, "context", Context.class);
+            ValidationSupport.checkList(structureDefinition.contextInvariant, "contextInvariant", String.class);
+            ValidationSupport.requireNonNull(structureDefinition.type, "type");
         }
 
         protected Builder from(StructureDefinition structureDefinition) {
@@ -1730,11 +1752,10 @@ public static class Mapping extends BackboneElement {
 
         private Mapping(Builder builder) {
             super(builder);
-            identity = ValidationSupport.requireNonNull(builder.identity, "identity");
+            identity = builder.identity;
             uri = builder.uri;
             name = builder.name;
             comment = builder.comment;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2035,7 +2056,17 @@ public Builder comment(String comment) {
              */
             @Override
             public Mapping build() {
-                return new Mapping(this);
+                Mapping mapping = new Mapping(this);
+                if (validating) {
+                    validate(mapping);
+                }
+                return mapping;
+            }
+
+            protected void validate(Mapping mapping) {
+                super.validate(mapping);
+                ValidationSupport.requireNonNull(mapping.identity, "identity");
+                ValidationSupport.requireValueOrChildren(mapping);
             }
 
             protected Builder from(Mapping mapping) {
@@ -2068,9 +2099,8 @@ public static class Context extends BackboneElement {
 
         private Context(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            expression = ValidationSupport.requireNonNull(builder.expression, "expression");
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            expression = builder.expression;
         }
 
         /**
@@ -2316,7 +2346,18 @@ public Builder expression(String expression) {
              */
             @Override
             public Context build() {
-                return new Context(this);
+                Context context = new Context(this);
+                if (validating) {
+                    validate(context);
+                }
+                return context;
+            }
+
+            protected void validate(Context context) {
+                super.validate(context);
+                ValidationSupport.requireNonNull(context.type, "type");
+                ValidationSupport.requireNonNull(context.expression, "expression");
+                ValidationSupport.requireValueOrChildren(context);
             }
 
             protected Builder from(Context context) {
@@ -2338,8 +2379,7 @@ public static class Snapshot extends BackboneElement {
 
         private Snapshot(Builder builder) {
             super(builder);
-            element = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.element, "element", ElementDefinition.class));
-            ValidationSupport.requireValueOrChildren(this);
+            element = Collections.unmodifiableList(builder.element);
         }
 
         /**
@@ -2575,7 +2615,17 @@ public Builder element(Collection<ElementDefinition> element) {
              */
             @Override
             public Snapshot build() {
-                return new Snapshot(this);
+                Snapshot snapshot = new Snapshot(this);
+                if (validating) {
+                    validate(snapshot);
+                }
+                return snapshot;
+            }
+
+            protected void validate(Snapshot snapshot) {
+                super.validate(snapshot);
+                ValidationSupport.checkNonEmptyList(snapshot.element, "element", ElementDefinition.class);
+                ValidationSupport.requireValueOrChildren(snapshot);
             }
 
             protected Builder from(Snapshot snapshot) {
@@ -2595,8 +2645,7 @@ public static class Differential extends BackboneElement {
 
         private Differential(Builder builder) {
             super(builder);
-            element = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.element, "element", ElementDefinition.class));
-            ValidationSupport.requireValueOrChildren(this);
+            element = Collections.unmodifiableList(builder.element);
         }
 
         /**
@@ -2832,7 +2881,17 @@ public Builder element(Collection<ElementDefinition> element) {
              */
             @Override
             public Differential build() {
-                return new Differential(this);
+                Differential differential = new Differential(this);
+                if (validating) {
+                    validate(differential);
+                }
+                return differential;
+            }
+
+            protected void validate(Differential differential) {
+                super.validate(differential);
+                ValidationSupport.checkNonEmptyList(differential.element, "element", ElementDefinition.class);
+                ValidationSupport.requireValueOrChildren(differential);
             }
 
             protected Builder from(Differential differential) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/StructureMap.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/StructureMap.java
index d662195a6f7..0fd897da1f5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/StructureMap.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/StructureMap.java
@@ -179,24 +179,24 @@ public class StructureMap extends DomainResource {
 
     private StructureMap(Builder builder) {
         super(builder);
-        url = ValidationSupport.requireNonNull(builder.url, "url");
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        url = builder.url;
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
-        name = ValidationSupport.requireNonNull(builder.name, "name");
+        name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         copyright = builder.copyright;
-        structure = Collections.unmodifiableList(ValidationSupport.checkList(builder.structure, "structure", Structure.class));
-        _import = Collections.unmodifiableList(ValidationSupport.checkList(builder._import, "import", Canonical.class));
-        group = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.group, "group", Group.class));
+        structure = Collections.unmodifiableList(builder.structure);
+        _import = Collections.unmodifiableList(builder._import);
+        group = Collections.unmodifiableList(builder.group);
     }
 
     /**
@@ -1198,7 +1198,25 @@ public Builder group(Collection<Group> group) {
          */
         @Override
         public StructureMap build() {
-            return new StructureMap(this);
+            StructureMap structureMap = new StructureMap(this);
+            if (validating) {
+                validate(structureMap);
+            }
+            return structureMap;
+        }
+
+        protected void validate(StructureMap structureMap) {
+            super.validate(structureMap);
+            ValidationSupport.requireNonNull(structureMap.url, "url");
+            ValidationSupport.checkList(structureMap.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(structureMap.name, "name");
+            ValidationSupport.requireNonNull(structureMap.status, "status");
+            ValidationSupport.checkList(structureMap.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(structureMap.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(structureMap.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(structureMap.structure, "structure", Structure.class);
+            ValidationSupport.checkList(structureMap._import, "import", Canonical.class);
+            ValidationSupport.checkNonEmptyList(structureMap.group, "group", Group.class);
         }
 
         protected Builder from(StructureMap structureMap) {
@@ -1248,11 +1266,10 @@ public static class Structure extends BackboneElement {
 
         private Structure(Builder builder) {
             super(builder);
-            url = ValidationSupport.requireNonNull(builder.url, "url");
-            mode = ValidationSupport.requireNonNull(builder.mode, "mode");
+            url = builder.url;
+            mode = builder.mode;
             alias = builder.alias;
             documentation = builder.documentation;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1556,7 +1573,18 @@ public Builder documentation(String documentation) {
              */
             @Override
             public Structure build() {
-                return new Structure(this);
+                Structure structure = new Structure(this);
+                if (validating) {
+                    validate(structure);
+                }
+                return structure;
+            }
+
+            protected void validate(Structure structure) {
+                super.validate(structure);
+                ValidationSupport.requireNonNull(structure.url, "url");
+                ValidationSupport.requireNonNull(structure.mode, "mode");
+                ValidationSupport.requireValueOrChildren(structure);
             }
 
             protected Builder from(Structure structure) {
@@ -1599,13 +1627,12 @@ public static class Group extends BackboneElement {
 
         private Group(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
+            name = builder.name;
             _extends = builder._extends;
-            typeMode = ValidationSupport.requireNonNull(builder.typeMode, "typeMode");
+            typeMode = builder.typeMode;
             documentation = builder.documentation;
-            input = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.input, "input", Input.class));
-            rule = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.rule, "rule", Rule.class));
-            ValidationSupport.requireValueOrChildren(this);
+            input = Collections.unmodifiableList(builder.input);
+            rule = Collections.unmodifiableList(builder.rule);
         }
 
         /**
@@ -2017,7 +2044,20 @@ public Builder rule(Collection<Rule> rule) {
              */
             @Override
             public Group build() {
-                return new Group(this);
+                Group group = new Group(this);
+                if (validating) {
+                    validate(group);
+                }
+                return group;
+            }
+
+            protected void validate(Group group) {
+                super.validate(group);
+                ValidationSupport.requireNonNull(group.name, "name");
+                ValidationSupport.requireNonNull(group.typeMode, "typeMode");
+                ValidationSupport.checkNonEmptyList(group.input, "input", Input.class);
+                ValidationSupport.checkNonEmptyList(group.rule, "rule", Rule.class);
+                ValidationSupport.requireValueOrChildren(group);
             }
 
             protected Builder from(Group group) {
@@ -2054,11 +2094,10 @@ public static class Input extends BackboneElement {
 
             private Input(Builder builder) {
                 super(builder);
-                name = ValidationSupport.requireNonNull(builder.name, "name");
+                name = builder.name;
                 type = builder.type;
-                mode = ValidationSupport.requireNonNull(builder.mode, "mode");
+                mode = builder.mode;
                 documentation = builder.documentation;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2362,7 +2401,18 @@ public Builder documentation(String documentation) {
                  */
                 @Override
                 public Input build() {
-                    return new Input(this);
+                    Input input = new Input(this);
+                    if (validating) {
+                        validate(input);
+                    }
+                    return input;
+                }
+
+                protected void validate(Input input) {
+                    super.validate(input);
+                    ValidationSupport.requireNonNull(input.name, "name");
+                    ValidationSupport.requireNonNull(input.mode, "mode");
+                    ValidationSupport.requireValueOrChildren(input);
                 }
 
                 protected Builder from(Input input) {
@@ -2396,13 +2446,12 @@ public static class Rule extends BackboneElement {
 
             private Rule(Builder builder) {
                 super(builder);
-                name = ValidationSupport.requireNonNull(builder.name, "name");
-                source = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.source, "source", Source.class));
-                target = Collections.unmodifiableList(ValidationSupport.checkList(builder.target, "target", Target.class));
-                rule = Collections.unmodifiableList(ValidationSupport.checkList(builder.rule, "rule", StructureMap.Group.Rule.class));
-                dependent = Collections.unmodifiableList(ValidationSupport.checkList(builder.dependent, "dependent", Dependent.class));
+                name = builder.name;
+                source = Collections.unmodifiableList(builder.source);
+                target = Collections.unmodifiableList(builder.target);
+                rule = Collections.unmodifiableList(builder.rule);
+                dependent = Collections.unmodifiableList(builder.dependent);
                 documentation = builder.documentation;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2846,7 +2895,21 @@ public Builder documentation(String documentation) {
                  */
                 @Override
                 public Rule build() {
-                    return new Rule(this);
+                    Rule rule = new Rule(this);
+                    if (validating) {
+                        validate(rule);
+                    }
+                    return rule;
+                }
+
+                protected void validate(Rule rule) {
+                    super.validate(rule);
+                    ValidationSupport.requireNonNull(rule.name, "name");
+                    ValidationSupport.checkNonEmptyList(rule.source, "source", Source.class);
+                    ValidationSupport.checkList(rule.target, "target", Target.class);
+                    ValidationSupport.checkList(rule.rule, "rule", StructureMap.Group.Rule.class);
+                    ValidationSupport.checkList(rule.dependent, "dependent", Dependent.class);
+                    ValidationSupport.requireValueOrChildren(rule);
                 }
 
                 protected Builder from(Rule rule) {
@@ -2898,18 +2961,17 @@ public static class Source extends BackboneElement {
 
                 private Source(Builder builder) {
                     super(builder);
-                    context = ValidationSupport.requireNonNull(builder.context, "context");
+                    context = builder.context;
                     min = builder.min;
                     max = builder.max;
                     type = builder.type;
-                    defaultValue = ValidationSupport.choiceElement(builder.defaultValue, "defaultValue", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+                    defaultValue = builder.defaultValue;
                     element = builder.element;
                     listMode = builder.listMode;
                     variable = builder.variable;
                     condition = builder.condition;
                     check = builder.check;
                     logMessage = builder.logMessage;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -3473,7 +3535,18 @@ public Builder logMessage(String logMessage) {
                      */
                     @Override
                     public Source build() {
-                        return new Source(this);
+                        Source source = new Source(this);
+                        if (validating) {
+                            validate(source);
+                        }
+                        return source;
+                    }
+
+                    protected void validate(Source source) {
+                        super.validate(source);
+                        ValidationSupport.requireNonNull(source.context, "context");
+                        ValidationSupport.choiceElement(source.defaultValue, "defaultValue", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+                        ValidationSupport.requireValueOrChildren(source);
                     }
 
                     protected Builder from(Source source) {
@@ -3539,11 +3612,10 @@ private Target(Builder builder) {
                     contextType = builder.contextType;
                     element = builder.element;
                     variable = builder.variable;
-                    listMode = Collections.unmodifiableList(ValidationSupport.checkList(builder.listMode, "listMode", StructureMapTargetListMode.class));
+                    listMode = Collections.unmodifiableList(builder.listMode);
                     listRuleId = builder.listRuleId;
                     transform = builder.transform;
-                    parameter = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameter, "parameter", Parameter.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    parameter = Collections.unmodifiableList(builder.parameter);
                 }
 
                 /**
@@ -3993,7 +4065,18 @@ public Builder parameter(Collection<Parameter> parameter) {
                      */
                     @Override
                     public Target build() {
-                        return new Target(this);
+                        Target target = new Target(this);
+                        if (validating) {
+                            validate(target);
+                        }
+                        return target;
+                    }
+
+                    protected void validate(Target target) {
+                        super.validate(target);
+                        ValidationSupport.checkList(target.listMode, "listMode", StructureMapTargetListMode.class);
+                        ValidationSupport.checkList(target.parameter, "parameter", Parameter.class);
+                        ValidationSupport.requireValueOrChildren(target);
                     }
 
                     protected Builder from(Target target) {
@@ -4021,8 +4104,7 @@ public static class Parameter extends BackboneElement {
 
                     private Parameter(Builder builder) {
                         super(builder);
-                        value = ValidationSupport.requireChoiceElement(builder.value, "value", Id.class, String.class, Boolean.class, Integer.class, Decimal.class);
-                        ValidationSupport.requireValueOrChildren(this);
+                        value = builder.value;
                     }
 
                     /**
@@ -4245,7 +4327,17 @@ public Builder value(Element value) {
                          */
                         @Override
                         public Parameter build() {
-                            return new Parameter(this);
+                            Parameter parameter = new Parameter(this);
+                            if (validating) {
+                                validate(parameter);
+                            }
+                            return parameter;
+                        }
+
+                        protected void validate(Parameter parameter) {
+                            super.validate(parameter);
+                            ValidationSupport.requireChoiceElement(parameter.value, "value", Id.class, String.class, Boolean.class, Integer.class, Decimal.class);
+                            ValidationSupport.requireValueOrChildren(parameter);
                         }
 
                         protected Builder from(Parameter parameter) {
@@ -4270,9 +4362,8 @@ public static class Dependent extends BackboneElement {
 
                 private Dependent(Builder builder) {
                     super(builder);
-                    name = ValidationSupport.requireNonNull(builder.name, "name");
-                    variable = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.variable, "variable", String.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    name = builder.name;
+                    variable = Collections.unmodifiableList(builder.variable);
                 }
 
                 /**
@@ -4540,7 +4631,18 @@ public Builder variable(Collection<String> variable) {
                      */
                     @Override
                     public Dependent build() {
-                        return new Dependent(this);
+                        Dependent dependent = new Dependent(this);
+                        if (validating) {
+                            validate(dependent);
+                        }
+                        return dependent;
+                    }
+
+                    protected void validate(Dependent dependent) {
+                        super.validate(dependent);
+                        ValidationSupport.requireNonNull(dependent.name, "name");
+                        ValidationSupport.checkNonEmptyList(dependent.variable, "variable", String.class);
+                        ValidationSupport.requireValueOrChildren(dependent);
                     }
 
                     protected Builder from(Dependent dependent) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Subscription.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Subscription.java
index f772ee59d3b..95d90d1689a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Subscription.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Subscription.java
@@ -76,13 +76,13 @@ public class Subscription extends DomainResource {
 
     private Subscription(Builder builder) {
         super(builder);
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactPoint.class));
+        status = builder.status;
+        contact = Collections.unmodifiableList(builder.contact);
         end = builder.end;
-        reason = ValidationSupport.requireNonNull(builder.reason, "reason");
-        criteria = ValidationSupport.requireNonNull(builder.criteria, "criteria");
+        reason = builder.reason;
+        criteria = builder.criteria;
         error = builder.error;
-        channel = ValidationSupport.requireNonNull(builder.channel, "channel");
+        channel = builder.channel;
     }
 
     /**
@@ -612,7 +612,20 @@ public Builder channel(Channel channel) {
          */
         @Override
         public Subscription build() {
-            return new Subscription(this);
+            Subscription subscription = new Subscription(this);
+            if (validating) {
+                validate(subscription);
+            }
+            return subscription;
+        }
+
+        protected void validate(Subscription subscription) {
+            super.validate(subscription);
+            ValidationSupport.requireNonNull(subscription.status, "status");
+            ValidationSupport.checkList(subscription.contact, "contact", ContactPoint.class);
+            ValidationSupport.requireNonNull(subscription.reason, "reason");
+            ValidationSupport.requireNonNull(subscription.criteria, "criteria");
+            ValidationSupport.requireNonNull(subscription.channel, "channel");
         }
 
         protected Builder from(Subscription subscription) {
@@ -656,11 +669,10 @@ public static class Channel extends BackboneElement {
 
         private Channel(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
+            type = builder.type;
             endpoint = builder.endpoint;
             payload = builder.payload;
-            header = Collections.unmodifiableList(ValidationSupport.checkList(builder.header, "header", String.class));
-            ValidationSupport.requireValueOrChildren(this);
+            header = Collections.unmodifiableList(builder.header);
         }
 
         /**
@@ -985,7 +997,18 @@ public Builder header(Collection<String> header) {
              */
             @Override
             public Channel build() {
-                return new Channel(this);
+                Channel channel = new Channel(this);
+                if (validating) {
+                    validate(channel);
+                }
+                return channel;
+            }
+
+            protected void validate(Channel channel) {
+                super.validate(channel);
+                ValidationSupport.requireNonNull(channel.type, "type");
+                ValidationSupport.checkList(channel.header, "header", String.class);
+                ValidationSupport.requireValueOrChildren(channel);
             }
 
             protected Builder from(Channel channel) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Substance.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Substance.java
index 12a3857c253..8146c5e0c27 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Substance.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Substance.java
@@ -96,13 +96,13 @@ public class Substance extends DomainResource {
 
     private Substance(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         status = builder.status;
-        category = Collections.unmodifiableList(ValidationSupport.checkList(builder.category, "category", CodeableConcept.class));
-        code = ValidationSupport.requireNonNull(builder.code, "code");
+        category = Collections.unmodifiableList(builder.category);
+        code = builder.code;
         description = builder.description;
-        instance = Collections.unmodifiableList(ValidationSupport.checkList(builder.instance, "instance", Instance.class));
-        ingredient = Collections.unmodifiableList(ValidationSupport.checkList(builder.ingredient, "ingredient", Ingredient.class));
+        instance = Collections.unmodifiableList(builder.instance);
+        ingredient = Collections.unmodifiableList(builder.ingredient);
     }
 
     /**
@@ -680,7 +680,20 @@ public Builder ingredient(Collection<Ingredient> ingredient) {
          */
         @Override
         public Substance build() {
-            return new Substance(this);
+            Substance substance = new Substance(this);
+            if (validating) {
+                validate(substance);
+            }
+            return substance;
+        }
+
+        protected void validate(Substance substance) {
+            super.validate(substance);
+            ValidationSupport.checkList(substance.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(substance.category, "category", CodeableConcept.class);
+            ValidationSupport.requireNonNull(substance.code, "code");
+            ValidationSupport.checkList(substance.instance, "instance", Instance.class);
+            ValidationSupport.checkList(substance.ingredient, "ingredient", Ingredient.class);
         }
 
         protected Builder from(Substance substance) {
@@ -712,7 +725,6 @@ private Instance(Builder builder) {
             identifier = builder.identifier;
             expiry = builder.expiry;
             quantity = builder.quantity;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -977,7 +989,16 @@ public Builder quantity(SimpleQuantity quantity) {
              */
             @Override
             public Instance build() {
-                return new Instance(this);
+                Instance instance = new Instance(this);
+                if (validating) {
+                    validate(instance);
+                }
+                return instance;
+            }
+
+            protected void validate(Instance instance) {
+                super.validate(instance);
+                ValidationSupport.requireValueOrChildren(instance);
             }
 
             protected Builder from(Instance instance) {
@@ -1011,9 +1032,7 @@ public static class Ingredient extends BackboneElement {
         private Ingredient(Builder builder) {
             super(builder);
             quantity = builder.quantity;
-            substance = ValidationSupport.requireChoiceElement(builder.substance, "substance", CodeableConcept.class, Reference.class);
-            ValidationSupport.checkReferenceType(substance, "substance", "Substance");
-            ValidationSupport.requireValueOrChildren(this);
+            substance = builder.substance;
         }
 
         /**
@@ -1267,7 +1286,18 @@ public Builder substance(Element substance) {
              */
             @Override
             public Ingredient build() {
-                return new Ingredient(this);
+                Ingredient ingredient = new Ingredient(this);
+                if (validating) {
+                    validate(ingredient);
+                }
+                return ingredient;
+            }
+
+            protected void validate(Ingredient ingredient) {
+                super.validate(ingredient);
+                ValidationSupport.requireChoiceElement(ingredient.substance, "substance", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkReferenceType(ingredient.substance, "substance", "Substance");
+                ValidationSupport.requireValueOrChildren(ingredient);
             }
 
             protected Builder from(Ingredient ingredient) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceNucleicAcid.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceNucleicAcid.java
index 3e1a4b7fb4a..bd66881f39e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceNucleicAcid.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceNucleicAcid.java
@@ -60,7 +60,7 @@ private SubstanceNucleicAcid(Builder builder) {
         numberOfSubunits = builder.numberOfSubunits;
         areaOfHybridisation = builder.areaOfHybridisation;
         oligoNucleotideType = builder.oligoNucleotideType;
-        subunit = Collections.unmodifiableList(ValidationSupport.checkList(builder.subunit, "subunit", Subunit.class));
+        subunit = Collections.unmodifiableList(builder.subunit);
     }
 
     /**
@@ -530,7 +530,16 @@ public Builder subunit(Collection<Subunit> subunit) {
          */
         @Override
         public SubstanceNucleicAcid build() {
-            return new SubstanceNucleicAcid(this);
+            SubstanceNucleicAcid substanceNucleicAcid = new SubstanceNucleicAcid(this);
+            if (validating) {
+                validate(substanceNucleicAcid);
+            }
+            return substanceNucleicAcid;
+        }
+
+        protected void validate(SubstanceNucleicAcid substanceNucleicAcid) {
+            super.validate(substanceNucleicAcid);
+            ValidationSupport.checkList(substanceNucleicAcid.subunit, "subunit", Subunit.class);
         }
 
         protected Builder from(SubstanceNucleicAcid substanceNucleicAcid) {
@@ -574,9 +583,8 @@ private Subunit(Builder builder) {
             sequenceAttachment = builder.sequenceAttachment;
             fivePrime = builder.fivePrime;
             threePrime = builder.threePrime;
-            linkage = Collections.unmodifiableList(ValidationSupport.checkList(builder.linkage, "linkage", Linkage.class));
-            sugar = Collections.unmodifiableList(ValidationSupport.checkList(builder.sugar, "sugar", Sugar.class));
-            ValidationSupport.requireValueOrChildren(this);
+            linkage = Collections.unmodifiableList(builder.linkage);
+            sugar = Collections.unmodifiableList(builder.sugar);
         }
 
         /**
@@ -1044,7 +1052,18 @@ public Builder sugar(Collection<Sugar> sugar) {
              */
             @Override
             public Subunit build() {
-                return new Subunit(this);
+                Subunit subunit = new Subunit(this);
+                if (validating) {
+                    validate(subunit);
+                }
+                return subunit;
+            }
+
+            protected void validate(Subunit subunit) {
+                super.validate(subunit);
+                ValidationSupport.checkList(subunit.linkage, "linkage", Linkage.class);
+                ValidationSupport.checkList(subunit.sugar, "sugar", Sugar.class);
+                ValidationSupport.requireValueOrChildren(subunit);
             }
 
             protected Builder from(Subunit subunit) {
@@ -1080,7 +1099,6 @@ private Linkage(Builder builder) {
                 identifier = builder.identifier;
                 name = builder.name;
                 residueSite = builder.residueSite;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1383,7 +1401,16 @@ public Builder residueSite(String residueSite) {
                  */
                 @Override
                 public Linkage build() {
-                    return new Linkage(this);
+                    Linkage linkage = new Linkage(this);
+                    if (validating) {
+                        validate(linkage);
+                    }
+                    return linkage;
+                }
+
+                protected void validate(Linkage linkage) {
+                    super.validate(linkage);
+                    ValidationSupport.requireValueOrChildren(linkage);
                 }
 
                 protected Builder from(Linkage linkage) {
@@ -1413,7 +1440,6 @@ private Sugar(Builder builder) {
                 identifier = builder.identifier;
                 name = builder.name;
                 residueSite = builder.residueSite;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1681,7 +1707,16 @@ public Builder residueSite(String residueSite) {
                  */
                 @Override
                 public Sugar build() {
-                    return new Sugar(this);
+                    Sugar sugar = new Sugar(this);
+                    if (validating) {
+                        validate(sugar);
+                    }
+                    return sugar;
+                }
+
+                protected void validate(Sugar sugar) {
+                    super.validate(sugar);
+                    ValidationSupport.requireValueOrChildren(sugar);
                 }
 
                 protected Builder from(Sugar sugar) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstancePolymer.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstancePolymer.java
index 57aeeb25de0..a568e9044b5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstancePolymer.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstancePolymer.java
@@ -60,10 +60,10 @@ private SubstancePolymer(Builder builder) {
         super(builder);
         clazz = builder.clazz;
         geometry = builder.geometry;
-        copolymerConnectivity = Collections.unmodifiableList(ValidationSupport.checkList(builder.copolymerConnectivity, "copolymerConnectivity", CodeableConcept.class));
-        modification = Collections.unmodifiableList(ValidationSupport.checkList(builder.modification, "modification", String.class));
-        monomerSet = Collections.unmodifiableList(ValidationSupport.checkList(builder.monomerSet, "monomerSet", MonomerSet.class));
-        repeat = Collections.unmodifiableList(ValidationSupport.checkList(builder.repeat, "repeat", Repeat.class));
+        copolymerConnectivity = Collections.unmodifiableList(builder.copolymerConnectivity);
+        modification = Collections.unmodifiableList(builder.modification);
+        monomerSet = Collections.unmodifiableList(builder.monomerSet);
+        repeat = Collections.unmodifiableList(builder.repeat);
     }
 
     /**
@@ -605,7 +605,19 @@ public Builder repeat(Collection<Repeat> repeat) {
          */
         @Override
         public SubstancePolymer build() {
-            return new SubstancePolymer(this);
+            SubstancePolymer substancePolymer = new SubstancePolymer(this);
+            if (validating) {
+                validate(substancePolymer);
+            }
+            return substancePolymer;
+        }
+
+        protected void validate(SubstancePolymer substancePolymer) {
+            super.validate(substancePolymer);
+            ValidationSupport.checkList(substancePolymer.copolymerConnectivity, "copolymerConnectivity", CodeableConcept.class);
+            ValidationSupport.checkList(substancePolymer.modification, "modification", String.class);
+            ValidationSupport.checkList(substancePolymer.monomerSet, "monomerSet", MonomerSet.class);
+            ValidationSupport.checkList(substancePolymer.repeat, "repeat", Repeat.class);
         }
 
         protected Builder from(SubstancePolymer substancePolymer) {
@@ -632,8 +644,7 @@ public static class MonomerSet extends BackboneElement {
         private MonomerSet(Builder builder) {
             super(builder);
             ratioType = builder.ratioType;
-            startingMaterial = Collections.unmodifiableList(ValidationSupport.checkList(builder.startingMaterial, "startingMaterial", StartingMaterial.class));
-            ValidationSupport.requireValueOrChildren(this);
+            startingMaterial = Collections.unmodifiableList(builder.startingMaterial);
         }
 
         /**
@@ -889,7 +900,17 @@ public Builder startingMaterial(Collection<StartingMaterial> startingMaterial) {
              */
             @Override
             public MonomerSet build() {
-                return new MonomerSet(this);
+                MonomerSet monomerSet = new MonomerSet(this);
+                if (validating) {
+                    validate(monomerSet);
+                }
+                return monomerSet;
+            }
+
+            protected void validate(MonomerSet monomerSet) {
+                super.validate(monomerSet);
+                ValidationSupport.checkList(monomerSet.startingMaterial, "startingMaterial", StartingMaterial.class);
+                ValidationSupport.requireValueOrChildren(monomerSet);
             }
 
             protected Builder from(MonomerSet monomerSet) {
@@ -919,7 +940,6 @@ private StartingMaterial(Builder builder) {
                 type = builder.type;
                 isDefining = builder.isDefining;
                 amount = builder.amount;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1213,7 +1233,16 @@ public Builder amount(SubstanceAmount amount) {
                  */
                 @Override
                 public StartingMaterial build() {
-                    return new StartingMaterial(this);
+                    StartingMaterial startingMaterial = new StartingMaterial(this);
+                    if (validating) {
+                        validate(startingMaterial);
+                    }
+                    return startingMaterial;
+                }
+
+                protected void validate(StartingMaterial startingMaterial) {
+                    super.validate(startingMaterial);
+                    ValidationSupport.requireValueOrChildren(startingMaterial);
                 }
 
                 protected Builder from(StartingMaterial startingMaterial) {
@@ -1246,8 +1275,7 @@ private Repeat(Builder builder) {
             numberOfUnits = builder.numberOfUnits;
             averageMolecularFormula = builder.averageMolecularFormula;
             repeatUnitAmountType = builder.repeatUnitAmountType;
-            repeatUnit = Collections.unmodifiableList(ValidationSupport.checkList(builder.repeatUnit, "repeatUnit", RepeatUnit.class));
-            ValidationSupport.requireValueOrChildren(this);
+            repeatUnit = Collections.unmodifiableList(builder.repeatUnit);
         }
 
         /**
@@ -1561,7 +1589,17 @@ public Builder repeatUnit(Collection<RepeatUnit> repeatUnit) {
              */
             @Override
             public Repeat build() {
-                return new Repeat(this);
+                Repeat repeat = new Repeat(this);
+                if (validating) {
+                    validate(repeat);
+                }
+                return repeat;
+            }
+
+            protected void validate(Repeat repeat) {
+                super.validate(repeat);
+                ValidationSupport.checkList(repeat.repeatUnit, "repeatUnit", RepeatUnit.class);
+                ValidationSupport.requireValueOrChildren(repeat);
             }
 
             protected Builder from(Repeat repeat) {
@@ -1594,9 +1632,8 @@ private RepeatUnit(Builder builder) {
                 orientationOfPolymerisation = builder.orientationOfPolymerisation;
                 repeatUnit = builder.repeatUnit;
                 amount = builder.amount;
-                degreeOfPolymerisation = Collections.unmodifiableList(ValidationSupport.checkList(builder.degreeOfPolymerisation, "degreeOfPolymerisation", DegreeOfPolymerisation.class));
-                structuralRepresentation = Collections.unmodifiableList(ValidationSupport.checkList(builder.structuralRepresentation, "structuralRepresentation", StructuralRepresentation.class));
-                ValidationSupport.requireValueOrChildren(this);
+                degreeOfPolymerisation = Collections.unmodifiableList(builder.degreeOfPolymerisation);
+                structuralRepresentation = Collections.unmodifiableList(builder.structuralRepresentation);
             }
 
             /**
@@ -1959,7 +1996,18 @@ public Builder structuralRepresentation(Collection<StructuralRepresentation> str
                  */
                 @Override
                 public RepeatUnit build() {
-                    return new RepeatUnit(this);
+                    RepeatUnit repeatUnit = new RepeatUnit(this);
+                    if (validating) {
+                        validate(repeatUnit);
+                    }
+                    return repeatUnit;
+                }
+
+                protected void validate(RepeatUnit repeatUnit) {
+                    super.validate(repeatUnit);
+                    ValidationSupport.checkList(repeatUnit.degreeOfPolymerisation, "degreeOfPolymerisation", DegreeOfPolymerisation.class);
+                    ValidationSupport.checkList(repeatUnit.structuralRepresentation, "structuralRepresentation", StructuralRepresentation.class);
+                    ValidationSupport.requireValueOrChildren(repeatUnit);
                 }
 
                 protected Builder from(RepeatUnit repeatUnit) {
@@ -1986,7 +2034,6 @@ private DegreeOfPolymerisation(Builder builder) {
                     super(builder);
                     degree = builder.degree;
                     amount = builder.amount;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -2222,7 +2269,16 @@ public Builder amount(SubstanceAmount amount) {
                      */
                     @Override
                     public DegreeOfPolymerisation build() {
-                        return new DegreeOfPolymerisation(this);
+                        DegreeOfPolymerisation degreeOfPolymerisation = new DegreeOfPolymerisation(this);
+                        if (validating) {
+                            validate(degreeOfPolymerisation);
+                        }
+                        return degreeOfPolymerisation;
+                    }
+
+                    protected void validate(DegreeOfPolymerisation degreeOfPolymerisation) {
+                        super.validate(degreeOfPolymerisation);
+                        ValidationSupport.requireValueOrChildren(degreeOfPolymerisation);
                     }
 
                     protected Builder from(DegreeOfPolymerisation degreeOfPolymerisation) {
@@ -2250,7 +2306,6 @@ private StructuralRepresentation(Builder builder) {
                     type = builder.type;
                     representation = builder.representation;
                     attachment = builder.attachment;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -2515,7 +2570,16 @@ public Builder attachment(Attachment attachment) {
                      */
                     @Override
                     public StructuralRepresentation build() {
-                        return new StructuralRepresentation(this);
+                        StructuralRepresentation structuralRepresentation = new StructuralRepresentation(this);
+                        if (validating) {
+                            validate(structuralRepresentation);
+                        }
+                        return structuralRepresentation;
+                    }
+
+                    protected void validate(StructuralRepresentation structuralRepresentation) {
+                        super.validate(structuralRepresentation);
+                        ValidationSupport.requireValueOrChildren(structuralRepresentation);
                     }
 
                     protected Builder from(StructuralRepresentation structuralRepresentation) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceProtein.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceProtein.java
index 5c0b622a9e2..18ec523ef9d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceProtein.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceProtein.java
@@ -59,8 +59,8 @@ private SubstanceProtein(Builder builder) {
         super(builder);
         sequenceType = builder.sequenceType;
         numberOfSubunits = builder.numberOfSubunits;
-        disulfideLinkage = Collections.unmodifiableList(ValidationSupport.checkList(builder.disulfideLinkage, "disulfideLinkage", String.class));
-        subunit = Collections.unmodifiableList(ValidationSupport.checkList(builder.subunit, "subunit", Subunit.class));
+        disulfideLinkage = Collections.unmodifiableList(builder.disulfideLinkage);
+        subunit = Collections.unmodifiableList(builder.subunit);
     }
 
     /**
@@ -545,7 +545,17 @@ public Builder subunit(Collection<Subunit> subunit) {
          */
         @Override
         public SubstanceProtein build() {
-            return new SubstanceProtein(this);
+            SubstanceProtein substanceProtein = new SubstanceProtein(this);
+            if (validating) {
+                validate(substanceProtein);
+            }
+            return substanceProtein;
+        }
+
+        protected void validate(SubstanceProtein substanceProtein) {
+            super.validate(substanceProtein);
+            ValidationSupport.checkList(substanceProtein.disulfideLinkage, "disulfideLinkage", String.class);
+            ValidationSupport.checkList(substanceProtein.subunit, "subunit", Subunit.class);
         }
 
         protected Builder from(SubstanceProtein substanceProtein) {
@@ -593,7 +603,6 @@ private Subunit(Builder builder) {
             nTerminalModification = builder.nTerminalModification;
             cTerminalModificationId = builder.cTerminalModificationId;
             cTerminalModification = builder.cTerminalModification;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1033,7 +1042,16 @@ public Builder cTerminalModification(String cTerminalModification) {
              */
             @Override
             public Subunit build() {
-                return new Subunit(this);
+                Subunit subunit = new Subunit(this);
+                if (validating) {
+                    validate(subunit);
+                }
+                return subunit;
+            }
+
+            protected void validate(Subunit subunit) {
+                super.validate(subunit);
+                ValidationSupport.requireValueOrChildren(subunit);
             }
 
             protected Builder from(Subunit subunit) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceReferenceInformation.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceReferenceInformation.java
index 074f1f4e243..b17ad9bce5e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceReferenceInformation.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceReferenceInformation.java
@@ -60,10 +60,10 @@ public class SubstanceReferenceInformation extends DomainResource {
     private SubstanceReferenceInformation(Builder builder) {
         super(builder);
         comment = builder.comment;
-        gene = Collections.unmodifiableList(ValidationSupport.checkList(builder.gene, "gene", Gene.class));
-        geneElement = Collections.unmodifiableList(ValidationSupport.checkList(builder.geneElement, "geneElement", GeneElement.class));
-        classification = Collections.unmodifiableList(ValidationSupport.checkList(builder.classification, "classification", Classification.class));
-        target = Collections.unmodifiableList(ValidationSupport.checkList(builder.target, "target", Target.class));
+        gene = Collections.unmodifiableList(builder.gene);
+        geneElement = Collections.unmodifiableList(builder.geneElement);
+        classification = Collections.unmodifiableList(builder.classification);
+        target = Collections.unmodifiableList(builder.target);
     }
 
     /**
@@ -576,7 +576,19 @@ public Builder target(Collection<Target> target) {
          */
         @Override
         public SubstanceReferenceInformation build() {
-            return new SubstanceReferenceInformation(this);
+            SubstanceReferenceInformation substanceReferenceInformation = new SubstanceReferenceInformation(this);
+            if (validating) {
+                validate(substanceReferenceInformation);
+            }
+            return substanceReferenceInformation;
+        }
+
+        protected void validate(SubstanceReferenceInformation substanceReferenceInformation) {
+            super.validate(substanceReferenceInformation);
+            ValidationSupport.checkList(substanceReferenceInformation.gene, "gene", Gene.class);
+            ValidationSupport.checkList(substanceReferenceInformation.geneElement, "geneElement", GeneElement.class);
+            ValidationSupport.checkList(substanceReferenceInformation.classification, "classification", Classification.class);
+            ValidationSupport.checkList(substanceReferenceInformation.target, "target", Target.class);
         }
 
         protected Builder from(SubstanceReferenceInformation substanceReferenceInformation) {
@@ -606,9 +618,7 @@ private Gene(Builder builder) {
             super(builder);
             geneSequenceOrigin = builder.geneSequenceOrigin;
             gene = builder.gene;
-            source = Collections.unmodifiableList(ValidationSupport.checkList(builder.source, "source", Reference.class));
-            ValidationSupport.checkReferenceType(source, "source", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            source = Collections.unmodifiableList(builder.source);
         }
 
         /**
@@ -903,7 +913,18 @@ public Builder source(Collection<Reference> source) {
              */
             @Override
             public Gene build() {
-                return new Gene(this);
+                Gene gene = new Gene(this);
+                if (validating) {
+                    validate(gene);
+                }
+                return gene;
+            }
+
+            protected void validate(Gene gene) {
+                super.validate(gene);
+                ValidationSupport.checkList(gene.source, "source", Reference.class);
+                ValidationSupport.checkReferenceType(gene.source, "source", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(gene);
             }
 
             protected Builder from(Gene gene) {
@@ -932,9 +953,7 @@ private GeneElement(Builder builder) {
             super(builder);
             type = builder.type;
             element = builder.element;
-            source = Collections.unmodifiableList(ValidationSupport.checkList(builder.source, "source", Reference.class));
-            ValidationSupport.checkReferenceType(source, "source", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            source = Collections.unmodifiableList(builder.source);
         }
 
         /**
@@ -1229,7 +1248,18 @@ public Builder source(Collection<Reference> source) {
              */
             @Override
             public GeneElement build() {
-                return new GeneElement(this);
+                GeneElement geneElement = new GeneElement(this);
+                if (validating) {
+                    validate(geneElement);
+                }
+                return geneElement;
+            }
+
+            protected void validate(GeneElement geneElement) {
+                super.validate(geneElement);
+                ValidationSupport.checkList(geneElement.source, "source", Reference.class);
+                ValidationSupport.checkReferenceType(geneElement.source, "source", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(geneElement);
             }
 
             protected Builder from(GeneElement geneElement) {
@@ -1260,10 +1290,8 @@ private Classification(Builder builder) {
             super(builder);
             domain = builder.domain;
             classification = builder.classification;
-            subtype = Collections.unmodifiableList(ValidationSupport.checkList(builder.subtype, "subtype", CodeableConcept.class));
-            source = Collections.unmodifiableList(ValidationSupport.checkList(builder.source, "source", Reference.class));
-            ValidationSupport.checkReferenceType(source, "source", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            subtype = Collections.unmodifiableList(builder.subtype);
+            source = Collections.unmodifiableList(builder.source);
         }
 
         /**
@@ -1607,7 +1635,19 @@ public Builder source(Collection<Reference> source) {
              */
             @Override
             public Classification build() {
-                return new Classification(this);
+                Classification classification = new Classification(this);
+                if (validating) {
+                    validate(classification);
+                }
+                return classification;
+            }
+
+            protected void validate(Classification classification) {
+                super.validate(classification);
+                ValidationSupport.checkList(classification.subtype, "subtype", CodeableConcept.class);
+                ValidationSupport.checkList(classification.source, "source", Reference.class);
+                ValidationSupport.checkReferenceType(classification.source, "source", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(classification);
             }
 
             protected Builder from(Classification classification) {
@@ -1651,11 +1691,9 @@ private Target(Builder builder) {
             interaction = builder.interaction;
             organism = builder.organism;
             organismType = builder.organismType;
-            amount = ValidationSupport.choiceElement(builder.amount, "amount", Quantity.class, Range.class, String.class);
+            amount = builder.amount;
             amountType = builder.amountType;
-            source = Collections.unmodifiableList(ValidationSupport.checkList(builder.source, "source", Reference.class));
-            ValidationSupport.checkReferenceType(source, "source", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            source = Collections.unmodifiableList(builder.source);
         }
 
         /**
@@ -2102,7 +2140,19 @@ public Builder source(Collection<Reference> source) {
              */
             @Override
             public Target build() {
-                return new Target(this);
+                Target target = new Target(this);
+                if (validating) {
+                    validate(target);
+                }
+                return target;
+            }
+
+            protected void validate(Target target) {
+                super.validate(target);
+                ValidationSupport.choiceElement(target.amount, "amount", Quantity.class, Range.class, String.class);
+                ValidationSupport.checkList(target.source, "source", Reference.class);
+                ValidationSupport.checkReferenceType(target.source, "source", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(target);
             }
 
             protected Builder from(Target target) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceSourceMaterial.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceSourceMaterial.java
index fdcef0ef1c0..5af734f3882 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceSourceMaterial.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceSourceMaterial.java
@@ -82,14 +82,14 @@ private SubstanceSourceMaterial(Builder builder) {
         sourceMaterialState = builder.sourceMaterialState;
         organismId = builder.organismId;
         organismName = builder.organismName;
-        parentSubstanceId = Collections.unmodifiableList(ValidationSupport.checkList(builder.parentSubstanceId, "parentSubstanceId", Identifier.class));
-        parentSubstanceName = Collections.unmodifiableList(ValidationSupport.checkList(builder.parentSubstanceName, "parentSubstanceName", String.class));
-        countryOfOrigin = Collections.unmodifiableList(ValidationSupport.checkList(builder.countryOfOrigin, "countryOfOrigin", CodeableConcept.class));
-        geographicalLocation = Collections.unmodifiableList(ValidationSupport.checkList(builder.geographicalLocation, "geographicalLocation", String.class));
+        parentSubstanceId = Collections.unmodifiableList(builder.parentSubstanceId);
+        parentSubstanceName = Collections.unmodifiableList(builder.parentSubstanceName);
+        countryOfOrigin = Collections.unmodifiableList(builder.countryOfOrigin);
+        geographicalLocation = Collections.unmodifiableList(builder.geographicalLocation);
         developmentStage = builder.developmentStage;
-        fractionDescription = Collections.unmodifiableList(ValidationSupport.checkList(builder.fractionDescription, "fractionDescription", FractionDescription.class));
+        fractionDescription = Collections.unmodifiableList(builder.fractionDescription);
         organism = builder.organism;
-        partDescription = Collections.unmodifiableList(ValidationSupport.checkList(builder.partDescription, "partDescription", PartDescription.class));
+        partDescription = Collections.unmodifiableList(builder.partDescription);
     }
 
     /**
@@ -926,7 +926,21 @@ public Builder partDescription(Collection<PartDescription> partDescription) {
          */
         @Override
         public SubstanceSourceMaterial build() {
-            return new SubstanceSourceMaterial(this);
+            SubstanceSourceMaterial substanceSourceMaterial = new SubstanceSourceMaterial(this);
+            if (validating) {
+                validate(substanceSourceMaterial);
+            }
+            return substanceSourceMaterial;
+        }
+
+        protected void validate(SubstanceSourceMaterial substanceSourceMaterial) {
+            super.validate(substanceSourceMaterial);
+            ValidationSupport.checkList(substanceSourceMaterial.parentSubstanceId, "parentSubstanceId", Identifier.class);
+            ValidationSupport.checkList(substanceSourceMaterial.parentSubstanceName, "parentSubstanceName", String.class);
+            ValidationSupport.checkList(substanceSourceMaterial.countryOfOrigin, "countryOfOrigin", CodeableConcept.class);
+            ValidationSupport.checkList(substanceSourceMaterial.geographicalLocation, "geographicalLocation", String.class);
+            ValidationSupport.checkList(substanceSourceMaterial.fractionDescription, "fractionDescription", FractionDescription.class);
+            ValidationSupport.checkList(substanceSourceMaterial.partDescription, "partDescription", PartDescription.class);
         }
 
         protected Builder from(SubstanceSourceMaterial substanceSourceMaterial) {
@@ -966,7 +980,6 @@ private FractionDescription(Builder builder) {
             super(builder);
             fraction = builder.fraction;
             materialType = builder.materialType;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1205,7 +1218,16 @@ public Builder materialType(CodeableConcept materialType) {
              */
             @Override
             public FractionDescription build() {
-                return new FractionDescription(this);
+                FractionDescription fractionDescription = new FractionDescription(this);
+                if (validating) {
+                    validate(fractionDescription);
+                }
+                return fractionDescription;
+            }
+
+            protected void validate(FractionDescription fractionDescription) {
+                super.validate(fractionDescription);
+                ValidationSupport.requireValueOrChildren(fractionDescription);
             }
 
             protected Builder from(FractionDescription fractionDescription) {
@@ -1247,10 +1269,9 @@ private Organism(Builder builder) {
             species = builder.species;
             intraspecificType = builder.intraspecificType;
             intraspecificDescription = builder.intraspecificDescription;
-            author = Collections.unmodifiableList(ValidationSupport.checkList(builder.author, "author", Author.class));
+            author = Collections.unmodifiableList(builder.author);
             hybrid = builder.hybrid;
             organismGeneral = builder.organismGeneral;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1689,7 +1710,17 @@ public Builder organismGeneral(OrganismGeneral organismGeneral) {
              */
             @Override
             public Organism build() {
-                return new Organism(this);
+                Organism organism = new Organism(this);
+                if (validating) {
+                    validate(organism);
+                }
+                return organism;
+            }
+
+            protected void validate(Organism organism) {
+                super.validate(organism);
+                ValidationSupport.checkList(organism.author, "author", Author.class);
+                ValidationSupport.requireValueOrChildren(organism);
             }
 
             protected Builder from(Organism organism) {
@@ -1719,7 +1750,6 @@ private Author(Builder builder) {
                 super(builder);
                 authorType = builder.authorType;
                 authorDescription = builder.authorDescription;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1966,7 +1996,16 @@ public Builder authorDescription(String authorDescription) {
                  */
                 @Override
                 public Author build() {
-                    return new Author(this);
+                    Author author = new Author(this);
+                    if (validating) {
+                        validate(author);
+                    }
+                    return author;
+                }
+
+                protected void validate(Author author) {
+                    super.validate(author);
+                    ValidationSupport.requireValueOrChildren(author);
                 }
 
                 protected Builder from(Author author) {
@@ -2000,7 +2039,6 @@ private Hybrid(Builder builder) {
                 paternalOrganismId = builder.paternalOrganismId;
                 paternalOrganismName = builder.paternalOrganismName;
                 hybridType = builder.hybridType;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2335,7 +2373,16 @@ public Builder hybridType(CodeableConcept hybridType) {
                  */
                 @Override
                 public Hybrid build() {
-                    return new Hybrid(this);
+                    Hybrid hybrid = new Hybrid(this);
+                    if (validating) {
+                        validate(hybrid);
+                    }
+                    return hybrid;
+                }
+
+                protected void validate(Hybrid hybrid) {
+                    super.validate(hybrid);
+                    ValidationSupport.requireValueOrChildren(hybrid);
                 }
 
                 protected Builder from(Hybrid hybrid) {
@@ -2369,7 +2416,6 @@ private OrganismGeneral(Builder builder) {
                 phylum = builder.phylum;
                 clazz = builder.clazz;
                 order = builder.order;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2663,7 +2709,16 @@ public Builder order(CodeableConcept order) {
                  */
                 @Override
                 public OrganismGeneral build() {
-                    return new OrganismGeneral(this);
+                    OrganismGeneral organismGeneral = new OrganismGeneral(this);
+                    if (validating) {
+                        validate(organismGeneral);
+                    }
+                    return organismGeneral;
+                }
+
+                protected void validate(OrganismGeneral organismGeneral) {
+                    super.validate(organismGeneral);
+                    ValidationSupport.requireValueOrChildren(organismGeneral);
                 }
 
                 protected Builder from(OrganismGeneral organismGeneral) {
@@ -2691,7 +2746,6 @@ private PartDescription(Builder builder) {
             super(builder);
             part = builder.part;
             partLocation = builder.partLocation;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2930,7 +2984,16 @@ public Builder partLocation(CodeableConcept partLocation) {
              */
             @Override
             public PartDescription build() {
-                return new PartDescription(this);
+                PartDescription partDescription = new PartDescription(this);
+                if (validating) {
+                    validate(partDescription);
+                }
+                return partDescription;
+            }
+
+            protected void validate(PartDescription partDescription) {
+                super.validate(partDescription);
+                ValidationSupport.requireValueOrChildren(partDescription);
             }
 
             protected Builder from(PartDescription partDescription) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceSpecification.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceSpecification.java
index 970867d03e5..8fc942cbaaf 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceSpecification.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SubstanceSpecification.java
@@ -102,26 +102,20 @@ private SubstanceSpecification(Builder builder) {
         status = builder.status;
         domain = builder.domain;
         description = builder.description;
-        source = Collections.unmodifiableList(ValidationSupport.checkList(builder.source, "source", Reference.class));
+        source = Collections.unmodifiableList(builder.source);
         comment = builder.comment;
-        moiety = Collections.unmodifiableList(ValidationSupport.checkList(builder.moiety, "moiety", Moiety.class));
-        property = Collections.unmodifiableList(ValidationSupport.checkList(builder.property, "property", Property.class));
+        moiety = Collections.unmodifiableList(builder.moiety);
+        property = Collections.unmodifiableList(builder.property);
         referenceInformation = builder.referenceInformation;
         structure = builder.structure;
-        code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", Code.class));
-        name = Collections.unmodifiableList(ValidationSupport.checkList(builder.name, "name", Name.class));
-        molecularWeight = Collections.unmodifiableList(ValidationSupport.checkList(builder.molecularWeight, "molecularWeight", SubstanceSpecification.Structure.Isotope.MolecularWeight.class));
-        relationship = Collections.unmodifiableList(ValidationSupport.checkList(builder.relationship, "relationship", Relationship.class));
+        code = Collections.unmodifiableList(builder.code);
+        name = Collections.unmodifiableList(builder.name);
+        molecularWeight = Collections.unmodifiableList(builder.molecularWeight);
+        relationship = Collections.unmodifiableList(builder.relationship);
         nucleicAcid = builder.nucleicAcid;
         polymer = builder.polymer;
         protein = builder.protein;
         sourceMaterial = builder.sourceMaterial;
-        ValidationSupport.checkReferenceType(source, "source", "DocumentReference");
-        ValidationSupport.checkReferenceType(referenceInformation, "referenceInformation", "SubstanceReferenceInformation");
-        ValidationSupport.checkReferenceType(nucleicAcid, "nucleicAcid", "SubstanceNucleicAcid");
-        ValidationSupport.checkReferenceType(polymer, "polymer", "SubstancePolymer");
-        ValidationSupport.checkReferenceType(protein, "protein", "SubstanceProtein");
-        ValidationSupport.checkReferenceType(sourceMaterial, "sourceMaterial", "SubstanceSourceMaterial");
     }
 
     /**
@@ -1135,7 +1129,28 @@ public Builder sourceMaterial(Reference sourceMaterial) {
          */
         @Override
         public SubstanceSpecification build() {
-            return new SubstanceSpecification(this);
+            SubstanceSpecification substanceSpecification = new SubstanceSpecification(this);
+            if (validating) {
+                validate(substanceSpecification);
+            }
+            return substanceSpecification;
+        }
+
+        protected void validate(SubstanceSpecification substanceSpecification) {
+            super.validate(substanceSpecification);
+            ValidationSupport.checkList(substanceSpecification.source, "source", Reference.class);
+            ValidationSupport.checkList(substanceSpecification.moiety, "moiety", Moiety.class);
+            ValidationSupport.checkList(substanceSpecification.property, "property", Property.class);
+            ValidationSupport.checkList(substanceSpecification.code, "code", Code.class);
+            ValidationSupport.checkList(substanceSpecification.name, "name", Name.class);
+            ValidationSupport.checkList(substanceSpecification.molecularWeight, "molecularWeight", SubstanceSpecification.Structure.Isotope.MolecularWeight.class);
+            ValidationSupport.checkList(substanceSpecification.relationship, "relationship", Relationship.class);
+            ValidationSupport.checkReferenceType(substanceSpecification.source, "source", "DocumentReference");
+            ValidationSupport.checkReferenceType(substanceSpecification.referenceInformation, "referenceInformation", "SubstanceReferenceInformation");
+            ValidationSupport.checkReferenceType(substanceSpecification.nucleicAcid, "nucleicAcid", "SubstanceNucleicAcid");
+            ValidationSupport.checkReferenceType(substanceSpecification.polymer, "polymer", "SubstancePolymer");
+            ValidationSupport.checkReferenceType(substanceSpecification.protein, "protein", "SubstanceProtein");
+            ValidationSupport.checkReferenceType(substanceSpecification.sourceMaterial, "sourceMaterial", "SubstanceSourceMaterial");
         }
 
         protected Builder from(SubstanceSpecification substanceSpecification) {
@@ -1191,8 +1206,7 @@ private Moiety(Builder builder) {
             stereochemistry = builder.stereochemistry;
             opticalActivity = builder.opticalActivity;
             molecularFormula = builder.molecularFormula;
-            amount = ValidationSupport.choiceElement(builder.amount, "amount", Quantity.class, String.class);
-            ValidationSupport.requireValueOrChildren(this);
+            amount = builder.amount;
         }
 
         /**
@@ -1579,7 +1593,17 @@ public Builder amount(Element amount) {
              */
             @Override
             public Moiety build() {
-                return new Moiety(this);
+                Moiety moiety = new Moiety(this);
+                if (validating) {
+                    validate(moiety);
+                }
+                return moiety;
+            }
+
+            protected void validate(Moiety moiety) {
+                super.validate(moiety);
+                ValidationSupport.choiceElement(moiety.amount, "amount", Quantity.class, String.class);
+                ValidationSupport.requireValueOrChildren(moiety);
             }
 
             protected Builder from(Moiety moiety) {
@@ -1619,10 +1643,8 @@ private Property(Builder builder) {
             category = builder.category;
             code = builder.code;
             parameters = builder.parameters;
-            definingSubstance = ValidationSupport.choiceElement(builder.definingSubstance, "definingSubstance", Reference.class, CodeableConcept.class);
-            amount = ValidationSupport.choiceElement(builder.amount, "amount", Quantity.class, String.class);
-            ValidationSupport.checkReferenceType(definingSubstance, "definingSubstance", "SubstanceSpecification", "Substance");
-            ValidationSupport.requireValueOrChildren(this);
+            definingSubstance = builder.definingSubstance;
+            amount = builder.amount;
         }
 
         /**
@@ -1963,7 +1985,19 @@ public Builder amount(Element amount) {
              */
             @Override
             public Property build() {
-                return new Property(this);
+                Property property = new Property(this);
+                if (validating) {
+                    validate(property);
+                }
+                return property;
+            }
+
+            protected void validate(Property property) {
+                super.validate(property);
+                ValidationSupport.choiceElement(property.definingSubstance, "definingSubstance", Reference.class, CodeableConcept.class);
+                ValidationSupport.choiceElement(property.amount, "amount", Quantity.class, String.class);
+                ValidationSupport.checkReferenceType(property.definingSubstance, "definingSubstance", "SubstanceSpecification", "Substance");
+                ValidationSupport.requireValueOrChildren(property);
             }
 
             protected Builder from(Property property) {
@@ -2006,12 +2040,10 @@ private Structure(Builder builder) {
             opticalActivity = builder.opticalActivity;
             molecularFormula = builder.molecularFormula;
             molecularFormulaByMoiety = builder.molecularFormulaByMoiety;
-            isotope = Collections.unmodifiableList(ValidationSupport.checkList(builder.isotope, "isotope", Isotope.class));
+            isotope = Collections.unmodifiableList(builder.isotope);
             molecularWeight = builder.molecularWeight;
-            source = Collections.unmodifiableList(ValidationSupport.checkList(builder.source, "source", Reference.class));
-            representation = Collections.unmodifiableList(ValidationSupport.checkList(builder.representation, "representation", Representation.class));
-            ValidationSupport.checkReferenceType(source, "source", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            source = Collections.unmodifiableList(builder.source);
+            representation = Collections.unmodifiableList(builder.representation);
         }
 
         /**
@@ -2494,7 +2526,20 @@ public Builder representation(Collection<Representation> representation) {
              */
             @Override
             public Structure build() {
-                return new Structure(this);
+                Structure structure = new Structure(this);
+                if (validating) {
+                    validate(structure);
+                }
+                return structure;
+            }
+
+            protected void validate(Structure structure) {
+                super.validate(structure);
+                ValidationSupport.checkList(structure.isotope, "isotope", Isotope.class);
+                ValidationSupport.checkList(structure.source, "source", Reference.class);
+                ValidationSupport.checkList(structure.representation, "representation", Representation.class);
+                ValidationSupport.checkReferenceType(structure.source, "source", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(structure);
             }
 
             protected Builder from(Structure structure) {
@@ -2533,7 +2578,6 @@ private Isotope(Builder builder) {
                 substitution = builder.substitution;
                 halfLife = builder.halfLife;
                 molecularWeight = builder.molecularWeight;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2856,7 +2900,16 @@ public Builder molecularWeight(MolecularWeight molecularWeight) {
                  */
                 @Override
                 public Isotope build() {
-                    return new Isotope(this);
+                    Isotope isotope = new Isotope(this);
+                    if (validating) {
+                        validate(isotope);
+                    }
+                    return isotope;
+                }
+
+                protected void validate(Isotope isotope) {
+                    super.validate(isotope);
+                    ValidationSupport.requireValueOrChildren(isotope);
                 }
 
                 protected Builder from(Isotope isotope) {
@@ -2886,7 +2939,6 @@ private MolecularWeight(Builder builder) {
                     method = builder.method;
                     type = builder.type;
                     amount = builder.amount;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -3154,7 +3206,16 @@ public Builder amount(Quantity amount) {
                      */
                     @Override
                     public MolecularWeight build() {
-                        return new MolecularWeight(this);
+                        MolecularWeight molecularWeight = new MolecularWeight(this);
+                        if (validating) {
+                            validate(molecularWeight);
+                        }
+                        return molecularWeight;
+                    }
+
+                    protected void validate(MolecularWeight molecularWeight) {
+                        super.validate(molecularWeight);
+                        ValidationSupport.requireValueOrChildren(molecularWeight);
                     }
 
                     protected Builder from(MolecularWeight molecularWeight) {
@@ -3184,7 +3245,6 @@ private Representation(Builder builder) {
                 type = builder.type;
                 representation = builder.representation;
                 attachment = builder.attachment;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -3449,7 +3509,16 @@ public Builder attachment(Attachment attachment) {
                  */
                 @Override
                 public Representation build() {
-                    return new Representation(this);
+                    Representation representation = new Representation(this);
+                    if (validating) {
+                        validate(representation);
+                    }
+                    return representation;
+                }
+
+                protected void validate(Representation representation) {
+                    super.validate(representation);
+                    ValidationSupport.requireValueOrChildren(representation);
                 }
 
                 protected Builder from(Representation representation) {
@@ -3485,9 +3554,7 @@ private Code(Builder builder) {
             status = builder.status;
             statusDate = builder.statusDate;
             comment = builder.comment;
-            source = Collections.unmodifiableList(ValidationSupport.checkList(builder.source, "source", Reference.class));
-            ValidationSupport.checkReferenceType(source, "source", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            source = Collections.unmodifiableList(builder.source);
         }
 
         /**
@@ -3840,7 +3907,18 @@ public Builder source(Collection<Reference> source) {
              */
             @Override
             public Code build() {
-                return new Code(this);
+                Code code = new Code(this);
+                if (validating) {
+                    validate(code);
+                }
+                return code;
+            }
+
+            protected void validate(Code code) {
+                super.validate(code);
+                ValidationSupport.checkList(code.source, "source", Reference.class);
+                ValidationSupport.checkReferenceType(code.source, "source", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(code);
             }
 
             protected Builder from(Code code) {
@@ -3886,19 +3964,17 @@ public static class Name extends BackboneElement {
 
         private Name(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
+            name = builder.name;
             type = builder.type;
             status = builder.status;
             preferred = builder.preferred;
-            language = Collections.unmodifiableList(ValidationSupport.checkList(builder.language, "language", CodeableConcept.class));
-            domain = Collections.unmodifiableList(ValidationSupport.checkList(builder.domain, "domain", CodeableConcept.class));
-            jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
-            synonym = Collections.unmodifiableList(ValidationSupport.checkList(builder.synonym, "synonym", SubstanceSpecification.Name.class));
-            translation = Collections.unmodifiableList(ValidationSupport.checkList(builder.translation, "translation", SubstanceSpecification.Name.class));
-            official = Collections.unmodifiableList(ValidationSupport.checkList(builder.official, "official", Official.class));
-            source = Collections.unmodifiableList(ValidationSupport.checkList(builder.source, "source", Reference.class));
-            ValidationSupport.checkReferenceType(source, "source", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            language = Collections.unmodifiableList(builder.language);
+            domain = Collections.unmodifiableList(builder.domain);
+            jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
+            synonym = Collections.unmodifiableList(builder.synonym);
+            translation = Collections.unmodifiableList(builder.translation);
+            official = Collections.unmodifiableList(builder.official);
+            source = Collections.unmodifiableList(builder.source);
         }
 
         /**
@@ -4557,7 +4633,25 @@ public Builder source(Collection<Reference> source) {
              */
             @Override
             public Name build() {
-                return new Name(this);
+                Name name = new Name(this);
+                if (validating) {
+                    validate(name);
+                }
+                return name;
+            }
+
+            protected void validate(Name name) {
+                super.validate(name);
+                ValidationSupport.requireNonNull(name.name, "name");
+                ValidationSupport.checkList(name.language, "language", CodeableConcept.class);
+                ValidationSupport.checkList(name.domain, "domain", CodeableConcept.class);
+                ValidationSupport.checkList(name.jurisdiction, "jurisdiction", CodeableConcept.class);
+                ValidationSupport.checkList(name.synonym, "synonym", SubstanceSpecification.Name.class);
+                ValidationSupport.checkList(name.translation, "translation", SubstanceSpecification.Name.class);
+                ValidationSupport.checkList(name.official, "official", Official.class);
+                ValidationSupport.checkList(name.source, "source", Reference.class);
+                ValidationSupport.checkReferenceType(name.source, "source", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(name);
             }
 
             protected Builder from(Name name) {
@@ -4593,7 +4687,6 @@ private Official(Builder builder) {
                 authority = builder.authority;
                 status = builder.status;
                 date = builder.date;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -4858,7 +4951,16 @@ public Builder date(DateTime date) {
                  */
                 @Override
                 public Official build() {
-                    return new Official(this);
+                    Official official = new Official(this);
+                    if (validating) {
+                        validate(official);
+                    }
+                    return official;
+                }
+
+                protected void validate(Official official) {
+                    super.validate(official);
+                    ValidationSupport.requireValueOrChildren(official);
                 }
 
                 protected Builder from(Official official) {
@@ -4897,16 +4999,13 @@ public static class Relationship extends BackboneElement {
 
         private Relationship(Builder builder) {
             super(builder);
-            substance = ValidationSupport.choiceElement(builder.substance, "substance", Reference.class, CodeableConcept.class);
+            substance = builder.substance;
             relationship = builder.relationship;
             isDefining = builder.isDefining;
-            amount = ValidationSupport.choiceElement(builder.amount, "amount", Quantity.class, Range.class, Ratio.class, String.class);
+            amount = builder.amount;
             amountRatioLowLimit = builder.amountRatioLowLimit;
             amountType = builder.amountType;
-            source = Collections.unmodifiableList(ValidationSupport.checkList(builder.source, "source", Reference.class));
-            ValidationSupport.checkReferenceType(substance, "substance", "SubstanceSpecification");
-            ValidationSupport.checkReferenceType(source, "source", "DocumentReference");
-            ValidationSupport.requireValueOrChildren(this);
+            source = Collections.unmodifiableList(builder.source);
         }
 
         /**
@@ -5342,7 +5441,21 @@ public Builder source(Collection<Reference> source) {
              */
             @Override
             public Relationship build() {
-                return new Relationship(this);
+                Relationship relationship = new Relationship(this);
+                if (validating) {
+                    validate(relationship);
+                }
+                return relationship;
+            }
+
+            protected void validate(Relationship relationship) {
+                super.validate(relationship);
+                ValidationSupport.choiceElement(relationship.substance, "substance", Reference.class, CodeableConcept.class);
+                ValidationSupport.choiceElement(relationship.amount, "amount", Quantity.class, Range.class, Ratio.class, String.class);
+                ValidationSupport.checkList(relationship.source, "source", Reference.class);
+                ValidationSupport.checkReferenceType(relationship.substance, "substance", "SubstanceSpecification");
+                ValidationSupport.checkReferenceType(relationship.source, "source", "DocumentReference");
+                ValidationSupport.requireValueOrChildren(relationship);
             }
 
             protected Builder from(Relationship relationship) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SupplyDelivery.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SupplyDelivery.java
index 27d266a1844..80d067cabb9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SupplyDelivery.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SupplyDelivery.java
@@ -87,24 +87,17 @@ public class SupplyDelivery extends DomainResource {
 
     private SupplyDelivery(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
+        basedOn = Collections.unmodifiableList(builder.basedOn);
+        partOf = Collections.unmodifiableList(builder.partOf);
         status = builder.status;
         patient = builder.patient;
         type = builder.type;
         suppliedItem = builder.suppliedItem;
-        occurrence = ValidationSupport.choiceElement(builder.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
+        occurrence = builder.occurrence;
         supplier = builder.supplier;
         destination = builder.destination;
-        receiver = Collections.unmodifiableList(ValidationSupport.checkList(builder.receiver, "receiver", Reference.class));
-        ValidationSupport.checkValueSetBinding(type, "type", "http://hl7.org/fhir/ValueSet/supplydelivery-type", "http://terminology.hl7.org/CodeSystem/supply-item-type", "medication", "device");
-        ValidationSupport.checkReferenceType(basedOn, "basedOn", "SupplyRequest");
-        ValidationSupport.checkReferenceType(partOf, "partOf", "SupplyDelivery", "Contract");
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(supplier, "supplier", "Practitioner", "PractitionerRole", "Organization");
-        ValidationSupport.checkReferenceType(destination, "destination", "Location");
-        ValidationSupport.checkReferenceType(receiver, "receiver", "Practitioner", "PractitionerRole");
+        receiver = Collections.unmodifiableList(builder.receiver);
     }
 
     /**
@@ -851,7 +844,27 @@ public Builder receiver(Collection<Reference> receiver) {
          */
         @Override
         public SupplyDelivery build() {
-            return new SupplyDelivery(this);
+            SupplyDelivery supplyDelivery = new SupplyDelivery(this);
+            if (validating) {
+                validate(supplyDelivery);
+            }
+            return supplyDelivery;
+        }
+
+        protected void validate(SupplyDelivery supplyDelivery) {
+            super.validate(supplyDelivery);
+            ValidationSupport.checkList(supplyDelivery.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(supplyDelivery.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(supplyDelivery.partOf, "partOf", Reference.class);
+            ValidationSupport.choiceElement(supplyDelivery.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
+            ValidationSupport.checkList(supplyDelivery.receiver, "receiver", Reference.class);
+            ValidationSupport.checkValueSetBinding(supplyDelivery.type, "type", "http://hl7.org/fhir/ValueSet/supplydelivery-type", "http://terminology.hl7.org/CodeSystem/supply-item-type", "medication", "device");
+            ValidationSupport.checkReferenceType(supplyDelivery.basedOn, "basedOn", "SupplyRequest");
+            ValidationSupport.checkReferenceType(supplyDelivery.partOf, "partOf", "SupplyDelivery", "Contract");
+            ValidationSupport.checkReferenceType(supplyDelivery.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(supplyDelivery.supplier, "supplier", "Practitioner", "PractitionerRole", "Organization");
+            ValidationSupport.checkReferenceType(supplyDelivery.destination, "destination", "Location");
+            ValidationSupport.checkReferenceType(supplyDelivery.receiver, "receiver", "Practitioner", "PractitionerRole");
         }
 
         protected Builder from(SupplyDelivery supplyDelivery) {
@@ -889,9 +902,7 @@ public static class SuppliedItem extends BackboneElement {
         private SuppliedItem(Builder builder) {
             super(builder);
             quantity = builder.quantity;
-            item = ValidationSupport.choiceElement(builder.item, "item", CodeableConcept.class, Reference.class);
-            ValidationSupport.checkReferenceType(item, "item", "Medication", "Substance", "Device");
-            ValidationSupport.requireValueOrChildren(this);
+            item = builder.item;
         }
 
         /**
@@ -1142,7 +1153,18 @@ public Builder item(Element item) {
              */
             @Override
             public SuppliedItem build() {
-                return new SuppliedItem(this);
+                SuppliedItem suppliedItem = new SuppliedItem(this);
+                if (validating) {
+                    validate(suppliedItem);
+                }
+                return suppliedItem;
+            }
+
+            protected void validate(SuppliedItem suppliedItem) {
+                super.validate(suppliedItem);
+                ValidationSupport.choiceElement(suppliedItem.item, "item", CodeableConcept.class, Reference.class);
+                ValidationSupport.checkReferenceType(suppliedItem.item, "item", "Medication", "Substance", "Device");
+                ValidationSupport.requireValueOrChildren(suppliedItem);
             }
 
             protected Builder from(SuppliedItem suppliedItem) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SupplyRequest.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SupplyRequest.java
index 0d2a3547f3b..284b76f9bc6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/SupplyRequest.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/SupplyRequest.java
@@ -122,27 +122,21 @@ public class SupplyRequest extends DomainResource {
 
     private SupplyRequest(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         status = builder.status;
         category = builder.category;
         priority = builder.priority;
-        item = ValidationSupport.requireChoiceElement(builder.item, "item", CodeableConcept.class, Reference.class);
-        quantity = ValidationSupport.requireNonNull(builder.quantity, "quantity");
-        parameter = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameter, "parameter", Parameter.class));
-        occurrence = ValidationSupport.choiceElement(builder.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
+        item = builder.item;
+        quantity = builder.quantity;
+        parameter = Collections.unmodifiableList(builder.parameter);
+        occurrence = builder.occurrence;
         authoredOn = builder.authoredOn;
         requester = builder.requester;
-        supplier = Collections.unmodifiableList(ValidationSupport.checkList(builder.supplier, "supplier", Reference.class));
-        reasonCode = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonCode, "reasonCode", CodeableConcept.class));
-        reasonReference = Collections.unmodifiableList(ValidationSupport.checkList(builder.reasonReference, "reasonReference", Reference.class));
+        supplier = Collections.unmodifiableList(builder.supplier);
+        reasonCode = Collections.unmodifiableList(builder.reasonCode);
+        reasonReference = Collections.unmodifiableList(builder.reasonReference);
         deliverFrom = builder.deliverFrom;
         deliverTo = builder.deliverTo;
-        ValidationSupport.checkReferenceType(item, "item", "Medication", "Substance", "Device");
-        ValidationSupport.checkReferenceType(requester, "requester", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
-        ValidationSupport.checkReferenceType(supplier, "supplier", "Organization", "HealthcareService");
-        ValidationSupport.checkReferenceType(reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
-        ValidationSupport.checkReferenceType(deliverFrom, "deliverFrom", "Organization", "Location");
-        ValidationSupport.checkReferenceType(deliverTo, "deliverTo", "Organization", "Location", "Patient");
     }
 
     /**
@@ -1053,7 +1047,29 @@ public Builder deliverTo(Reference deliverTo) {
          */
         @Override
         public SupplyRequest build() {
-            return new SupplyRequest(this);
+            SupplyRequest supplyRequest = new SupplyRequest(this);
+            if (validating) {
+                validate(supplyRequest);
+            }
+            return supplyRequest;
+        }
+
+        protected void validate(SupplyRequest supplyRequest) {
+            super.validate(supplyRequest);
+            ValidationSupport.checkList(supplyRequest.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireChoiceElement(supplyRequest.item, "item", CodeableConcept.class, Reference.class);
+            ValidationSupport.requireNonNull(supplyRequest.quantity, "quantity");
+            ValidationSupport.checkList(supplyRequest.parameter, "parameter", Parameter.class);
+            ValidationSupport.choiceElement(supplyRequest.occurrence, "occurrence", DateTime.class, Period.class, Timing.class);
+            ValidationSupport.checkList(supplyRequest.supplier, "supplier", Reference.class);
+            ValidationSupport.checkList(supplyRequest.reasonCode, "reasonCode", CodeableConcept.class);
+            ValidationSupport.checkList(supplyRequest.reasonReference, "reasonReference", Reference.class);
+            ValidationSupport.checkReferenceType(supplyRequest.item, "item", "Medication", "Substance", "Device");
+            ValidationSupport.checkReferenceType(supplyRequest.requester, "requester", "Practitioner", "PractitionerRole", "Organization", "Patient", "RelatedPerson", "Device");
+            ValidationSupport.checkReferenceType(supplyRequest.supplier, "supplier", "Organization", "HealthcareService");
+            ValidationSupport.checkReferenceType(supplyRequest.reasonReference, "reasonReference", "Condition", "Observation", "DiagnosticReport", "DocumentReference");
+            ValidationSupport.checkReferenceType(supplyRequest.deliverFrom, "deliverFrom", "Organization", "Location");
+            ValidationSupport.checkReferenceType(supplyRequest.deliverTo, "deliverTo", "Organization", "Location", "Patient");
         }
 
         protected Builder from(SupplyRequest supplyRequest) {
@@ -1093,8 +1109,7 @@ public static class Parameter extends BackboneElement {
         private Parameter(Builder builder) {
             super(builder);
             code = builder.code;
-            value = ValidationSupport.choiceElement(builder.value, "value", CodeableConcept.class, Quantity.class, Range.class, Boolean.class);
-            ValidationSupport.requireValueOrChildren(this);
+            value = builder.value;
         }
 
         /**
@@ -1338,7 +1353,17 @@ public Builder value(Element value) {
              */
             @Override
             public Parameter build() {
-                return new Parameter(this);
+                Parameter parameter = new Parameter(this);
+                if (validating) {
+                    validate(parameter);
+                }
+                return parameter;
+            }
+
+            protected void validate(Parameter parameter) {
+                super.validate(parameter);
+                ValidationSupport.choiceElement(parameter.value, "value", CodeableConcept.class, Quantity.class, Range.class, Boolean.class);
+                ValidationSupport.requireValueOrChildren(parameter);
             }
 
             protected Builder from(Parameter parameter) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Task.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Task.java
index 61001696c05..463ce02c437 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/Task.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/Task.java
@@ -216,16 +216,16 @@ public class Task extends DomainResource {
 
     private Task(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         instantiatesCanonical = builder.instantiatesCanonical;
         instantiatesUri = builder.instantiatesUri;
-        basedOn = Collections.unmodifiableList(ValidationSupport.checkList(builder.basedOn, "basedOn", Reference.class));
+        basedOn = Collections.unmodifiableList(builder.basedOn);
         groupIdentifier = builder.groupIdentifier;
-        partOf = Collections.unmodifiableList(ValidationSupport.checkList(builder.partOf, "partOf", Reference.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        partOf = Collections.unmodifiableList(builder.partOf);
+        status = builder.status;
         statusReason = builder.statusReason;
         businessStatus = builder.businessStatus;
-        intent = ValidationSupport.requireNonNull(builder.intent, "intent");
+        intent = builder.intent;
         priority = builder.priority;
         code = builder.code;
         description = builder.description;
@@ -236,24 +236,17 @@ private Task(Builder builder) {
         authoredOn = builder.authoredOn;
         lastModified = builder.lastModified;
         requester = builder.requester;
-        performerType = Collections.unmodifiableList(ValidationSupport.checkList(builder.performerType, "performerType", CodeableConcept.class));
+        performerType = Collections.unmodifiableList(builder.performerType);
         owner = builder.owner;
         location = builder.location;
         reasonCode = builder.reasonCode;
         reasonReference = builder.reasonReference;
-        insurance = Collections.unmodifiableList(ValidationSupport.checkList(builder.insurance, "insurance", Reference.class));
-        note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-        relevantHistory = Collections.unmodifiableList(ValidationSupport.checkList(builder.relevantHistory, "relevantHistory", Reference.class));
+        insurance = Collections.unmodifiableList(builder.insurance);
+        note = Collections.unmodifiableList(builder.note);
+        relevantHistory = Collections.unmodifiableList(builder.relevantHistory);
         restriction = builder.restriction;
-        input = Collections.unmodifiableList(ValidationSupport.checkList(builder.input, "input", Input.class));
-        output = Collections.unmodifiableList(ValidationSupport.checkList(builder.output, "output", Output.class));
-        ValidationSupport.checkReferenceType(partOf, "partOf", "Task");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(requester, "requester", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
-        ValidationSupport.checkReferenceType(owner, "owner", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "HealthcareService", "Patient", "Device", "RelatedPerson");
-        ValidationSupport.checkReferenceType(location, "location", "Location");
-        ValidationSupport.checkReferenceType(insurance, "insurance", "Coverage", "ClaimResponse");
-        ValidationSupport.checkReferenceType(relevantHistory, "relevantHistory", "Provenance");
+        input = Collections.unmodifiableList(builder.input);
+        output = Collections.unmodifiableList(builder.output);
     }
 
     /**
@@ -1719,7 +1712,33 @@ public Builder output(Collection<Output> output) {
          */
         @Override
         public Task build() {
-            return new Task(this);
+            Task task = new Task(this);
+            if (validating) {
+                validate(task);
+            }
+            return task;
+        }
+
+        protected void validate(Task task) {
+            super.validate(task);
+            ValidationSupport.checkList(task.identifier, "identifier", Identifier.class);
+            ValidationSupport.checkList(task.basedOn, "basedOn", Reference.class);
+            ValidationSupport.checkList(task.partOf, "partOf", Reference.class);
+            ValidationSupport.requireNonNull(task.status, "status");
+            ValidationSupport.requireNonNull(task.intent, "intent");
+            ValidationSupport.checkList(task.performerType, "performerType", CodeableConcept.class);
+            ValidationSupport.checkList(task.insurance, "insurance", Reference.class);
+            ValidationSupport.checkList(task.note, "note", Annotation.class);
+            ValidationSupport.checkList(task.relevantHistory, "relevantHistory", Reference.class);
+            ValidationSupport.checkList(task.input, "input", Input.class);
+            ValidationSupport.checkList(task.output, "output", Output.class);
+            ValidationSupport.checkReferenceType(task.partOf, "partOf", "Task");
+            ValidationSupport.checkReferenceType(task.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(task.requester, "requester", "Device", "Organization", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson");
+            ValidationSupport.checkReferenceType(task.owner, "owner", "Practitioner", "PractitionerRole", "Organization", "CareTeam", "HealthcareService", "Patient", "Device", "RelatedPerson");
+            ValidationSupport.checkReferenceType(task.location, "location", "Location");
+            ValidationSupport.checkReferenceType(task.insurance, "insurance", "Coverage", "ClaimResponse");
+            ValidationSupport.checkReferenceType(task.relevantHistory, "relevantHistory", "Provenance");
         }
 
         protected Builder from(Task task) {
@@ -1773,9 +1792,7 @@ private Restriction(Builder builder) {
             super(builder);
             repetitions = builder.repetitions;
             period = builder.period;
-            recipient = Collections.unmodifiableList(ValidationSupport.checkList(builder.recipient, "recipient", Reference.class));
-            ValidationSupport.checkReferenceType(recipient, "recipient", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Group", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
+            recipient = Collections.unmodifiableList(builder.recipient);
         }
 
         /**
@@ -2080,7 +2097,18 @@ public Builder recipient(Collection<Reference> recipient) {
              */
             @Override
             public Restriction build() {
-                return new Restriction(this);
+                Restriction restriction = new Restriction(this);
+                if (validating) {
+                    validate(restriction);
+                }
+                return restriction;
+            }
+
+            protected void validate(Restriction restriction) {
+                super.validate(restriction);
+                ValidationSupport.checkList(restriction.recipient, "recipient", Reference.class);
+                ValidationSupport.checkReferenceType(restriction.recipient, "recipient", "Patient", "Practitioner", "PractitionerRole", "RelatedPerson", "Group", "Organization");
+                ValidationSupport.requireValueOrChildren(restriction);
             }
 
             protected Builder from(Restriction restriction) {
@@ -2110,9 +2138,8 @@ public static class Input extends BackboneElement {
 
         private Input(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            value = ValidationSupport.requireChoiceElement(builder.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            value = builder.value;
         }
 
         /**
@@ -2412,7 +2439,18 @@ public Builder value(Element value) {
              */
             @Override
             public Input build() {
-                return new Input(this);
+                Input input = new Input(this);
+                if (validating) {
+                    validate(input);
+                }
+                return input;
+            }
+
+            protected void validate(Input input) {
+                super.validate(input);
+                ValidationSupport.requireNonNull(input.type, "type");
+                ValidationSupport.requireChoiceElement(input.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+                ValidationSupport.requireValueOrChildren(input);
             }
 
             protected Builder from(Input input) {
@@ -2441,9 +2479,8 @@ public static class Output extends BackboneElement {
 
         private Output(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            value = ValidationSupport.requireChoiceElement(builder.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
-            ValidationSupport.requireValueOrChildren(this);
+            type = builder.type;
+            value = builder.value;
         }
 
         /**
@@ -2743,7 +2780,18 @@ public Builder value(Element value) {
              */
             @Override
             public Output build() {
-                return new Output(this);
+                Output output = new Output(this);
+                if (validating) {
+                    validate(output);
+                }
+                return output;
+            }
+
+            protected void validate(Output output) {
+                super.validate(output);
+                ValidationSupport.requireNonNull(output.type, "type");
+                ValidationSupport.requireChoiceElement(output.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+                ValidationSupport.requireValueOrChildren(output);
             }
 
             protected Builder from(Output output) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/TerminologyCapabilities.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/TerminologyCapabilities.java
index a93cae285ed..eb59434c81e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/TerminologyCapabilities.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/TerminologyCapabilities.java
@@ -178,21 +178,21 @@ private TerminologyCapabilities(Builder builder) {
         version = builder.version;
         name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
-        date = ValidationSupport.requireNonNull(builder.date, "date");
+        date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         copyright = builder.copyright;
-        kind = ValidationSupport.requireNonNull(builder.kind, "kind");
+        kind = builder.kind;
         software = builder.software;
         implementation = builder.implementation;
         lockedDate = builder.lockedDate;
-        codeSystem = Collections.unmodifiableList(ValidationSupport.checkList(builder.codeSystem, "codeSystem", CodeSystem.class));
+        codeSystem = Collections.unmodifiableList(builder.codeSystem);
         expansion = builder.expansion;
         codeSearch = builder.codeSearch;
         validateCode = builder.validateCode;
@@ -1317,7 +1317,22 @@ public Builder closure(Closure closure) {
          */
         @Override
         public TerminologyCapabilities build() {
-            return new TerminologyCapabilities(this);
+            TerminologyCapabilities terminologyCapabilities = new TerminologyCapabilities(this);
+            if (validating) {
+                validate(terminologyCapabilities);
+            }
+            return terminologyCapabilities;
+        }
+
+        protected void validate(TerminologyCapabilities terminologyCapabilities) {
+            super.validate(terminologyCapabilities);
+            ValidationSupport.requireNonNull(terminologyCapabilities.status, "status");
+            ValidationSupport.requireNonNull(terminologyCapabilities.date, "date");
+            ValidationSupport.checkList(terminologyCapabilities.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(terminologyCapabilities.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(terminologyCapabilities.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.requireNonNull(terminologyCapabilities.kind, "kind");
+            ValidationSupport.checkList(terminologyCapabilities.codeSystem, "codeSystem", CodeSystem.class);
         }
 
         protected Builder from(TerminologyCapabilities terminologyCapabilities) {
@@ -1363,9 +1378,8 @@ public static class Software extends BackboneElement {
 
         private Software(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
+            name = builder.name;
             version = builder.version;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1608,7 +1622,17 @@ public Builder version(String version) {
              */
             @Override
             public Software build() {
-                return new Software(this);
+                Software software = new Software(this);
+                if (validating) {
+                    validate(software);
+                }
+                return software;
+            }
+
+            protected void validate(Software software) {
+                super.validate(software);
+                ValidationSupport.requireNonNull(software.name, "name");
+                ValidationSupport.requireValueOrChildren(software);
             }
 
             protected Builder from(Software software) {
@@ -1633,9 +1657,8 @@ public static class Implementation extends BackboneElement {
 
         private Implementation(Builder builder) {
             super(builder);
-            description = ValidationSupport.requireNonNull(builder.description, "description");
+            description = builder.description;
             url = builder.url;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1878,7 +1901,17 @@ public Builder url(Url url) {
              */
             @Override
             public Implementation build() {
-                return new Implementation(this);
+                Implementation implementation = new Implementation(this);
+                if (validating) {
+                    validate(implementation);
+                }
+                return implementation;
+            }
+
+            protected void validate(Implementation implementation) {
+                super.validate(implementation);
+                ValidationSupport.requireNonNull(implementation.description, "description");
+                ValidationSupport.requireValueOrChildren(implementation);
             }
 
             protected Builder from(Implementation implementation) {
@@ -1902,9 +1935,8 @@ public static class CodeSystem extends BackboneElement {
         private CodeSystem(Builder builder) {
             super(builder);
             uri = builder.uri;
-            version = Collections.unmodifiableList(ValidationSupport.checkList(builder.version, "version", Version.class));
+            version = Collections.unmodifiableList(builder.version);
             subsumption = builder.subsumption;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2189,7 +2221,17 @@ public Builder subsumption(Boolean subsumption) {
              */
             @Override
             public CodeSystem build() {
-                return new CodeSystem(this);
+                CodeSystem codeSystem = new CodeSystem(this);
+                if (validating) {
+                    validate(codeSystem);
+                }
+                return codeSystem;
+            }
+
+            protected void validate(CodeSystem codeSystem) {
+                super.validate(codeSystem);
+                ValidationSupport.checkList(codeSystem.version, "version", Version.class);
+                ValidationSupport.requireValueOrChildren(codeSystem);
             }
 
             protected Builder from(CodeSystem codeSystem) {
@@ -2219,10 +2261,9 @@ private Version(Builder builder) {
                 code = builder.code;
                 isDefault = builder.isDefault;
                 compositional = builder.compositional;
-                language = Collections.unmodifiableList(ValidationSupport.checkList(builder.language, "language", Code.class));
-                filter = Collections.unmodifiableList(ValidationSupport.checkList(builder.filter, "filter", Filter.class));
-                property = Collections.unmodifiableList(ValidationSupport.checkList(builder.property, "property", Code.class));
-                ValidationSupport.requireValueOrChildren(this);
+                language = Collections.unmodifiableList(builder.language);
+                filter = Collections.unmodifiableList(builder.filter);
+                property = Collections.unmodifiableList(builder.property);
             }
 
             /**
@@ -2634,7 +2675,19 @@ public Builder property(Collection<Code> property) {
                  */
                 @Override
                 public Version build() {
-                    return new Version(this);
+                    Version version = new Version(this);
+                    if (validating) {
+                        validate(version);
+                    }
+                    return version;
+                }
+
+                protected void validate(Version version) {
+                    super.validate(version);
+                    ValidationSupport.checkList(version.language, "language", Code.class);
+                    ValidationSupport.checkList(version.filter, "filter", Filter.class);
+                    ValidationSupport.checkList(version.property, "property", Code.class);
+                    ValidationSupport.requireValueOrChildren(version);
                 }
 
                 protected Builder from(Version version) {
@@ -2660,9 +2713,8 @@ public static class Filter extends BackboneElement {
 
                 private Filter(Builder builder) {
                     super(builder);
-                    code = ValidationSupport.requireNonNull(builder.code, "code");
-                    op = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.op, "op", Code.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    code = builder.code;
+                    op = Collections.unmodifiableList(builder.op);
                 }
 
                 /**
@@ -2930,7 +2982,18 @@ public Builder op(Collection<Code> op) {
                      */
                     @Override
                     public Filter build() {
-                        return new Filter(this);
+                        Filter filter = new Filter(this);
+                        if (validating) {
+                            validate(filter);
+                        }
+                        return filter;
+                    }
+
+                    protected void validate(Filter filter) {
+                        super.validate(filter);
+                        ValidationSupport.requireNonNull(filter.code, "code");
+                        ValidationSupport.checkNonEmptyList(filter.op, "op", Code.class);
+                        ValidationSupport.requireValueOrChildren(filter);
                     }
 
                     protected Builder from(Filter filter) {
@@ -2959,9 +3022,8 @@ private Expansion(Builder builder) {
             hierarchical = builder.hierarchical;
             paging = builder.paging;
             incomplete = builder.incomplete;
-            parameter = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameter, "parameter", Parameter.class));
+            parameter = Collections.unmodifiableList(builder.parameter);
             textFilter = builder.textFilter;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3304,7 +3366,17 @@ public Builder textFilter(Markdown textFilter) {
              */
             @Override
             public Expansion build() {
-                return new Expansion(this);
+                Expansion expansion = new Expansion(this);
+                if (validating) {
+                    validate(expansion);
+                }
+                return expansion;
+            }
+
+            protected void validate(Expansion expansion) {
+                super.validate(expansion);
+                ValidationSupport.checkList(expansion.parameter, "parameter", Parameter.class);
+                ValidationSupport.requireValueOrChildren(expansion);
             }
 
             protected Builder from(Expansion expansion) {
@@ -3328,9 +3400,8 @@ public static class Parameter extends BackboneElement {
 
             private Parameter(Builder builder) {
                 super(builder);
-                name = ValidationSupport.requireNonNull(builder.name, "name");
+                name = builder.name;
                 documentation = builder.documentation;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -3573,7 +3644,17 @@ public Builder documentation(String documentation) {
                  */
                 @Override
                 public Parameter build() {
-                    return new Parameter(this);
+                    Parameter parameter = new Parameter(this);
+                    if (validating) {
+                        validate(parameter);
+                    }
+                    return parameter;
+                }
+
+                protected void validate(Parameter parameter) {
+                    super.validate(parameter);
+                    ValidationSupport.requireNonNull(parameter.name, "name");
+                    ValidationSupport.requireValueOrChildren(parameter);
                 }
 
                 protected Builder from(Parameter parameter) {
@@ -3595,8 +3676,7 @@ public static class ValidateCode extends BackboneElement {
 
         private ValidateCode(Builder builder) {
             super(builder);
-            translations = ValidationSupport.requireNonNull(builder.translations, "translations");
-            ValidationSupport.requireValueOrChildren(this);
+            translations = builder.translations;
         }
 
         /**
@@ -3810,7 +3890,17 @@ public Builder translations(Boolean translations) {
              */
             @Override
             public ValidateCode build() {
-                return new ValidateCode(this);
+                ValidateCode validateCode = new ValidateCode(this);
+                if (validating) {
+                    validate(validateCode);
+                }
+                return validateCode;
+            }
+
+            protected void validate(ValidateCode validateCode) {
+                super.validate(validateCode);
+                ValidationSupport.requireNonNull(validateCode.translations, "translations");
+                ValidationSupport.requireValueOrChildren(validateCode);
             }
 
             protected Builder from(ValidateCode validateCode) {
@@ -3830,8 +3920,7 @@ public static class Translation extends BackboneElement {
 
         private Translation(Builder builder) {
             super(builder);
-            needsMap = ValidationSupport.requireNonNull(builder.needsMap, "needsMap");
-            ValidationSupport.requireValueOrChildren(this);
+            needsMap = builder.needsMap;
         }
 
         /**
@@ -4045,7 +4134,17 @@ public Builder needsMap(Boolean needsMap) {
              */
             @Override
             public Translation build() {
-                return new Translation(this);
+                Translation translation = new Translation(this);
+                if (validating) {
+                    validate(translation);
+                }
+                return translation;
+            }
+
+            protected void validate(Translation translation) {
+                super.validate(translation);
+                ValidationSupport.requireNonNull(translation.needsMap, "needsMap");
+                ValidationSupport.requireValueOrChildren(translation);
             }
 
             protected Builder from(Translation translation) {
@@ -4065,7 +4164,6 @@ public static class Closure extends BackboneElement {
         private Closure(Builder builder) {
             super(builder);
             translation = builder.translation;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -4272,7 +4370,16 @@ public Builder translation(Boolean translation) {
              */
             @Override
             public Closure build() {
-                return new Closure(this);
+                Closure closure = new Closure(this);
+                if (validating) {
+                    validate(closure);
+                }
+                return closure;
+            }
+
+            protected void validate(Closure closure) {
+                super.validate(closure);
+                ValidationSupport.requireValueOrChildren(closure);
             }
 
             protected Builder from(Closure closure) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/TestReport.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/TestReport.java
index bc5493a33ef..4562be314c4 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/TestReport.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/TestReport.java
@@ -107,17 +107,16 @@ private TestReport(Builder builder) {
         super(builder);
         identifier = builder.identifier;
         name = builder.name;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        testScript = ValidationSupport.requireNonNull(builder.testScript, "testScript");
-        result = ValidationSupport.requireNonNull(builder.result, "result");
+        status = builder.status;
+        testScript = builder.testScript;
+        result = builder.result;
         score = builder.score;
         tester = builder.tester;
         issued = builder.issued;
-        participant = Collections.unmodifiableList(ValidationSupport.checkList(builder.participant, "participant", Participant.class));
+        participant = Collections.unmodifiableList(builder.participant);
         setup = builder.setup;
-        test = Collections.unmodifiableList(ValidationSupport.checkList(builder.test, "test", Test.class));
+        test = Collections.unmodifiableList(builder.test);
         teardown = builder.teardown;
-        ValidationSupport.checkReferenceType(testScript, "testScript", "TestScript");
     }
 
     /**
@@ -815,7 +814,21 @@ public Builder teardown(Teardown teardown) {
          */
         @Override
         public TestReport build() {
-            return new TestReport(this);
+            TestReport testReport = new TestReport(this);
+            if (validating) {
+                validate(testReport);
+            }
+            return testReport;
+        }
+
+        protected void validate(TestReport testReport) {
+            super.validate(testReport);
+            ValidationSupport.requireNonNull(testReport.status, "status");
+            ValidationSupport.requireNonNull(testReport.testScript, "testScript");
+            ValidationSupport.requireNonNull(testReport.result, "result");
+            ValidationSupport.checkList(testReport.participant, "participant", Participant.class);
+            ValidationSupport.checkList(testReport.test, "test", Test.class);
+            ValidationSupport.checkReferenceType(testReport.testScript, "testScript", "TestScript");
         }
 
         protected Builder from(TestReport testReport) {
@@ -854,10 +867,9 @@ public static class Participant extends BackboneElement {
 
         private Participant(Builder builder) {
             super(builder);
-            type = ValidationSupport.requireNonNull(builder.type, "type");
-            uri = ValidationSupport.requireNonNull(builder.uri, "uri");
+            type = builder.type;
+            uri = builder.uri;
             display = builder.display;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1132,7 +1144,18 @@ public Builder display(String display) {
              */
             @Override
             public Participant build() {
-                return new Participant(this);
+                Participant participant = new Participant(this);
+                if (validating) {
+                    validate(participant);
+                }
+                return participant;
+            }
+
+            protected void validate(Participant participant) {
+                super.validate(participant);
+                ValidationSupport.requireNonNull(participant.type, "type");
+                ValidationSupport.requireNonNull(participant.uri, "uri");
+                ValidationSupport.requireValueOrChildren(participant);
             }
 
             protected Builder from(Participant participant) {
@@ -1154,8 +1177,7 @@ public static class Setup extends BackboneElement {
 
         private Setup(Builder builder) {
             super(builder);
-            action = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.action, "action", Action.class));
-            ValidationSupport.requireValueOrChildren(this);
+            action = Collections.unmodifiableList(builder.action);
         }
 
         /**
@@ -1391,7 +1413,17 @@ public Builder action(Collection<Action> action) {
              */
             @Override
             public Setup build() {
-                return new Setup(this);
+                Setup setup = new Setup(this);
+                if (validating) {
+                    validate(setup);
+                }
+                return setup;
+            }
+
+            protected void validate(Setup setup) {
+                super.validate(setup);
+                ValidationSupport.checkNonEmptyList(setup.action, "action", Action.class);
+                ValidationSupport.requireValueOrChildren(setup);
             }
 
             protected Builder from(Setup setup) {
@@ -1412,7 +1444,6 @@ private Action(Builder builder) {
                 super(builder);
                 operation = builder.operation;
                 _assert = builder._assert;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -1648,7 +1679,16 @@ public Builder _assert(Assert _assert) {
                  */
                 @Override
                 public Action build() {
-                    return new Action(this);
+                    Action action = new Action(this);
+                    if (validating) {
+                        validate(action);
+                    }
+                    return action;
+                }
+
+                protected void validate(Action action) {
+                    super.validate(action);
+                    ValidationSupport.requireValueOrChildren(action);
                 }
 
                 protected Builder from(Action action) {
@@ -1676,10 +1716,9 @@ public static class Operation extends BackboneElement {
 
                 private Operation(Builder builder) {
                     super(builder);
-                    result = ValidationSupport.requireNonNull(builder.result, "result");
+                    result = builder.result;
                     message = builder.message;
                     detail = builder.detail;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -1951,7 +1990,17 @@ public Builder detail(Uri detail) {
                      */
                     @Override
                     public Operation build() {
-                        return new Operation(this);
+                        Operation operation = new Operation(this);
+                        if (validating) {
+                            validate(operation);
+                        }
+                        return operation;
+                    }
+
+                    protected void validate(Operation operation) {
+                        super.validate(operation);
+                        ValidationSupport.requireNonNull(operation.result, "result");
+                        ValidationSupport.requireValueOrChildren(operation);
                     }
 
                     protected Builder from(Operation operation) {
@@ -1981,10 +2030,9 @@ public static class Assert extends BackboneElement {
 
                 private Assert(Builder builder) {
                     super(builder);
-                    result = ValidationSupport.requireNonNull(builder.result, "result");
+                    result = builder.result;
                     message = builder.message;
                     detail = builder.detail;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -2256,7 +2304,17 @@ public Builder detail(String detail) {
                      */
                     @Override
                     public Assert build() {
-                        return new Assert(this);
+                        Assert _assert = new Assert(this);
+                        if (validating) {
+                            validate(_assert);
+                        }
+                        return _assert;
+                    }
+
+                    protected void validate(Assert _assert) {
+                        super.validate(_assert);
+                        ValidationSupport.requireNonNull(_assert.result, "result");
+                        ValidationSupport.requireValueOrChildren(_assert);
                     }
 
                     protected Builder from(Assert _assert) {
@@ -2284,8 +2342,7 @@ private Test(Builder builder) {
             super(builder);
             name = builder.name;
             description = builder.description;
-            action = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.action, "action", Action.class));
-            ValidationSupport.requireValueOrChildren(this);
+            action = Collections.unmodifiableList(builder.action);
         }
 
         /**
@@ -2579,7 +2636,17 @@ public Builder action(Collection<Action> action) {
              */
             @Override
             public Test build() {
-                return new Test(this);
+                Test test = new Test(this);
+                if (validating) {
+                    validate(test);
+                }
+                return test;
+            }
+
+            protected void validate(Test test) {
+                super.validate(test);
+                ValidationSupport.checkNonEmptyList(test.action, "action", Action.class);
+                ValidationSupport.requireValueOrChildren(test);
             }
 
             protected Builder from(Test test) {
@@ -2602,7 +2669,6 @@ private Action(Builder builder) {
                 super(builder);
                 operation = builder.operation;
                 _assert = builder._assert;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2838,7 +2904,16 @@ public Builder _assert(TestReport.Setup.Action.Assert _assert) {
                  */
                 @Override
                 public Action build() {
-                    return new Action(this);
+                    Action action = new Action(this);
+                    if (validating) {
+                        validate(action);
+                    }
+                    return action;
+                }
+
+                protected void validate(Action action) {
+                    super.validate(action);
+                    ValidationSupport.requireValueOrChildren(action);
                 }
 
                 protected Builder from(Action action) {
@@ -2861,8 +2936,7 @@ public static class Teardown extends BackboneElement {
 
         private Teardown(Builder builder) {
             super(builder);
-            action = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.action, "action", Action.class));
-            ValidationSupport.requireValueOrChildren(this);
+            action = Collections.unmodifiableList(builder.action);
         }
 
         /**
@@ -3098,7 +3172,17 @@ public Builder action(Collection<Action> action) {
              */
             @Override
             public Teardown build() {
-                return new Teardown(this);
+                Teardown teardown = new Teardown(this);
+                if (validating) {
+                    validate(teardown);
+                }
+                return teardown;
+            }
+
+            protected void validate(Teardown teardown) {
+                super.validate(teardown);
+                ValidationSupport.checkNonEmptyList(teardown.action, "action", Action.class);
+                ValidationSupport.requireValueOrChildren(teardown);
             }
 
             protected Builder from(Teardown teardown) {
@@ -3117,8 +3201,7 @@ public static class Action extends BackboneElement {
 
             private Action(Builder builder) {
                 super(builder);
-                operation = ValidationSupport.requireNonNull(builder.operation, "operation");
-                ValidationSupport.requireValueOrChildren(this);
+                operation = builder.operation;
             }
 
             /**
@@ -3332,7 +3415,17 @@ public Builder operation(TestReport.Setup.Action.Operation operation) {
                  */
                 @Override
                 public Action build() {
-                    return new Action(this);
+                    Action action = new Action(this);
+                    if (validating) {
+                        validate(action);
+                    }
+                    return action;
+                }
+
+                protected void validate(Action action) {
+                    super.validate(action);
+                    ValidationSupport.requireNonNull(action.operation, "operation");
+                    ValidationSupport.requireValueOrChildren(action);
                 }
 
                 protected Builder from(Action action) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/TestScript.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/TestScript.java
index 0738016968c..9a2f8d12cfc 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/TestScript.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/TestScript.java
@@ -245,29 +245,29 @@ public class TestScript extends DomainResource {
 
     private TestScript(Builder builder) {
         super(builder);
-        url = ValidationSupport.requireNonNull(builder.url, "url");
+        url = builder.url;
         identifier = builder.identifier;
         version = builder.version;
-        name = ValidationSupport.requireNonNull(builder.name, "name");
+        name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         purpose = builder.purpose;
         copyright = builder.copyright;
-        origin = Collections.unmodifiableList(ValidationSupport.checkList(builder.origin, "origin", Origin.class));
-        destination = Collections.unmodifiableList(ValidationSupport.checkList(builder.destination, "destination", Destination.class));
+        origin = Collections.unmodifiableList(builder.origin);
+        destination = Collections.unmodifiableList(builder.destination);
         metadata = builder.metadata;
-        fixture = Collections.unmodifiableList(ValidationSupport.checkList(builder.fixture, "fixture", Fixture.class));
-        profile = Collections.unmodifiableList(ValidationSupport.checkList(builder.profile, "profile", Reference.class));
-        variable = Collections.unmodifiableList(ValidationSupport.checkList(builder.variable, "variable", Variable.class));
+        fixture = Collections.unmodifiableList(builder.fixture);
+        profile = Collections.unmodifiableList(builder.profile);
+        variable = Collections.unmodifiableList(builder.variable);
         setup = builder.setup;
-        test = Collections.unmodifiableList(ValidationSupport.checkList(builder.test, "test", Test.class));
+        test = Collections.unmodifiableList(builder.test);
         teardown = builder.teardown;
     }
 
@@ -1475,7 +1475,27 @@ public Builder teardown(Teardown teardown) {
          */
         @Override
         public TestScript build() {
-            return new TestScript(this);
+            TestScript testScript = new TestScript(this);
+            if (validating) {
+                validate(testScript);
+            }
+            return testScript;
+        }
+
+        protected void validate(TestScript testScript) {
+            super.validate(testScript);
+            ValidationSupport.requireNonNull(testScript.url, "url");
+            ValidationSupport.requireNonNull(testScript.name, "name");
+            ValidationSupport.requireNonNull(testScript.status, "status");
+            ValidationSupport.checkList(testScript.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(testScript.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(testScript.jurisdiction, "jurisdiction", CodeableConcept.class);
+            ValidationSupport.checkList(testScript.origin, "origin", Origin.class);
+            ValidationSupport.checkList(testScript.destination, "destination", Destination.class);
+            ValidationSupport.checkList(testScript.fixture, "fixture", Fixture.class);
+            ValidationSupport.checkList(testScript.profile, "profile", Reference.class);
+            ValidationSupport.checkList(testScript.variable, "variable", Variable.class);
+            ValidationSupport.checkList(testScript.test, "test", Test.class);
         }
 
         protected Builder from(TestScript testScript) {
@@ -1525,9 +1545,8 @@ public static class Origin extends BackboneElement {
 
         private Origin(Builder builder) {
             super(builder);
-            index = ValidationSupport.requireNonNull(builder.index, "index");
-            profile = ValidationSupport.requireNonNull(builder.profile, "profile");
-            ValidationSupport.requireValueOrChildren(this);
+            index = builder.index;
+            profile = builder.profile;
         }
 
         /**
@@ -1773,7 +1792,18 @@ public Builder profile(Coding profile) {
              */
             @Override
             public Origin build() {
-                return new Origin(this);
+                Origin origin = new Origin(this);
+                if (validating) {
+                    validate(origin);
+                }
+                return origin;
+            }
+
+            protected void validate(Origin origin) {
+                super.validate(origin);
+                ValidationSupport.requireNonNull(origin.index, "index");
+                ValidationSupport.requireNonNull(origin.profile, "profile");
+                ValidationSupport.requireValueOrChildren(origin);
             }
 
             protected Builder from(Origin origin) {
@@ -1802,9 +1832,8 @@ public static class Destination extends BackboneElement {
 
         private Destination(Builder builder) {
             super(builder);
-            index = ValidationSupport.requireNonNull(builder.index, "index");
-            profile = ValidationSupport.requireNonNull(builder.profile, "profile");
-            ValidationSupport.requireValueOrChildren(this);
+            index = builder.index;
+            profile = builder.profile;
         }
 
         /**
@@ -2050,7 +2079,18 @@ public Builder profile(Coding profile) {
              */
             @Override
             public Destination build() {
-                return new Destination(this);
+                Destination destination = new Destination(this);
+                if (validating) {
+                    validate(destination);
+                }
+                return destination;
+            }
+
+            protected void validate(Destination destination) {
+                super.validate(destination);
+                ValidationSupport.requireNonNull(destination.index, "index");
+                ValidationSupport.requireNonNull(destination.profile, "profile");
+                ValidationSupport.requireValueOrChildren(destination);
             }
 
             protected Builder from(Destination destination) {
@@ -2072,9 +2112,8 @@ public static class Metadata extends BackboneElement {
 
         private Metadata(Builder builder) {
             super(builder);
-            link = Collections.unmodifiableList(ValidationSupport.checkList(builder.link, "link", Link.class));
-            capability = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.capability, "capability", Capability.class));
-            ValidationSupport.requireValueOrChildren(this);
+            link = Collections.unmodifiableList(builder.link);
+            capability = Collections.unmodifiableList(builder.capability);
         }
 
         /**
@@ -2359,7 +2398,18 @@ public Builder capability(Collection<Capability> capability) {
              */
             @Override
             public Metadata build() {
-                return new Metadata(this);
+                Metadata metadata = new Metadata(this);
+                if (validating) {
+                    validate(metadata);
+                }
+                return metadata;
+            }
+
+            protected void validate(Metadata metadata) {
+                super.validate(metadata);
+                ValidationSupport.checkList(metadata.link, "link", Link.class);
+                ValidationSupport.checkNonEmptyList(metadata.capability, "capability", Capability.class);
+                ValidationSupport.requireValueOrChildren(metadata);
             }
 
             protected Builder from(Metadata metadata) {
@@ -2380,9 +2430,8 @@ public static class Link extends BackboneElement {
 
             private Link(Builder builder) {
                 super(builder);
-                url = ValidationSupport.requireNonNull(builder.url, "url");
+                url = builder.url;
                 description = builder.description;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -2625,7 +2674,17 @@ public Builder description(String description) {
                  */
                 @Override
                 public Link build() {
-                    return new Link(this);
+                    Link link = new Link(this);
+                    if (validating) {
+                        validate(link);
+                    }
+                    return link;
+                }
+
+                protected void validate(Link link) {
+                    super.validate(link);
+                    ValidationSupport.requireNonNull(link.url, "url");
+                    ValidationSupport.requireValueOrChildren(link);
                 }
 
                 protected Builder from(Link link) {
@@ -2654,14 +2713,13 @@ public static class Capability extends BackboneElement {
 
             private Capability(Builder builder) {
                 super(builder);
-                required = ValidationSupport.requireNonNull(builder.required, "required");
-                validated = ValidationSupport.requireNonNull(builder.validated, "validated");
+                required = builder.required;
+                validated = builder.validated;
                 description = builder.description;
-                origin = Collections.unmodifiableList(ValidationSupport.checkList(builder.origin, "origin", Integer.class));
+                origin = Collections.unmodifiableList(builder.origin);
                 destination = builder.destination;
-                link = Collections.unmodifiableList(ValidationSupport.checkList(builder.link, "link", Uri.class));
-                capabilities = ValidationSupport.requireNonNull(builder.capabilities, "capabilities");
-                ValidationSupport.requireValueOrChildren(this);
+                link = Collections.unmodifiableList(builder.link);
+                capabilities = builder.capabilities;
             }
 
             /**
@@ -3101,7 +3159,21 @@ public Builder capabilities(Canonical capabilities) {
                  */
                 @Override
                 public Capability build() {
-                    return new Capability(this);
+                    Capability capability = new Capability(this);
+                    if (validating) {
+                        validate(capability);
+                    }
+                    return capability;
+                }
+
+                protected void validate(Capability capability) {
+                    super.validate(capability);
+                    ValidationSupport.requireNonNull(capability.required, "required");
+                    ValidationSupport.requireNonNull(capability.validated, "validated");
+                    ValidationSupport.checkList(capability.origin, "origin", Integer.class);
+                    ValidationSupport.checkList(capability.link, "link", Uri.class);
+                    ValidationSupport.requireNonNull(capability.capabilities, "capabilities");
+                    ValidationSupport.requireValueOrChildren(capability);
                 }
 
                 protected Builder from(Capability capability) {
@@ -3131,10 +3203,9 @@ public static class Fixture extends BackboneElement {
 
         private Fixture(Builder builder) {
             super(builder);
-            autocreate = ValidationSupport.requireNonNull(builder.autocreate, "autocreate");
-            autodelete = ValidationSupport.requireNonNull(builder.autodelete, "autodelete");
+            autocreate = builder.autocreate;
+            autodelete = builder.autodelete;
             resource = builder.resource;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3417,7 +3488,18 @@ public Builder resource(Reference resource) {
              */
             @Override
             public Fixture build() {
-                return new Fixture(this);
+                Fixture fixture = new Fixture(this);
+                if (validating) {
+                    validate(fixture);
+                }
+                return fixture;
+            }
+
+            protected void validate(Fixture fixture) {
+                super.validate(fixture);
+                ValidationSupport.requireNonNull(fixture.autocreate, "autocreate");
+                ValidationSupport.requireNonNull(fixture.autodelete, "autodelete");
+                ValidationSupport.requireValueOrChildren(fixture);
             }
 
             protected Builder from(Fixture fixture) {
@@ -3446,7 +3528,7 @@ public static class Variable extends BackboneElement {
 
         private Variable(Builder builder) {
             super(builder);
-            name = ValidationSupport.requireNonNull(builder.name, "name");
+            name = builder.name;
             defaultValue = builder.defaultValue;
             description = builder.description;
             expression = builder.expression;
@@ -3454,7 +3536,6 @@ private Variable(Builder builder) {
             hint = builder.hint;
             path = builder.path;
             sourceId = builder.sourceId;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3875,7 +3956,17 @@ public Builder sourceId(Id sourceId) {
              */
             @Override
             public Variable build() {
-                return new Variable(this);
+                Variable variable = new Variable(this);
+                if (validating) {
+                    validate(variable);
+                }
+                return variable;
+            }
+
+            protected void validate(Variable variable) {
+                super.validate(variable);
+                ValidationSupport.requireNonNull(variable.name, "name");
+                ValidationSupport.requireValueOrChildren(variable);
             }
 
             protected Builder from(Variable variable) {
@@ -3902,8 +3993,7 @@ public static class Setup extends BackboneElement {
 
         private Setup(Builder builder) {
             super(builder);
-            action = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.action, "action", Action.class));
-            ValidationSupport.requireValueOrChildren(this);
+            action = Collections.unmodifiableList(builder.action);
         }
 
         /**
@@ -4139,7 +4229,17 @@ public Builder action(Collection<Action> action) {
              */
             @Override
             public Setup build() {
-                return new Setup(this);
+                Setup setup = new Setup(this);
+                if (validating) {
+                    validate(setup);
+                }
+                return setup;
+            }
+
+            protected void validate(Setup setup) {
+                super.validate(setup);
+                ValidationSupport.checkNonEmptyList(setup.action, "action", Action.class);
+                ValidationSupport.requireValueOrChildren(setup);
             }
 
             protected Builder from(Setup setup) {
@@ -4160,7 +4260,6 @@ private Action(Builder builder) {
                 super(builder);
                 operation = builder.operation;
                 _assert = builder._assert;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -4396,7 +4495,16 @@ public Builder _assert(Assert _assert) {
                  */
                 @Override
                 public Action build() {
-                    return new Action(this);
+                    Action action = new Action(this);
+                    if (validating) {
+                        validate(action);
+                    }
+                    return action;
+                }
+
+                protected void validate(Action action) {
+                    super.validate(action);
+                    ValidationSupport.requireValueOrChildren(action);
                 }
 
                 protected Builder from(Action action) {
@@ -4469,17 +4577,16 @@ private Operation(Builder builder) {
                     accept = builder.accept;
                     contentType = builder.contentType;
                     destination = builder.destination;
-                    encodeRequestUrl = ValidationSupport.requireNonNull(builder.encodeRequestUrl, "encodeRequestUrl");
+                    encodeRequestUrl = builder.encodeRequestUrl;
                     method = builder.method;
                     origin = builder.origin;
                     params = builder.params;
-                    requestHeader = Collections.unmodifiableList(ValidationSupport.checkList(builder.requestHeader, "requestHeader", RequestHeader.class));
+                    requestHeader = Collections.unmodifiableList(builder.requestHeader);
                     requestId = builder.requestId;
                     responseId = builder.responseId;
                     sourceId = builder.sourceId;
                     targetId = builder.targetId;
                     url = builder.url;
-                    ValidationSupport.requireValueOrChildren(this);
                 }
 
                 /**
@@ -5183,7 +5290,18 @@ public Builder url(String url) {
                      */
                     @Override
                     public Operation build() {
-                        return new Operation(this);
+                        Operation operation = new Operation(this);
+                        if (validating) {
+                            validate(operation);
+                        }
+                        return operation;
+                    }
+
+                    protected void validate(Operation operation) {
+                        super.validate(operation);
+                        ValidationSupport.requireNonNull(operation.encodeRequestUrl, "encodeRequestUrl");
+                        ValidationSupport.checkList(operation.requestHeader, "requestHeader", RequestHeader.class);
+                        ValidationSupport.requireValueOrChildren(operation);
                     }
 
                     protected Builder from(Operation operation) {
@@ -5220,9 +5338,8 @@ public static class RequestHeader extends BackboneElement {
 
                     private RequestHeader(Builder builder) {
                         super(builder);
-                        field = ValidationSupport.requireNonNull(builder.field, "field");
-                        value = ValidationSupport.requireNonNull(builder.value, "value");
-                        ValidationSupport.requireValueOrChildren(this);
+                        field = builder.field;
+                        value = builder.value;
                     }
 
                     /**
@@ -5468,7 +5585,18 @@ public Builder value(String value) {
                          */
                         @Override
                         public RequestHeader build() {
-                            return new RequestHeader(this);
+                            RequestHeader requestHeader = new RequestHeader(this);
+                            if (validating) {
+                                validate(requestHeader);
+                            }
+                            return requestHeader;
+                        }
+
+                        protected void validate(RequestHeader requestHeader) {
+                            super.validate(requestHeader);
+                            ValidationSupport.requireNonNull(requestHeader.field, "field");
+                            ValidationSupport.requireNonNull(requestHeader.value, "value");
+                            ValidationSupport.requireValueOrChildren(requestHeader);
                         }
 
                         protected Builder from(RequestHeader requestHeader) {
@@ -5568,8 +5696,7 @@ private Assert(Builder builder) {
                     sourceId = builder.sourceId;
                     validateProfileId = builder.validateProfileId;
                     value = builder.value;
-                    warningOnly = ValidationSupport.requireNonNull(builder.warningOnly, "warningOnly");
-                    ValidationSupport.requireValueOrChildren(this);
+                    warningOnly = builder.warningOnly;
                 }
 
                 /**
@@ -6401,7 +6528,17 @@ public Builder warningOnly(Boolean warningOnly) {
                      */
                     @Override
                     public Assert build() {
-                        return new Assert(this);
+                        Assert _assert = new Assert(this);
+                        if (validating) {
+                            validate(_assert);
+                        }
+                        return _assert;
+                    }
+
+                    protected void validate(Assert _assert) {
+                        super.validate(_assert);
+                        ValidationSupport.requireNonNull(_assert.warningOnly, "warningOnly");
+                        ValidationSupport.requireValueOrChildren(_assert);
                     }
 
                     protected Builder from(Assert _assert) {
@@ -6448,8 +6585,7 @@ private Test(Builder builder) {
             super(builder);
             name = builder.name;
             description = builder.description;
-            action = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.action, "action", Action.class));
-            ValidationSupport.requireValueOrChildren(this);
+            action = Collections.unmodifiableList(builder.action);
         }
 
         /**
@@ -6743,7 +6879,17 @@ public Builder action(Collection<Action> action) {
              */
             @Override
             public Test build() {
-                return new Test(this);
+                Test test = new Test(this);
+                if (validating) {
+                    validate(test);
+                }
+                return test;
+            }
+
+            protected void validate(Test test) {
+                super.validate(test);
+                ValidationSupport.checkNonEmptyList(test.action, "action", Action.class);
+                ValidationSupport.requireValueOrChildren(test);
             }
 
             protected Builder from(Test test) {
@@ -6766,7 +6912,6 @@ private Action(Builder builder) {
                 super(builder);
                 operation = builder.operation;
                 _assert = builder._assert;
-                ValidationSupport.requireValueOrChildren(this);
             }
 
             /**
@@ -7002,7 +7147,16 @@ public Builder _assert(TestScript.Setup.Action.Assert _assert) {
                  */
                 @Override
                 public Action build() {
-                    return new Action(this);
+                    Action action = new Action(this);
+                    if (validating) {
+                        validate(action);
+                    }
+                    return action;
+                }
+
+                protected void validate(Action action) {
+                    super.validate(action);
+                    ValidationSupport.requireValueOrChildren(action);
                 }
 
                 protected Builder from(Action action) {
@@ -7024,8 +7178,7 @@ public static class Teardown extends BackboneElement {
 
         private Teardown(Builder builder) {
             super(builder);
-            action = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.action, "action", Action.class));
-            ValidationSupport.requireValueOrChildren(this);
+            action = Collections.unmodifiableList(builder.action);
         }
 
         /**
@@ -7261,7 +7414,17 @@ public Builder action(Collection<Action> action) {
              */
             @Override
             public Teardown build() {
-                return new Teardown(this);
+                Teardown teardown = new Teardown(this);
+                if (validating) {
+                    validate(teardown);
+                }
+                return teardown;
+            }
+
+            protected void validate(Teardown teardown) {
+                super.validate(teardown);
+                ValidationSupport.checkNonEmptyList(teardown.action, "action", Action.class);
+                ValidationSupport.requireValueOrChildren(teardown);
             }
 
             protected Builder from(Teardown teardown) {
@@ -7280,8 +7443,7 @@ public static class Action extends BackboneElement {
 
             private Action(Builder builder) {
                 super(builder);
-                operation = ValidationSupport.requireNonNull(builder.operation, "operation");
-                ValidationSupport.requireValueOrChildren(this);
+                operation = builder.operation;
             }
 
             /**
@@ -7495,7 +7657,17 @@ public Builder operation(TestScript.Setup.Action.Operation operation) {
                  */
                 @Override
                 public Action build() {
-                    return new Action(this);
+                    Action action = new Action(this);
+                    if (validating) {
+                        validate(action);
+                    }
+                    return action;
+                }
+
+                protected void validate(Action action) {
+                    super.validate(action);
+                    ValidationSupport.requireNonNull(action.operation, "operation");
+                    ValidationSupport.requireValueOrChildren(action);
                 }
 
                 protected Builder from(Action action) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ValueSet.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ValueSet.java
index af247ac8861..a775d6abb2d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/ValueSet.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/ValueSet.java
@@ -181,18 +181,18 @@ public class ValueSet extends DomainResource {
     private ValueSet(Builder builder) {
         super(builder);
         url = builder.url;
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
+        identifier = Collections.unmodifiableList(builder.identifier);
         version = builder.version;
         name = builder.name;
         title = builder.title;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         experimental = builder.experimental;
         date = builder.date;
         publisher = builder.publisher;
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
+        contact = Collections.unmodifiableList(builder.contact);
         description = builder.description;
-        useContext = Collections.unmodifiableList(ValidationSupport.checkList(builder.useContext, "useContext", UsageContext.class));
-        jurisdiction = Collections.unmodifiableList(ValidationSupport.checkList(builder.jurisdiction, "jurisdiction", CodeableConcept.class));
+        useContext = Collections.unmodifiableList(builder.useContext);
+        jurisdiction = Collections.unmodifiableList(builder.jurisdiction);
         immutable = builder.immutable;
         purpose = builder.purpose;
         copyright = builder.copyright;
@@ -1133,7 +1133,20 @@ public Builder expansion(Expansion expansion) {
          */
         @Override
         public ValueSet build() {
-            return new ValueSet(this);
+            ValueSet valueSet = new ValueSet(this);
+            if (validating) {
+                validate(valueSet);
+            }
+            return valueSet;
+        }
+
+        protected void validate(ValueSet valueSet) {
+            super.validate(valueSet);
+            ValidationSupport.checkList(valueSet.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(valueSet.status, "status");
+            ValidationSupport.checkList(valueSet.contact, "contact", ContactDetail.class);
+            ValidationSupport.checkList(valueSet.useContext, "useContext", UsageContext.class);
+            ValidationSupport.checkList(valueSet.jurisdiction, "jurisdiction", CodeableConcept.class);
         }
 
         protected Builder from(ValueSet valueSet) {
@@ -1178,9 +1191,8 @@ private Compose(Builder builder) {
             super(builder);
             lockedDate = builder.lockedDate;
             inactive = builder.inactive;
-            include = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.include, "include", Include.class));
-            exclude = Collections.unmodifiableList(ValidationSupport.checkList(builder.exclude, "exclude", ValueSet.Compose.Include.class));
-            ValidationSupport.requireValueOrChildren(this);
+            include = Collections.unmodifiableList(builder.include);
+            exclude = Collections.unmodifiableList(builder.exclude);
         }
 
         /**
@@ -1531,7 +1543,18 @@ public Builder exclude(Collection<ValueSet.Compose.Include> exclude) {
              */
             @Override
             public Compose build() {
-                return new Compose(this);
+                Compose compose = new Compose(this);
+                if (validating) {
+                    validate(compose);
+                }
+                return compose;
+            }
+
+            protected void validate(Compose compose) {
+                super.validate(compose);
+                ValidationSupport.checkNonEmptyList(compose.include, "include", Include.class);
+                ValidationSupport.checkList(compose.exclude, "exclude", ValueSet.Compose.Include.class);
+                ValidationSupport.requireValueOrChildren(compose);
             }
 
             protected Builder from(Compose compose) {
@@ -1562,10 +1585,9 @@ private Include(Builder builder) {
                 super(builder);
                 system = builder.system;
                 version = builder.version;
-                concept = Collections.unmodifiableList(ValidationSupport.checkList(builder.concept, "concept", Concept.class));
-                filter = Collections.unmodifiableList(ValidationSupport.checkList(builder.filter, "filter", Filter.class));
-                valueSet = Collections.unmodifiableList(ValidationSupport.checkList(builder.valueSet, "valueSet", Canonical.class));
-                ValidationSupport.requireValueOrChildren(this);
+                concept = Collections.unmodifiableList(builder.concept);
+                filter = Collections.unmodifiableList(builder.filter);
+                valueSet = Collections.unmodifiableList(builder.valueSet);
             }
 
             /**
@@ -1957,7 +1979,19 @@ public Builder valueSet(Collection<Canonical> valueSet) {
                  */
                 @Override
                 public Include build() {
-                    return new Include(this);
+                    Include include = new Include(this);
+                    if (validating) {
+                        validate(include);
+                    }
+                    return include;
+                }
+
+                protected void validate(Include include) {
+                    super.validate(include);
+                    ValidationSupport.checkList(include.concept, "concept", Concept.class);
+                    ValidationSupport.checkList(include.filter, "filter", Filter.class);
+                    ValidationSupport.checkList(include.valueSet, "valueSet", Canonical.class);
+                    ValidationSupport.requireValueOrChildren(include);
                 }
 
                 protected Builder from(Include include) {
@@ -1982,10 +2016,9 @@ public static class Concept extends BackboneElement {
 
                 private Concept(Builder builder) {
                     super(builder);
-                    code = ValidationSupport.requireNonNull(builder.code, "code");
+                    code = builder.code;
                     display = builder.display;
-                    designation = Collections.unmodifiableList(ValidationSupport.checkList(builder.designation, "designation", Designation.class));
-                    ValidationSupport.requireValueOrChildren(this);
+                    designation = Collections.unmodifiableList(builder.designation);
                 }
 
                 /**
@@ -2282,7 +2315,18 @@ public Builder designation(Collection<Designation> designation) {
                      */
                     @Override
                     public Concept build() {
-                        return new Concept(this);
+                        Concept concept = new Concept(this);
+                        if (validating) {
+                            validate(concept);
+                        }
+                        return concept;
+                    }
+
+                    protected void validate(Concept concept) {
+                        super.validate(concept);
+                        ValidationSupport.requireNonNull(concept.code, "code");
+                        ValidationSupport.checkList(concept.designation, "designation", Designation.class);
+                        ValidationSupport.requireValueOrChildren(concept);
                     }
 
                     protected Builder from(Concept concept) {
@@ -2321,9 +2365,7 @@ private Designation(Builder builder) {
                         super(builder);
                         language = builder.language;
                         use = builder.use;
-                        value = ValidationSupport.requireNonNull(builder.value, "value");
-                        ValidationSupport.checkValueSetBinding(language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
-                        ValidationSupport.requireValueOrChildren(this);
+                        value = builder.value;
                     }
 
                     /**
@@ -2595,7 +2637,18 @@ public Builder value(String value) {
                          */
                         @Override
                         public Designation build() {
-                            return new Designation(this);
+                            Designation designation = new Designation(this);
+                            if (validating) {
+                                validate(designation);
+                            }
+                            return designation;
+                        }
+
+                        protected void validate(Designation designation) {
+                            super.validate(designation);
+                            ValidationSupport.requireNonNull(designation.value, "value");
+                            ValidationSupport.checkValueSetBinding(designation.language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+                            ValidationSupport.requireValueOrChildren(designation);
                         }
 
                         protected Builder from(Designation designation) {
@@ -2632,10 +2685,9 @@ public static class Filter extends BackboneElement {
 
                 private Filter(Builder builder) {
                     super(builder);
-                    property = ValidationSupport.requireNonNull(builder.property, "property");
-                    op = ValidationSupport.requireNonNull(builder.op, "op");
-                    value = ValidationSupport.requireNonNull(builder.value, "value");
-                    ValidationSupport.requireValueOrChildren(this);
+                    property = builder.property;
+                    op = builder.op;
+                    value = builder.value;
                 }
 
                 /**
@@ -2919,7 +2971,19 @@ public Builder value(String value) {
                      */
                     @Override
                     public Filter build() {
-                        return new Filter(this);
+                        Filter filter = new Filter(this);
+                        if (validating) {
+                            validate(filter);
+                        }
+                        return filter;
+                    }
+
+                    protected void validate(Filter filter) {
+                        super.validate(filter);
+                        ValidationSupport.requireNonNull(filter.property, "property");
+                        ValidationSupport.requireNonNull(filter.op, "op");
+                        ValidationSupport.requireNonNull(filter.value, "value");
+                        ValidationSupport.requireValueOrChildren(filter);
                     }
 
                     protected Builder from(Filter filter) {
@@ -2950,12 +3014,11 @@ public static class Expansion extends BackboneElement {
         private Expansion(Builder builder) {
             super(builder);
             identifier = builder.identifier;
-            timestamp = ValidationSupport.requireNonNull(builder.timestamp, "timestamp");
+            timestamp = builder.timestamp;
             total = builder.total;
             offset = builder.offset;
-            parameter = Collections.unmodifiableList(ValidationSupport.checkList(builder.parameter, "parameter", Parameter.class));
-            contains = Collections.unmodifiableList(ValidationSupport.checkList(builder.contains, "contains", Contains.class));
-            ValidationSupport.requireValueOrChildren(this);
+            parameter = Collections.unmodifiableList(builder.parameter);
+            contains = Collections.unmodifiableList(builder.contains);
         }
 
         /**
@@ -3367,7 +3430,19 @@ public Builder contains(Collection<Contains> contains) {
              */
             @Override
             public Expansion build() {
-                return new Expansion(this);
+                Expansion expansion = new Expansion(this);
+                if (validating) {
+                    validate(expansion);
+                }
+                return expansion;
+            }
+
+            protected void validate(Expansion expansion) {
+                super.validate(expansion);
+                ValidationSupport.requireNonNull(expansion.timestamp, "timestamp");
+                ValidationSupport.checkList(expansion.parameter, "parameter", Parameter.class);
+                ValidationSupport.checkList(expansion.contains, "contains", Contains.class);
+                ValidationSupport.requireValueOrChildren(expansion);
             }
 
             protected Builder from(Expansion expansion) {
@@ -3394,9 +3469,8 @@ public static class Parameter extends BackboneElement {
 
             private Parameter(Builder builder) {
                 super(builder);
-                name = ValidationSupport.requireNonNull(builder.name, "name");
-                value = ValidationSupport.choiceElement(builder.value, "value", String.class, Boolean.class, Integer.class, Decimal.class, Uri.class, Code.class, DateTime.class);
-                ValidationSupport.requireValueOrChildren(this);
+                name = builder.name;
+                value = builder.value;
             }
 
             /**
@@ -3652,7 +3726,18 @@ public Builder value(Element value) {
                  */
                 @Override
                 public Parameter build() {
-                    return new Parameter(this);
+                    Parameter parameter = new Parameter(this);
+                    if (validating) {
+                        validate(parameter);
+                    }
+                    return parameter;
+                }
+
+                protected void validate(Parameter parameter) {
+                    super.validate(parameter);
+                    ValidationSupport.requireNonNull(parameter.name, "name");
+                    ValidationSupport.choiceElement(parameter.value, "value", String.class, Boolean.class, Integer.class, Decimal.class, Uri.class, Code.class, DateTime.class);
+                    ValidationSupport.requireValueOrChildren(parameter);
                 }
 
                 protected Builder from(Parameter parameter) {
@@ -3685,9 +3770,8 @@ private Contains(Builder builder) {
                 version = builder.version;
                 code = builder.code;
                 display = builder.display;
-                designation = Collections.unmodifiableList(ValidationSupport.checkList(builder.designation, "designation", ValueSet.Compose.Include.Concept.Designation.class));
-                contains = Collections.unmodifiableList(ValidationSupport.checkList(builder.contains, "contains", ValueSet.Expansion.Contains.class));
-                ValidationSupport.requireValueOrChildren(this);
+                designation = Collections.unmodifiableList(builder.designation);
+                contains = Collections.unmodifiableList(builder.contains);
             }
 
             /**
@@ -4152,7 +4236,18 @@ public Builder contains(Collection<ValueSet.Expansion.Contains> contains) {
                  */
                 @Override
                 public Contains build() {
-                    return new Contains(this);
+                    Contains contains = new Contains(this);
+                    if (validating) {
+                        validate(contains);
+                    }
+                    return contains;
+                }
+
+                protected void validate(Contains contains) {
+                    super.validate(contains);
+                    ValidationSupport.checkList(contains.designation, "designation", ValueSet.Compose.Include.Concept.Designation.class);
+                    ValidationSupport.checkList(contains.contains, "contains", ValueSet.Expansion.Contains.class);
+                    ValidationSupport.requireValueOrChildren(contains);
                 }
 
                 protected Builder from(Contains contains) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/VerificationResult.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/VerificationResult.java
index ed1e9f1a007..0258f17b16a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/VerificationResult.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/VerificationResult.java
@@ -154,20 +154,20 @@ public class VerificationResult extends DomainResource {
 
     private VerificationResult(Builder builder) {
         super(builder);
-        target = Collections.unmodifiableList(ValidationSupport.checkList(builder.target, "target", Reference.class));
-        targetLocation = Collections.unmodifiableList(ValidationSupport.checkList(builder.targetLocation, "targetLocation", String.class));
+        target = Collections.unmodifiableList(builder.target);
+        targetLocation = Collections.unmodifiableList(builder.targetLocation);
         need = builder.need;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
+        status = builder.status;
         statusDate = builder.statusDate;
         validationType = builder.validationType;
-        validationProcess = Collections.unmodifiableList(ValidationSupport.checkList(builder.validationProcess, "validationProcess", CodeableConcept.class));
+        validationProcess = Collections.unmodifiableList(builder.validationProcess);
         frequency = builder.frequency;
         lastPerformed = builder.lastPerformed;
         nextScheduled = builder.nextScheduled;
         failureAction = builder.failureAction;
-        primarySource = Collections.unmodifiableList(ValidationSupport.checkList(builder.primarySource, "primarySource", PrimarySource.class));
+        primarySource = Collections.unmodifiableList(builder.primarySource);
         attestation = builder.attestation;
-        validator = Collections.unmodifiableList(ValidationSupport.checkList(builder.validator, "validator", Validator.class));
+        validator = Collections.unmodifiableList(builder.validator);
     }
 
     /**
@@ -975,7 +975,21 @@ public Builder validator(Collection<Validator> validator) {
          */
         @Override
         public VerificationResult build() {
-            return new VerificationResult(this);
+            VerificationResult verificationResult = new VerificationResult(this);
+            if (validating) {
+                validate(verificationResult);
+            }
+            return verificationResult;
+        }
+
+        protected void validate(VerificationResult verificationResult) {
+            super.validate(verificationResult);
+            ValidationSupport.checkList(verificationResult.target, "target", Reference.class);
+            ValidationSupport.checkList(verificationResult.targetLocation, "targetLocation", String.class);
+            ValidationSupport.requireNonNull(verificationResult.status, "status");
+            ValidationSupport.checkList(verificationResult.validationProcess, "validationProcess", CodeableConcept.class);
+            ValidationSupport.checkList(verificationResult.primarySource, "primarySource", PrimarySource.class);
+            ValidationSupport.checkList(verificationResult.validator, "validator", Validator.class);
         }
 
         protected Builder from(VerificationResult verificationResult) {
@@ -1047,14 +1061,12 @@ public static class PrimarySource extends BackboneElement {
         private PrimarySource(Builder builder) {
             super(builder);
             who = builder.who;
-            type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", CodeableConcept.class));
-            communicationMethod = Collections.unmodifiableList(ValidationSupport.checkList(builder.communicationMethod, "communicationMethod", CodeableConcept.class));
+            type = Collections.unmodifiableList(builder.type);
+            communicationMethod = Collections.unmodifiableList(builder.communicationMethod);
             validationStatus = builder.validationStatus;
             validationDate = builder.validationDate;
             canPushUpdates = builder.canPushUpdates;
-            pushTypeAvailable = Collections.unmodifiableList(ValidationSupport.checkList(builder.pushTypeAvailable, "pushTypeAvailable", CodeableConcept.class));
-            ValidationSupport.checkReferenceType(who, "who", "Organization", "Practitioner", "PractitionerRole");
-            ValidationSupport.requireValueOrChildren(this);
+            pushTypeAvailable = Collections.unmodifiableList(builder.pushTypeAvailable);
         }
 
         /**
@@ -1507,7 +1519,20 @@ public Builder pushTypeAvailable(Collection<CodeableConcept> pushTypeAvailable)
              */
             @Override
             public PrimarySource build() {
-                return new PrimarySource(this);
+                PrimarySource primarySource = new PrimarySource(this);
+                if (validating) {
+                    validate(primarySource);
+                }
+                return primarySource;
+            }
+
+            protected void validate(PrimarySource primarySource) {
+                super.validate(primarySource);
+                ValidationSupport.checkList(primarySource.type, "type", CodeableConcept.class);
+                ValidationSupport.checkList(primarySource.communicationMethod, "communicationMethod", CodeableConcept.class);
+                ValidationSupport.checkList(primarySource.pushTypeAvailable, "pushTypeAvailable", CodeableConcept.class);
+                ValidationSupport.checkReferenceType(primarySource.who, "who", "Organization", "Practitioner", "PractitionerRole");
+                ValidationSupport.requireValueOrChildren(primarySource);
             }
 
             protected Builder from(PrimarySource primarySource) {
@@ -1559,9 +1584,6 @@ private Attestation(Builder builder) {
             proxyIdentityCertificate = builder.proxyIdentityCertificate;
             proxySignature = builder.proxySignature;
             sourceSignature = builder.sourceSignature;
-            ValidationSupport.checkReferenceType(who, "who", "Practitioner", "PractitionerRole", "Organization");
-            ValidationSupport.checkReferenceType(onBehalfOf, "onBehalfOf", "Organization", "Practitioner", "PractitionerRole");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1990,7 +2012,18 @@ public Builder sourceSignature(Signature sourceSignature) {
              */
             @Override
             public Attestation build() {
-                return new Attestation(this);
+                Attestation attestation = new Attestation(this);
+                if (validating) {
+                    validate(attestation);
+                }
+                return attestation;
+            }
+
+            protected void validate(Attestation attestation) {
+                super.validate(attestation);
+                ValidationSupport.checkReferenceType(attestation.who, "who", "Practitioner", "PractitionerRole", "Organization");
+                ValidationSupport.checkReferenceType(attestation.onBehalfOf, "onBehalfOf", "Organization", "Practitioner", "PractitionerRole");
+                ValidationSupport.requireValueOrChildren(attestation);
             }
 
             protected Builder from(Attestation attestation) {
@@ -2020,11 +2053,9 @@ public static class Validator extends BackboneElement {
 
         private Validator(Builder builder) {
             super(builder);
-            organization = ValidationSupport.requireNonNull(builder.organization, "organization");
+            organization = builder.organization;
             identityCertificate = builder.identityCertificate;
             attestationSignature = builder.attestationSignature;
-            ValidationSupport.checkReferenceType(organization, "organization", "Organization");
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -2301,7 +2332,18 @@ public Builder attestationSignature(Signature attestationSignature) {
              */
             @Override
             public Validator build() {
-                return new Validator(this);
+                Validator validator = new Validator(this);
+                if (validating) {
+                    validate(validator);
+                }
+                return validator;
+            }
+
+            protected void validate(Validator validator) {
+                super.validate(validator);
+                ValidationSupport.requireNonNull(validator.organization, "organization");
+                ValidationSupport.checkReferenceType(validator.organization, "organization", "Organization");
+                ValidationSupport.requireValueOrChildren(validator);
             }
 
             protected Builder from(Validator validator) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/resource/VisionPrescription.java b/fhir-model/src/main/java/com/ibm/fhir/model/resource/VisionPrescription.java
index f6ba480086d..1b13df389ae 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/resource/VisionPrescription.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/resource/VisionPrescription.java
@@ -85,17 +85,14 @@ public class VisionPrescription extends DomainResource {
 
     private VisionPrescription(Builder builder) {
         super(builder);
-        identifier = Collections.unmodifiableList(ValidationSupport.checkList(builder.identifier, "identifier", Identifier.class));
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        created = ValidationSupport.requireNonNull(builder.created, "created");
-        patient = ValidationSupport.requireNonNull(builder.patient, "patient");
+        identifier = Collections.unmodifiableList(builder.identifier);
+        status = builder.status;
+        created = builder.created;
+        patient = builder.patient;
         encounter = builder.encounter;
-        dateWritten = ValidationSupport.requireNonNull(builder.dateWritten, "dateWritten");
-        prescriber = ValidationSupport.requireNonNull(builder.prescriber, "prescriber");
-        lensSpecification = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.lensSpecification, "lensSpecification", LensSpecification.class));
-        ValidationSupport.checkReferenceType(patient, "patient", "Patient");
-        ValidationSupport.checkReferenceType(encounter, "encounter", "Encounter");
-        ValidationSupport.checkReferenceType(prescriber, "prescriber", "Practitioner", "PractitionerRole");
+        dateWritten = builder.dateWritten;
+        prescriber = builder.prescriber;
+        lensSpecification = Collections.unmodifiableList(builder.lensSpecification);
     }
 
     /**
@@ -700,7 +697,25 @@ public Builder lensSpecification(Collection<LensSpecification> lensSpecification
          */
         @Override
         public VisionPrescription build() {
-            return new VisionPrescription(this);
+            VisionPrescription visionPrescription = new VisionPrescription(this);
+            if (validating) {
+                validate(visionPrescription);
+            }
+            return visionPrescription;
+        }
+
+        protected void validate(VisionPrescription visionPrescription) {
+            super.validate(visionPrescription);
+            ValidationSupport.checkList(visionPrescription.identifier, "identifier", Identifier.class);
+            ValidationSupport.requireNonNull(visionPrescription.status, "status");
+            ValidationSupport.requireNonNull(visionPrescription.created, "created");
+            ValidationSupport.requireNonNull(visionPrescription.patient, "patient");
+            ValidationSupport.requireNonNull(visionPrescription.dateWritten, "dateWritten");
+            ValidationSupport.requireNonNull(visionPrescription.prescriber, "prescriber");
+            ValidationSupport.checkNonEmptyList(visionPrescription.lensSpecification, "lensSpecification", LensSpecification.class);
+            ValidationSupport.checkReferenceType(visionPrescription.patient, "patient", "Patient");
+            ValidationSupport.checkReferenceType(visionPrescription.encounter, "encounter", "Encounter");
+            ValidationSupport.checkReferenceType(visionPrescription.prescriber, "prescriber", "Practitioner", "PractitionerRole");
         }
 
         protected Builder from(VisionPrescription visionPrescription) {
@@ -755,12 +770,12 @@ public static class LensSpecification extends BackboneElement {
 
         private LensSpecification(Builder builder) {
             super(builder);
-            product = ValidationSupport.requireNonNull(builder.product, "product");
-            eye = ValidationSupport.requireNonNull(builder.eye, "eye");
+            product = builder.product;
+            eye = builder.eye;
             sphere = builder.sphere;
             cylinder = builder.cylinder;
             axis = builder.axis;
-            prism = Collections.unmodifiableList(ValidationSupport.checkList(builder.prism, "prism", Prism.class));
+            prism = Collections.unmodifiableList(builder.prism);
             add = builder.add;
             power = builder.power;
             backCurve = builder.backCurve;
@@ -768,8 +783,7 @@ private LensSpecification(Builder builder) {
             duration = builder.duration;
             color = builder.color;
             brand = builder.brand;
-            note = Collections.unmodifiableList(ValidationSupport.checkList(builder.note, "note", Annotation.class));
-            ValidationSupport.requireValueOrChildren(this);
+            note = Collections.unmodifiableList(builder.note);
         }
 
         /**
@@ -1403,7 +1417,20 @@ public Builder note(Collection<Annotation> note) {
              */
             @Override
             public LensSpecification build() {
-                return new LensSpecification(this);
+                LensSpecification lensSpecification = new LensSpecification(this);
+                if (validating) {
+                    validate(lensSpecification);
+                }
+                return lensSpecification;
+            }
+
+            protected void validate(LensSpecification lensSpecification) {
+                super.validate(lensSpecification);
+                ValidationSupport.requireNonNull(lensSpecification.product, "product");
+                ValidationSupport.requireNonNull(lensSpecification.eye, "eye");
+                ValidationSupport.checkList(lensSpecification.prism, "prism", Prism.class);
+                ValidationSupport.checkList(lensSpecification.note, "note", Annotation.class);
+                ValidationSupport.requireValueOrChildren(lensSpecification);
             }
 
             protected Builder from(LensSpecification lensSpecification) {
@@ -1443,9 +1470,8 @@ public static class Prism extends BackboneElement {
 
             private Prism(Builder builder) {
                 super(builder);
-                amount = ValidationSupport.requireNonNull(builder.amount, "amount");
-                base = ValidationSupport.requireNonNull(builder.base, "base");
-                ValidationSupport.requireValueOrChildren(this);
+                amount = builder.amount;
+                base = builder.base;
             }
 
             /**
@@ -1691,7 +1717,18 @@ public Builder base(VisionBase base) {
                  */
                 @Override
                 public Prism build() {
-                    return new Prism(this);
+                    Prism prism = new Prism(this);
+                    if (validating) {
+                        validate(prism);
+                    }
+                    return prism;
+                }
+
+                protected void validate(Prism prism) {
+                    super.validate(prism);
+                    ValidationSupport.requireNonNull(prism.amount, "amount");
+                    ValidationSupport.requireNonNull(prism.base, "base");
+                    ValidationSupport.requireValueOrChildren(prism);
                 }
 
                 protected Builder from(Prism prism) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Address.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Address.java
index 3d3d1690a1d..0a91ba449a3 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Address.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Address.java
@@ -67,14 +67,13 @@ private Address(Builder builder) {
         use = builder.use;
         type = builder.type;
         text = builder.text;
-        line = Collections.unmodifiableList(ValidationSupport.checkList(builder.line, "line", String.class));
+        line = Collections.unmodifiableList(builder.line);
         city = builder.city;
         district = builder.district;
         state = builder.state;
         postalCode = builder.postalCode;
         country = builder.country;
         period = builder.period;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -520,7 +519,17 @@ public Builder period(Period period) {
          */
         @Override
         public Address build() {
-            return new Address(this);
+            Address address = new Address(this);
+            if (validating) {
+                validate(address);
+            }
+            return address;
+        }
+
+        protected void validate(Address address) {
+            super.validate(address);
+            ValidationSupport.checkList(address.line, "line", String.class);
+            ValidationSupport.requireValueOrChildren(address);
         }
 
         protected Builder from(Address address) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Age.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Age.java
index 20251fc2567..49dce92751f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Age.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Age.java
@@ -252,7 +252,15 @@ public Builder code(Code code) {
          */
         @Override
         public Age build() {
-            return new Age(this);
+            Age age = new Age(this);
+            if (validating) {
+                validate(age);
+            }
+            return age;
+        }
+
+        protected void validate(Age age) {
+            super.validate(age);
         }
 
         protected Builder from(Age age) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Annotation.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Annotation.java
index b063dc3458b..c251c0c319c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Annotation.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Annotation.java
@@ -35,11 +35,9 @@ public class Annotation extends Element {
 
     private Annotation(Builder builder) {
         super(builder);
-        author = ValidationSupport.choiceElement(builder.author, "author", Reference.class, String.class);
+        author = builder.author;
         time = builder.time;
-        text = ValidationSupport.requireNonNull(builder.text, "text");
-        ValidationSupport.checkReferenceType(author, "author", "Practitioner", "Patient", "RelatedPerson", "Organization");
-        ValidationSupport.requireValueOrChildren(this);
+        text = builder.text;
     }
 
     /**
@@ -274,7 +272,19 @@ public Builder text(Markdown text) {
          */
         @Override
         public Annotation build() {
-            return new Annotation(this);
+            Annotation annotation = new Annotation(this);
+            if (validating) {
+                validate(annotation);
+            }
+            return annotation;
+        }
+
+        protected void validate(Annotation annotation) {
+            super.validate(annotation);
+            ValidationSupport.choiceElement(annotation.author, "author", Reference.class, String.class);
+            ValidationSupport.requireNonNull(annotation.text, "text");
+            ValidationSupport.checkReferenceType(annotation.author, "author", "Practitioner", "Patient", "RelatedPerson", "Organization");
+            ValidationSupport.requireValueOrChildren(annotation);
         }
 
         protected Builder from(Annotation annotation) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Attachment.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Attachment.java
index 3e841f8d934..97de8d01740 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Attachment.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Attachment.java
@@ -77,8 +77,6 @@ private Attachment(Builder builder) {
         hash = builder.hash;
         title = builder.title;
         creation = builder.creation;
-        ValidationSupport.checkValueSetBinding(language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -439,7 +437,17 @@ public Builder creation(DateTime creation) {
          */
         @Override
         public Attachment build() {
-            return new Attachment(this);
+            Attachment attachment = new Attachment(this);
+            if (validating) {
+                validate(attachment);
+            }
+            return attachment;
+        }
+
+        protected void validate(Attachment attachment) {
+            super.validate(attachment);
+            ValidationSupport.checkValueSetBinding(attachment.language, "language", "http://hl7.org/fhir/ValueSet/all-languages", "urn:ietf:bcp:47");
+            ValidationSupport.requireValueOrChildren(attachment);
         }
 
         protected Builder from(Attachment attachment) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/BackboneElement.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/BackboneElement.java
index e38396e7461..3070ff6051b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/BackboneElement.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/BackboneElement.java
@@ -26,7 +26,7 @@ public abstract class BackboneElement extends Element {
 
     protected BackboneElement(Builder builder) {
         super(builder);
-        modifierExtension = Collections.unmodifiableList(ValidationSupport.checkList(builder.modifierExtension, "modifierExtension", Extension.class));
+        modifierExtension = Collections.unmodifiableList(builder.modifierExtension);
     }
 
     /**
@@ -169,6 +169,11 @@ public Builder modifierExtension(Collection<Extension> modifierExtension) {
         @Override
         public abstract BackboneElement build();
 
+        protected void validate(BackboneElement backboneElement) {
+            super.validate(backboneElement);
+            ValidationSupport.checkList(backboneElement.modifierExtension, "modifierExtension", Extension.class);
+        }
+
         protected Builder from(BackboneElement backboneElement) {
             super.from(backboneElement);
             modifierExtension.addAll(backboneElement.modifierExtension);
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Base64Binary.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Base64Binary.java
index 94a075b754e..7998209d729 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Base64Binary.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Base64Binary.java
@@ -26,7 +26,6 @@ public class Base64Binary extends Element {
     private Base64Binary(Builder builder) {
         super(builder);
         value = builder.value;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -223,7 +222,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Base64Binary build() {
-            return new Base64Binary(this);
+            Base64Binary base64Binary = new Base64Binary(this);
+            if (validating) {
+                validate(base64Binary);
+            }
+            return base64Binary;
+        }
+
+        protected void validate(Base64Binary base64Binary) {
+            super.validate(base64Binary);
+            ValidationSupport.requireValueOrChildren(base64Binary);
         }
 
         protected Builder from(Base64Binary base64Binary) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Boolean.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Boolean.java
index 5bcdfc1e107..0cba02fab1a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Boolean.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Boolean.java
@@ -27,7 +27,6 @@ public class Boolean extends Element {
     private Boolean(Builder builder) {
         super(builder);
         value = builder.value;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -213,7 +212,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Boolean build() {
-            return new Boolean(this);
+            Boolean _boolean = new Boolean(this);
+            if (validating) {
+                validate(_boolean);
+            }
+            return _boolean;
+        }
+
+        protected void validate(Boolean _boolean) {
+            super.validate(_boolean);
+            ValidationSupport.requireValueOrChildren(_boolean);
         }
 
         protected Builder from(Boolean _boolean) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Canonical.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Canonical.java
index a683e8ee93e..1812f4de267 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Canonical.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Canonical.java
@@ -225,7 +225,15 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Canonical build() {
-            return new Canonical(this);
+            Canonical canonical = new Canonical(this);
+            if (validating) {
+                validate(canonical);
+            }
+            return canonical;
+        }
+
+        protected void validate(Canonical canonical) {
+            super.validate(canonical);
         }
 
         protected Builder from(Canonical canonical) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Code.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Code.java
index 7376feab250..7784cb5bc3f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Code.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Code.java
@@ -22,7 +22,6 @@
 public class Code extends String {
     protected Code(Builder builder) {
         super(builder);
-        ValidationSupport.checkCode(value);
     }
 
     @Override
@@ -197,7 +196,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Code build() {
-            return new Code(this);
+            Code code = new Code(this);
+            if (validating) {
+                validate(code);
+            }
+            return code;
+        }
+
+        protected void validate(Code code) {
+            super.validate(code);
+            ValidationSupport.checkCode(code.value);
         }
 
         protected Builder from(Code code) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/CodeableConcept.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/CodeableConcept.java
index b2b2eff8314..857ada938c7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/CodeableConcept.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/CodeableConcept.java
@@ -30,9 +30,8 @@ public class CodeableConcept extends Element {
 
     private CodeableConcept(Builder builder) {
         super(builder);
-        coding = Collections.unmodifiableList(ValidationSupport.checkList(builder.coding, "coding", Coding.class));
+        coding = Collections.unmodifiableList(builder.coding);
         text = builder.text;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -239,7 +238,17 @@ public Builder text(String text) {
          */
         @Override
         public CodeableConcept build() {
-            return new CodeableConcept(this);
+            CodeableConcept codeableConcept = new CodeableConcept(this);
+            if (validating) {
+                validate(codeableConcept);
+            }
+            return codeableConcept;
+        }
+
+        protected void validate(CodeableConcept codeableConcept) {
+            super.validate(codeableConcept);
+            ValidationSupport.checkList(codeableConcept.coding, "coding", Coding.class);
+            ValidationSupport.requireValueOrChildren(codeableConcept);
         }
 
         protected Builder from(CodeableConcept codeableConcept) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Coding.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Coding.java
index ed724445148..e5c1e9bc715 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Coding.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Coding.java
@@ -38,7 +38,6 @@ private Coding(Builder builder) {
         code = builder.code;
         display = builder.display;
         userSelected = builder.userSelected;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -316,7 +315,16 @@ public Builder userSelected(Boolean userSelected) {
          */
         @Override
         public Coding build() {
-            return new Coding(this);
+            Coding coding = new Coding(this);
+            if (validating) {
+                validate(coding);
+            }
+            return coding;
+        }
+
+        protected void validate(Coding coding) {
+            super.validate(coding);
+            ValidationSupport.requireValueOrChildren(coding);
         }
 
         protected Builder from(Coding coding) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/ContactDetail.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/ContactDetail.java
index 9fb9d21ab66..2af1e2f8bf5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/ContactDetail.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/ContactDetail.java
@@ -31,8 +31,7 @@ public class ContactDetail extends Element {
     private ContactDetail(Builder builder) {
         super(builder);
         name = builder.name;
-        telecom = Collections.unmodifiableList(ValidationSupport.checkList(builder.telecom, "telecom", ContactPoint.class));
-        ValidationSupport.requireValueOrChildren(this);
+        telecom = Collections.unmodifiableList(builder.telecom);
     }
 
     /**
@@ -237,7 +236,17 @@ public Builder telecom(Collection<ContactPoint> telecom) {
          */
         @Override
         public ContactDetail build() {
-            return new ContactDetail(this);
+            ContactDetail contactDetail = new ContactDetail(this);
+            if (validating) {
+                validate(contactDetail);
+            }
+            return contactDetail;
+        }
+
+        protected void validate(ContactDetail contactDetail) {
+            super.validate(contactDetail);
+            ValidationSupport.checkList(contactDetail.telecom, "telecom", ContactPoint.class);
+            ValidationSupport.requireValueOrChildren(contactDetail);
         }
 
         protected Builder from(ContactDetail contactDetail) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/ContactPoint.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/ContactPoint.java
index 17cc792af38..30cdfa1f935 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/ContactPoint.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/ContactPoint.java
@@ -63,7 +63,6 @@ private ContactPoint(Builder builder) {
         use = builder.use;
         rank = builder.rank;
         period = builder.period;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -339,7 +338,16 @@ public Builder period(Period period) {
          */
         @Override
         public ContactPoint build() {
-            return new ContactPoint(this);
+            ContactPoint contactPoint = new ContactPoint(this);
+            if (validating) {
+                validate(contactPoint);
+            }
+            return contactPoint;
+        }
+
+        protected void validate(ContactPoint contactPoint) {
+            super.validate(contactPoint);
+            ValidationSupport.requireValueOrChildren(contactPoint);
         }
 
         protected Builder from(ContactPoint contactPoint) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Contributor.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Contributor.java
index 24c0930da9a..b93ee7f992e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Contributor.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Contributor.java
@@ -44,10 +44,9 @@ public class Contributor extends Element {
 
     private Contributor(Builder builder) {
         super(builder);
-        type = ValidationSupport.requireNonNull(builder.type, "type");
-        name = ValidationSupport.requireNonNull(builder.name, "name");
-        contact = Collections.unmodifiableList(ValidationSupport.checkList(builder.contact, "contact", ContactDetail.class));
-        ValidationSupport.requireValueOrChildren(this);
+        type = builder.type;
+        name = builder.name;
+        contact = Collections.unmodifiableList(builder.contact);
     }
 
     /**
@@ -291,7 +290,19 @@ public Builder contact(Collection<ContactDetail> contact) {
          */
         @Override
         public Contributor build() {
-            return new Contributor(this);
+            Contributor contributor = new Contributor(this);
+            if (validating) {
+                validate(contributor);
+            }
+            return contributor;
+        }
+
+        protected void validate(Contributor contributor) {
+            super.validate(contributor);
+            ValidationSupport.requireNonNull(contributor.type, "type");
+            ValidationSupport.requireNonNull(contributor.name, "name");
+            ValidationSupport.checkList(contributor.contact, "contact", ContactDetail.class);
+            ValidationSupport.requireValueOrChildren(contributor);
         }
 
         protected Builder from(Contributor contributor) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Count.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Count.java
index e57068d4064..2b6d2df2a87 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Count.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Count.java
@@ -236,7 +236,15 @@ public Builder code(Code code) {
          */
         @Override
         public Count build() {
-            return new Count(this);
+            Count count = new Count(this);
+            if (validating) {
+                validate(count);
+            }
+            return count;
+        }
+
+        protected void validate(Count count) {
+            super.validate(count);
         }
 
         protected Builder from(Count count) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/DataRequirement.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/DataRequirement.java
index 1679432ac3d..4291b731cb4 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/DataRequirement.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/DataRequirement.java
@@ -88,16 +88,14 @@ public class DataRequirement extends Element {
 
     private DataRequirement(Builder builder) {
         super(builder);
-        type = ValidationSupport.requireNonNull(builder.type, "type");
-        profile = Collections.unmodifiableList(ValidationSupport.checkList(builder.profile, "profile", Canonical.class));
-        subject = ValidationSupport.choiceElement(builder.subject, "subject", CodeableConcept.class, Reference.class);
-        mustSupport = Collections.unmodifiableList(ValidationSupport.checkList(builder.mustSupport, "mustSupport", String.class));
-        codeFilter = Collections.unmodifiableList(ValidationSupport.checkList(builder.codeFilter, "codeFilter", CodeFilter.class));
-        dateFilter = Collections.unmodifiableList(ValidationSupport.checkList(builder.dateFilter, "dateFilter", DateFilter.class));
+        type = builder.type;
+        profile = Collections.unmodifiableList(builder.profile);
+        subject = builder.subject;
+        mustSupport = Collections.unmodifiableList(builder.mustSupport);
+        codeFilter = Collections.unmodifiableList(builder.codeFilter);
+        dateFilter = Collections.unmodifiableList(builder.dateFilter);
         limit = builder.limit;
-        sort = Collections.unmodifiableList(ValidationSupport.checkList(builder.sort, "sort", Sort.class));
-        ValidationSupport.checkReferenceType(subject, "subject", "Group");
-        ValidationSupport.requireValueOrChildren(this);
+        sort = Collections.unmodifiableList(builder.sort);
     }
 
     /**
@@ -600,7 +598,24 @@ public Builder sort(Collection<Sort> sort) {
          */
         @Override
         public DataRequirement build() {
-            return new DataRequirement(this);
+            DataRequirement dataRequirement = new DataRequirement(this);
+            if (validating) {
+                validate(dataRequirement);
+            }
+            return dataRequirement;
+        }
+
+        protected void validate(DataRequirement dataRequirement) {
+            super.validate(dataRequirement);
+            ValidationSupport.requireNonNull(dataRequirement.type, "type");
+            ValidationSupport.checkList(dataRequirement.profile, "profile", Canonical.class);
+            ValidationSupport.choiceElement(dataRequirement.subject, "subject", CodeableConcept.class, Reference.class);
+            ValidationSupport.checkList(dataRequirement.mustSupport, "mustSupport", String.class);
+            ValidationSupport.checkList(dataRequirement.codeFilter, "codeFilter", CodeFilter.class);
+            ValidationSupport.checkList(dataRequirement.dateFilter, "dateFilter", DateFilter.class);
+            ValidationSupport.checkList(dataRequirement.sort, "sort", Sort.class);
+            ValidationSupport.checkReferenceType(dataRequirement.subject, "subject", "Group");
+            ValidationSupport.requireValueOrChildren(dataRequirement);
         }
 
         protected Builder from(DataRequirement dataRequirement) {
@@ -636,8 +651,7 @@ private CodeFilter(Builder builder) {
             path = builder.path;
             searchParam = builder.searchParam;
             valueSet = builder.valueSet;
-            code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", Coding.class));
-            ValidationSupport.requireValueOrChildren(this);
+            code = Collections.unmodifiableList(builder.code);
         }
 
         /**
@@ -969,7 +983,17 @@ public Builder code(Collection<Coding> code) {
              */
             @Override
             public CodeFilter build() {
-                return new CodeFilter(this);
+                CodeFilter codeFilter = new CodeFilter(this);
+                if (validating) {
+                    validate(codeFilter);
+                }
+                return codeFilter;
+            }
+
+            protected void validate(CodeFilter codeFilter) {
+                super.validate(codeFilter);
+                ValidationSupport.checkList(codeFilter.code, "code", Coding.class);
+                ValidationSupport.requireValueOrChildren(codeFilter);
             }
 
             protected Builder from(CodeFilter codeFilter) {
@@ -1000,8 +1024,7 @@ private DateFilter(Builder builder) {
             super(builder);
             path = builder.path;
             searchParam = builder.searchParam;
-            value = ValidationSupport.choiceElement(builder.value, "value", DateTime.class, Period.class, Duration.class);
-            ValidationSupport.requireValueOrChildren(this);
+            value = builder.value;
         }
 
         /**
@@ -1287,7 +1310,17 @@ public Builder value(Element value) {
              */
             @Override
             public DateFilter build() {
-                return new DateFilter(this);
+                DateFilter dateFilter = new DateFilter(this);
+                if (validating) {
+                    validate(dateFilter);
+                }
+                return dateFilter;
+            }
+
+            protected void validate(DateFilter dateFilter) {
+                super.validate(dateFilter);
+                ValidationSupport.choiceElement(dateFilter.value, "value", DateTime.class, Period.class, Duration.class);
+                ValidationSupport.requireValueOrChildren(dateFilter);
             }
 
             protected Builder from(DateFilter dateFilter) {
@@ -1319,9 +1352,8 @@ public static class Sort extends BackboneElement {
 
         private Sort(Builder builder) {
             super(builder);
-            path = ValidationSupport.requireNonNull(builder.path, "path");
-            direction = ValidationSupport.requireNonNull(builder.direction, "direction");
-            ValidationSupport.requireValueOrChildren(this);
+            path = builder.path;
+            direction = builder.direction;
         }
 
         /**
@@ -1569,7 +1601,18 @@ public Builder direction(SortDirection direction) {
              */
             @Override
             public Sort build() {
-                return new Sort(this);
+                Sort sort = new Sort(this);
+                if (validating) {
+                    validate(sort);
+                }
+                return sort;
+            }
+
+            protected void validate(Sort sort) {
+                super.validate(sort);
+                ValidationSupport.requireNonNull(sort.path, "path");
+                ValidationSupport.requireNonNull(sort.direction, "direction");
+                ValidationSupport.requireValueOrChildren(sort);
             }
 
             protected Builder from(Sort sort) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Date.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Date.java
index e3980681c86..d44522f6da3 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Date.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Date.java
@@ -32,8 +32,6 @@ public class Date extends Element {
     private Date(Builder builder) {
         super(builder);
         value = builder.value;
-        ValidationSupport.checkValueType(value, LocalDate.class, YearMonth.class, Year.class);
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -223,7 +221,17 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Date build() {
-            return new Date(this);
+            Date date = new Date(this);
+            if (validating) {
+                validate(date);
+            }
+            return date;
+        }
+
+        protected void validate(Date date) {
+            super.validate(date);
+            ValidationSupport.checkValueType(date.value, LocalDate.class, YearMonth.class, Year.class);
+            ValidationSupport.requireValueOrChildren(date);
         }
 
         protected Builder from(Date date) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/DateTime.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/DateTime.java
index 278c742e56d..3920e1039be 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/DateTime.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/DateTime.java
@@ -43,8 +43,6 @@ public class DateTime extends Element {
     private DateTime(Builder builder) {
         super(builder);
         value = ModelSupport.truncateTime(builder.value, ChronoUnit.MICROS);
-        ValidationSupport.checkValueType(value, ZonedDateTime.class, LocalDate.class, YearMonth.class, Year.class);
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -252,7 +250,17 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public DateTime build() {
-            return new DateTime(this);
+            DateTime dateTime = new DateTime(this);
+            if (validating) {
+                validate(dateTime);
+            }
+            return dateTime;
+        }
+
+        protected void validate(DateTime dateTime) {
+            super.validate(dateTime);
+            ValidationSupport.checkValueType(dateTime.value, ZonedDateTime.class, LocalDate.class, YearMonth.class, Year.class);
+            ValidationSupport.requireValueOrChildren(dateTime);
         }
 
         protected Builder from(DateTime dateTime) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Decimal.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Decimal.java
index e6b1737df23..db6cb668ff2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Decimal.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Decimal.java
@@ -25,7 +25,6 @@ public class Decimal extends Element {
     private Decimal(Builder builder) {
         super(builder);
         value = builder.value;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -222,7 +221,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Decimal build() {
-            return new Decimal(this);
+            Decimal decimal = new Decimal(this);
+            if (validating) {
+                validate(decimal);
+            }
+            return decimal;
+        }
+
+        protected void validate(Decimal decimal) {
+            super.validate(decimal);
+            ValidationSupport.requireValueOrChildren(decimal);
         }
 
         protected Builder from(Decimal decimal) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Distance.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Distance.java
index ef9f5cc5346..1b5ba249be2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Distance.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Distance.java
@@ -252,7 +252,15 @@ public Builder code(Code code) {
          */
         @Override
         public Distance build() {
-            return new Distance(this);
+            Distance distance = new Distance(this);
+            if (validating) {
+                validate(distance);
+            }
+            return distance;
+        }
+
+        protected void validate(Distance distance) {
+            super.validate(distance);
         }
 
         protected Builder from(Distance distance) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Dosage.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Dosage.java
index ffd077ccb61..f7026aa548c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Dosage.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Dosage.java
@@ -88,18 +88,17 @@ private Dosage(Builder builder) {
         super(builder);
         sequence = builder.sequence;
         text = builder.text;
-        additionalInstruction = Collections.unmodifiableList(ValidationSupport.checkList(builder.additionalInstruction, "additionalInstruction", CodeableConcept.class));
+        additionalInstruction = Collections.unmodifiableList(builder.additionalInstruction);
         patientInstruction = builder.patientInstruction;
         timing = builder.timing;
-        asNeeded = ValidationSupport.choiceElement(builder.asNeeded, "asNeeded", Boolean.class, CodeableConcept.class);
+        asNeeded = builder.asNeeded;
         site = builder.site;
         route = builder.route;
         method = builder.method;
-        doseAndRate = Collections.unmodifiableList(ValidationSupport.checkList(builder.doseAndRate, "doseAndRate", DoseAndRate.class));
+        doseAndRate = Collections.unmodifiableList(builder.doseAndRate);
         maxDosePerPeriod = builder.maxDosePerPeriod;
         maxDosePerAdministration = builder.maxDosePerAdministration;
         maxDosePerLifetime = builder.maxDosePerLifetime;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -708,7 +707,19 @@ public Builder maxDosePerLifetime(SimpleQuantity maxDosePerLifetime) {
          */
         @Override
         public Dosage build() {
-            return new Dosage(this);
+            Dosage dosage = new Dosage(this);
+            if (validating) {
+                validate(dosage);
+            }
+            return dosage;
+        }
+
+        protected void validate(Dosage dosage) {
+            super.validate(dosage);
+            ValidationSupport.checkList(dosage.additionalInstruction, "additionalInstruction", CodeableConcept.class);
+            ValidationSupport.choiceElement(dosage.asNeeded, "asNeeded", Boolean.class, CodeableConcept.class);
+            ValidationSupport.checkList(dosage.doseAndRate, "doseAndRate", DoseAndRate.class);
+            ValidationSupport.requireValueOrChildren(dosage);
         }
 
         protected Builder from(Dosage dosage) {
@@ -752,9 +763,8 @@ public static class DoseAndRate extends BackboneElement {
         private DoseAndRate(Builder builder) {
             super(builder);
             type = builder.type;
-            dose = ValidationSupport.choiceElement(builder.dose, "dose", Range.class, SimpleQuantity.class);
-            rate = ValidationSupport.choiceElement(builder.rate, "rate", Ratio.class, Range.class, SimpleQuantity.class);
-            ValidationSupport.requireValueOrChildren(this);
+            dose = builder.dose;
+            rate = builder.rate;
         }
 
         /**
@@ -1030,7 +1040,18 @@ public Builder rate(Element rate) {
              */
             @Override
             public DoseAndRate build() {
-                return new DoseAndRate(this);
+                DoseAndRate doseAndRate = new DoseAndRate(this);
+                if (validating) {
+                    validate(doseAndRate);
+                }
+                return doseAndRate;
+            }
+
+            protected void validate(DoseAndRate doseAndRate) {
+                super.validate(doseAndRate);
+                ValidationSupport.choiceElement(doseAndRate.dose, "dose", Range.class, SimpleQuantity.class);
+                ValidationSupport.choiceElement(doseAndRate.rate, "rate", Ratio.class, Range.class, SimpleQuantity.class);
+                ValidationSupport.requireValueOrChildren(doseAndRate);
             }
 
             protected Builder from(DoseAndRate doseAndRate) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Duration.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Duration.java
index 8a012768ee4..17667c05894 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Duration.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Duration.java
@@ -252,7 +252,15 @@ public Builder code(Code code) {
          */
         @Override
         public Duration build() {
-            return new Duration(this);
+            Duration duration = new Duration(this);
+            if (validating) {
+                validate(duration);
+            }
+            return duration;
+        }
+
+        protected void validate(Duration duration) {
+            super.validate(duration);
         }
 
         protected Builder from(Duration duration) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Element.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Element.java
index b3d267c323c..72f0e78ddff 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Element.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Element.java
@@ -38,8 +38,7 @@ public abstract class Element extends AbstractVisitable {
 
     protected Element(Builder builder) {
         id = builder.id;
-        extension = Collections.unmodifiableList(ValidationSupport.checkList(builder.extension, "extension", Extension.class));
-        ValidationSupport.checkString(id);
+        extension = Collections.unmodifiableList(builder.extension);
     }
 
     /**
@@ -166,6 +165,11 @@ public Builder extension(Collection<Extension> extension) {
         @Override
         public abstract Element build();
 
+        protected void validate(Element element) {
+            ValidationSupport.checkList(element.extension, "extension", Extension.class);
+            ValidationSupport.checkString(element.id);
+        }
+
         protected Builder from(Element element) {
             id = element.id;
             extension.addAll(element.extension);
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/ElementDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/ElementDefinition.java
index 1591c4e1684..385f6630e8c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/ElementDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/ElementDefinition.java
@@ -270,41 +270,40 @@ public class ElementDefinition extends BackboneElement {
 
     private ElementDefinition(Builder builder) {
         super(builder);
-        path = ValidationSupport.requireNonNull(builder.path, "path");
-        representation = Collections.unmodifiableList(ValidationSupport.checkList(builder.representation, "representation", PropertyRepresentation.class));
+        path = builder.path;
+        representation = Collections.unmodifiableList(builder.representation);
         sliceName = builder.sliceName;
         sliceIsConstraining = builder.sliceIsConstraining;
         label = builder.label;
-        code = Collections.unmodifiableList(ValidationSupport.checkList(builder.code, "code", Coding.class));
+        code = Collections.unmodifiableList(builder.code);
         slicing = builder.slicing;
         _short = builder._short;
         definition = builder.definition;
         comment = builder.comment;
         requirements = builder.requirements;
-        alias = Collections.unmodifiableList(ValidationSupport.checkList(builder.alias, "alias", String.class));
+        alias = Collections.unmodifiableList(builder.alias);
         min = builder.min;
         max = builder.max;
         base = builder.base;
         contentReference = builder.contentReference;
-        type = Collections.unmodifiableList(ValidationSupport.checkList(builder.type, "type", Type.class));
-        defaultValue = ValidationSupport.choiceElement(builder.defaultValue, "defaultValue", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+        type = Collections.unmodifiableList(builder.type);
+        defaultValue = builder.defaultValue;
         meaningWhenMissing = builder.meaningWhenMissing;
         orderMeaning = builder.orderMeaning;
-        fixed = ValidationSupport.choiceElement(builder.fixed, "fixed", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
-        pattern = ValidationSupport.choiceElement(builder.pattern, "pattern", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
-        example = Collections.unmodifiableList(ValidationSupport.checkList(builder.example, "example", Example.class));
-        minValue = ValidationSupport.choiceElement(builder.minValue, "minValue", Date.class, DateTime.class, Instant.class, Time.class, Decimal.class, Integer.class, PositiveInt.class, UnsignedInt.class, Quantity.class);
-        maxValue = ValidationSupport.choiceElement(builder.maxValue, "maxValue", Date.class, DateTime.class, Instant.class, Time.class, Decimal.class, Integer.class, PositiveInt.class, UnsignedInt.class, Quantity.class);
+        fixed = builder.fixed;
+        pattern = builder.pattern;
+        example = Collections.unmodifiableList(builder.example);
+        minValue = builder.minValue;
+        maxValue = builder.maxValue;
         maxLength = builder.maxLength;
-        condition = Collections.unmodifiableList(ValidationSupport.checkList(builder.condition, "condition", Id.class));
-        constraint = Collections.unmodifiableList(ValidationSupport.checkList(builder.constraint, "constraint", Constraint.class));
+        condition = Collections.unmodifiableList(builder.condition);
+        constraint = Collections.unmodifiableList(builder.constraint);
         mustSupport = builder.mustSupport;
         isModifier = builder.isModifier;
         isModifierReason = builder.isModifierReason;
         isSummary = builder.isSummary;
         binding = builder.binding;
-        mapping = Collections.unmodifiableList(ValidationSupport.checkList(builder.mapping, "mapping", Mapping.class));
-        ValidationSupport.requireValueOrChildren(this);
+        mapping = Collections.unmodifiableList(builder.mapping);
     }
 
     /**
@@ -1924,7 +1923,30 @@ public Builder mapping(Collection<Mapping> mapping) {
          */
         @Override
         public ElementDefinition build() {
-            return new ElementDefinition(this);
+            ElementDefinition elementDefinition = new ElementDefinition(this);
+            if (validating) {
+                validate(elementDefinition);
+            }
+            return elementDefinition;
+        }
+
+        protected void validate(ElementDefinition elementDefinition) {
+            super.validate(elementDefinition);
+            ValidationSupport.requireNonNull(elementDefinition.path, "path");
+            ValidationSupport.checkList(elementDefinition.representation, "representation", PropertyRepresentation.class);
+            ValidationSupport.checkList(elementDefinition.code, "code", Coding.class);
+            ValidationSupport.checkList(elementDefinition.alias, "alias", String.class);
+            ValidationSupport.checkList(elementDefinition.type, "type", Type.class);
+            ValidationSupport.choiceElement(elementDefinition.defaultValue, "defaultValue", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+            ValidationSupport.choiceElement(elementDefinition.fixed, "fixed", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+            ValidationSupport.choiceElement(elementDefinition.pattern, "pattern", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+            ValidationSupport.checkList(elementDefinition.example, "example", Example.class);
+            ValidationSupport.choiceElement(elementDefinition.minValue, "minValue", Date.class, DateTime.class, Instant.class, Time.class, Decimal.class, Integer.class, PositiveInt.class, UnsignedInt.class, Quantity.class);
+            ValidationSupport.choiceElement(elementDefinition.maxValue, "maxValue", Date.class, DateTime.class, Instant.class, Time.class, Decimal.class, Integer.class, PositiveInt.class, UnsignedInt.class, Quantity.class);
+            ValidationSupport.checkList(elementDefinition.condition, "condition", Id.class);
+            ValidationSupport.checkList(elementDefinition.constraint, "constraint", Constraint.class);
+            ValidationSupport.checkList(elementDefinition.mapping, "mapping", Mapping.class);
+            ValidationSupport.requireValueOrChildren(elementDefinition);
         }
 
         protected Builder from(ElementDefinition elementDefinition) {
@@ -1993,11 +2015,10 @@ public static class Slicing extends BackboneElement {
 
         private Slicing(Builder builder) {
             super(builder);
-            discriminator = Collections.unmodifiableList(ValidationSupport.checkList(builder.discriminator, "discriminator", Discriminator.class));
+            discriminator = Collections.unmodifiableList(builder.discriminator);
             description = builder.description;
             ordered = builder.ordered;
-            rules = ValidationSupport.requireNonNull(builder.rules, "rules");
-            ValidationSupport.requireValueOrChildren(this);
+            rules = builder.rules;
         }
 
         /**
@@ -2326,7 +2347,18 @@ public Builder rules(SlicingRules rules) {
              */
             @Override
             public Slicing build() {
-                return new Slicing(this);
+                Slicing slicing = new Slicing(this);
+                if (validating) {
+                    validate(slicing);
+                }
+                return slicing;
+            }
+
+            protected void validate(Slicing slicing) {
+                super.validate(slicing);
+                ValidationSupport.checkList(slicing.discriminator, "discriminator", Discriminator.class);
+                ValidationSupport.requireNonNull(slicing.rules, "rules");
+                ValidationSupport.requireValueOrChildren(slicing);
             }
 
             protected Builder from(Slicing slicing) {
@@ -2360,9 +2392,8 @@ public static class Discriminator extends BackboneElement {
 
             private Discriminator(Builder builder) {
                 super(builder);
-                type = ValidationSupport.requireNonNull(builder.type, "type");
-                path = ValidationSupport.requireNonNull(builder.path, "path");
-                ValidationSupport.requireValueOrChildren(this);
+                type = builder.type;
+                path = builder.path;
             }
 
             /**
@@ -2608,7 +2639,18 @@ public Builder path(String path) {
                  */
                 @Override
                 public Discriminator build() {
-                    return new Discriminator(this);
+                    Discriminator discriminator = new Discriminator(this);
+                    if (validating) {
+                        validate(discriminator);
+                    }
+                    return discriminator;
+                }
+
+                protected void validate(Discriminator discriminator) {
+                    super.validate(discriminator);
+                    ValidationSupport.requireNonNull(discriminator.type, "type");
+                    ValidationSupport.requireNonNull(discriminator.path, "path");
+                    ValidationSupport.requireValueOrChildren(discriminator);
                 }
 
                 protected Builder from(Discriminator discriminator) {
@@ -2641,10 +2683,9 @@ public static class Base extends BackboneElement {
 
         private Base(Builder builder) {
             super(builder);
-            path = ValidationSupport.requireNonNull(builder.path, "path");
-            min = ValidationSupport.requireNonNull(builder.min, "min");
-            max = ValidationSupport.requireNonNull(builder.max, "max");
-            ValidationSupport.requireValueOrChildren(this);
+            path = builder.path;
+            min = builder.min;
+            max = builder.max;
         }
 
         /**
@@ -2924,7 +2965,19 @@ public Builder max(String max) {
              */
             @Override
             public Base build() {
-                return new Base(this);
+                Base base = new Base(this);
+                if (validating) {
+                    validate(base);
+                }
+                return base;
+            }
+
+            protected void validate(Base base) {
+                super.validate(base);
+                ValidationSupport.requireNonNull(base.path, "path");
+                ValidationSupport.requireNonNull(base.min, "min");
+                ValidationSupport.requireNonNull(base.max, "max");
+                ValidationSupport.requireValueOrChildren(base);
             }
 
             protected Builder from(Base base) {
@@ -2973,12 +3026,11 @@ public static class Type extends BackboneElement {
 
         private Type(Builder builder) {
             super(builder);
-            code = ValidationSupport.requireNonNull(builder.code, "code");
-            profile = Collections.unmodifiableList(ValidationSupport.checkList(builder.profile, "profile", Canonical.class));
-            targetProfile = Collections.unmodifiableList(ValidationSupport.checkList(builder.targetProfile, "targetProfile", Canonical.class));
-            aggregation = Collections.unmodifiableList(ValidationSupport.checkList(builder.aggregation, "aggregation", AggregationMode.class));
+            code = builder.code;
+            profile = Collections.unmodifiableList(builder.profile);
+            targetProfile = Collections.unmodifiableList(builder.targetProfile);
+            aggregation = Collections.unmodifiableList(builder.aggregation);
             versioning = builder.versioning;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -3397,7 +3449,20 @@ public Builder versioning(ReferenceVersionRules versioning) {
              */
             @Override
             public Type build() {
-                return new Type(this);
+                Type type = new Type(this);
+                if (validating) {
+                    validate(type);
+                }
+                return type;
+            }
+
+            protected void validate(Type type) {
+                super.validate(type);
+                ValidationSupport.requireNonNull(type.code, "code");
+                ValidationSupport.checkList(type.profile, "profile", Canonical.class);
+                ValidationSupport.checkList(type.targetProfile, "targetProfile", Canonical.class);
+                ValidationSupport.checkList(type.aggregation, "aggregation", AggregationMode.class);
+                ValidationSupport.requireValueOrChildren(type);
             }
 
             protected Builder from(Type type) {
@@ -3426,9 +3491,8 @@ public static class Example extends BackboneElement {
 
         private Example(Builder builder) {
             super(builder);
-            label = ValidationSupport.requireNonNull(builder.label, "label");
-            value = ValidationSupport.requireChoiceElement(builder.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
-            ValidationSupport.requireValueOrChildren(this);
+            label = builder.label;
+            value = builder.value;
         }
 
         /**
@@ -3726,7 +3790,18 @@ public Builder value(Element value) {
              */
             @Override
             public Example build() {
-                return new Example(this);
+                Example example = new Example(this);
+                if (validating) {
+                    validate(example);
+                }
+                return example;
+            }
+
+            protected void validate(Example example) {
+                super.validate(example);
+                ValidationSupport.requireNonNull(example.label, "label");
+                ValidationSupport.requireChoiceElement(example.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+                ValidationSupport.requireValueOrChildren(example);
             }
 
             protected Builder from(Example example) {
@@ -3769,14 +3844,13 @@ public static class Constraint extends BackboneElement {
 
         private Constraint(Builder builder) {
             super(builder);
-            key = ValidationSupport.requireNonNull(builder.key, "key");
+            key = builder.key;
             requirements = builder.requirements;
-            severity = ValidationSupport.requireNonNull(builder.severity, "severity");
-            human = ValidationSupport.requireNonNull(builder.human, "human");
+            severity = builder.severity;
+            human = builder.human;
             expression = builder.expression;
             xpath = builder.xpath;
             source = builder.source;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -4170,7 +4244,19 @@ public Builder source(Canonical source) {
              */
             @Override
             public Constraint build() {
-                return new Constraint(this);
+                Constraint constraint = new Constraint(this);
+                if (validating) {
+                    validate(constraint);
+                }
+                return constraint;
+            }
+
+            protected void validate(Constraint constraint) {
+                super.validate(constraint);
+                ValidationSupport.requireNonNull(constraint.key, "key");
+                ValidationSupport.requireNonNull(constraint.severity, "severity");
+                ValidationSupport.requireNonNull(constraint.human, "human");
+                ValidationSupport.requireValueOrChildren(constraint);
             }
 
             protected Builder from(Constraint constraint) {
@@ -4208,10 +4294,9 @@ public static class Binding extends BackboneElement {
 
         private Binding(Builder builder) {
             super(builder);
-            strength = ValidationSupport.requireNonNull(builder.strength, "strength");
+            strength = builder.strength;
             description = builder.description;
             valueSet = builder.valueSet;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -4483,7 +4568,17 @@ public Builder valueSet(Canonical valueSet) {
              */
             @Override
             public Binding build() {
-                return new Binding(this);
+                Binding binding = new Binding(this);
+                if (validating) {
+                    validate(binding);
+                }
+                return binding;
+            }
+
+            protected void validate(Binding binding) {
+                super.validate(binding);
+                ValidationSupport.requireNonNull(binding.strength, "strength");
+                ValidationSupport.requireValueOrChildren(binding);
             }
 
             protected Builder from(Binding binding) {
@@ -4519,11 +4614,10 @@ public static class Mapping extends BackboneElement {
 
         private Mapping(Builder builder) {
             super(builder);
-            identity = ValidationSupport.requireNonNull(builder.identity, "identity");
+            identity = builder.identity;
             language = builder.language;
-            map = ValidationSupport.requireNonNull(builder.map, "map");
+            map = builder.map;
             comment = builder.comment;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -4825,7 +4919,18 @@ public Builder comment(String comment) {
              */
             @Override
             public Mapping build() {
-                return new Mapping(this);
+                Mapping mapping = new Mapping(this);
+                if (validating) {
+                    validate(mapping);
+                }
+                return mapping;
+            }
+
+            protected void validate(Mapping mapping) {
+                super.validate(mapping);
+                ValidationSupport.requireNonNull(mapping.identity, "identity");
+                ValidationSupport.requireNonNull(mapping.map, "map");
+                ValidationSupport.requireValueOrChildren(mapping);
             }
 
             protected Builder from(Mapping mapping) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Expression.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Expression.java
index 03e12d8184f..753293a6352 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Expression.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Expression.java
@@ -63,10 +63,9 @@ private Expression(Builder builder) {
         super(builder);
         description = builder.description;
         name = builder.name;
-        language = ValidationSupport.requireNonNull(builder.language, "language");
+        language = builder.language;
         expression = builder.expression;
         reference = builder.reference;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -347,7 +346,17 @@ public Builder reference(Uri reference) {
          */
         @Override
         public Expression build() {
-            return new Expression(this);
+            Expression expression = new Expression(this);
+            if (validating) {
+                validate(expression);
+            }
+            return expression;
+        }
+
+        protected void validate(Expression expression) {
+            super.validate(expression);
+            ValidationSupport.requireNonNull(expression.language, "language");
+            ValidationSupport.requireValueOrChildren(expression);
         }
 
         protected Builder from(Expression expression) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Extension.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Extension.java
index a5a3708ad03..8f1ad4a42c1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Extension.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Extension.java
@@ -36,10 +36,8 @@ public class Extension extends Element {
 
     private Extension(Builder builder) {
         super(builder);
-        url = ValidationSupport.requireNonNull(builder.url, "url");
-        value = ValidationSupport.choiceElement(builder.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
-        ValidationSupport.checkUri(url);
-        ValidationSupport.requireValueOrChildren(this);
+        url = builder.url;
+        value = builder.value;
     }
 
     /**
@@ -287,7 +285,19 @@ public Builder value(Element value) {
          */
         @Override
         public Extension build() {
-            return new Extension(this);
+            Extension extension = new Extension(this);
+            if (validating) {
+                validate(extension);
+            }
+            return extension;
+        }
+
+        protected void validate(Extension extension) {
+            super.validate(extension);
+            ValidationSupport.requireNonNull(extension.url, "url");
+            ValidationSupport.choiceElement(extension.value, "value", Base64Binary.class, Boolean.class, Canonical.class, Code.class, Date.class, DateTime.class, Decimal.class, Id.class, Instant.class, Integer.class, Markdown.class, Oid.class, PositiveInt.class, String.class, Time.class, UnsignedInt.class, Uri.class, Url.class, Uuid.class, Address.class, Age.class, Annotation.class, Attachment.class, CodeableConcept.class, Coding.class, ContactPoint.class, Count.class, Distance.class, Duration.class, HumanName.class, Identifier.class, Money.class, Period.class, Quantity.class, Range.class, Ratio.class, Reference.class, SampledData.class, Signature.class, Timing.class, ContactDetail.class, Contributor.class, DataRequirement.class, Expression.class, ParameterDefinition.class, RelatedArtifact.class, TriggerDefinition.class, UsageContext.class, Dosage.class, Meta.class);
+            ValidationSupport.checkUri(extension.url);
+            ValidationSupport.requireValueOrChildren(extension);
         }
 
         protected Builder from(Extension extension) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/HumanName.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/HumanName.java
index 0478329e68c..0909ee99db8 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/HumanName.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/HumanName.java
@@ -52,11 +52,10 @@ private HumanName(Builder builder) {
         use = builder.use;
         text = builder.text;
         family = builder.family;
-        given = Collections.unmodifiableList(ValidationSupport.checkList(builder.given, "given", String.class));
-        prefix = Collections.unmodifiableList(ValidationSupport.checkList(builder.prefix, "prefix", String.class));
-        suffix = Collections.unmodifiableList(ValidationSupport.checkList(builder.suffix, "suffix", String.class));
+        given = Collections.unmodifiableList(builder.given);
+        prefix = Collections.unmodifiableList(builder.prefix);
+        suffix = Collections.unmodifiableList(builder.suffix);
         period = builder.period;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -456,7 +455,19 @@ public Builder period(Period period) {
          */
         @Override
         public HumanName build() {
-            return new HumanName(this);
+            HumanName humanName = new HumanName(this);
+            if (validating) {
+                validate(humanName);
+            }
+            return humanName;
+        }
+
+        protected void validate(HumanName humanName) {
+            super.validate(humanName);
+            ValidationSupport.checkList(humanName.given, "given", String.class);
+            ValidationSupport.checkList(humanName.prefix, "prefix", String.class);
+            ValidationSupport.checkList(humanName.suffix, "suffix", String.class);
+            ValidationSupport.requireValueOrChildren(humanName);
         }
 
         protected Builder from(HumanName humanName) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Id.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Id.java
index 667a3c16c9e..1eb854a6e6b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Id.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Id.java
@@ -22,7 +22,6 @@
 public class Id extends String {
     private Id(Builder builder) {
         super(builder);
-        ValidationSupport.checkId(value);
     }
 
     @Override
@@ -186,7 +185,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Id build() {
-            return new Id(this);
+            Id id = new Id(this);
+            if (validating) {
+                validate(id);
+            }
+            return id;
+        }
+
+        protected void validate(Id id) {
+            super.validate(id);
+            ValidationSupport.checkId(id.value);
         }
 
         protected Builder from(Id id) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Identifier.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Identifier.java
index 53301be3377..d50fb994675 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Identifier.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Identifier.java
@@ -67,8 +67,6 @@ private Identifier(Builder builder) {
         value = builder.value;
         period = builder.period;
         assigner = builder.assigner;
-        ValidationSupport.checkReferenceType(assigner, "assigner", "Organization");
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -374,7 +372,17 @@ public Builder assigner(Reference assigner) {
          */
         @Override
         public Identifier build() {
-            return new Identifier(this);
+            Identifier identifier = new Identifier(this);
+            if (validating) {
+                validate(identifier);
+            }
+            return identifier;
+        }
+
+        protected void validate(Identifier identifier) {
+            super.validate(identifier);
+            ValidationSupport.checkReferenceType(identifier.assigner, "assigner", "Organization");
+            ValidationSupport.requireValueOrChildren(identifier);
         }
 
         protected Builder from(Identifier identifier) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Instant.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Instant.java
index b6cfe3d0206..3f44ba2cd44 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Instant.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Instant.java
@@ -36,7 +36,6 @@ public class Instant extends Element {
     private Instant(Builder builder) {
         super(builder);
         value = ModelSupport.truncateTime(builder.value, ChronoUnit.MICROS);
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -240,7 +239,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Instant build() {
-            return new Instant(this);
+            Instant instant = new Instant(this);
+            if (validating) {
+                validate(instant);
+            }
+            return instant;
+        }
+
+        protected void validate(Instant instant) {
+            super.validate(instant);
+            ValidationSupport.requireValueOrChildren(instant);
         }
 
         protected Builder from(Instant instant) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Integer.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Integer.java
index 78a6ec437ff..843da9519de 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Integer.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Integer.java
@@ -24,7 +24,6 @@ public class Integer extends Element {
     protected Integer(Builder builder) {
         super(builder);
         value = builder.value;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -221,7 +220,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Integer build() {
-            return new Integer(this);
+            Integer integer = new Integer(this);
+            if (validating) {
+                validate(integer);
+            }
+            return integer;
+        }
+
+        protected void validate(Integer integer) {
+            super.validate(integer);
+            ValidationSupport.requireValueOrChildren(integer);
         }
 
         protected Builder from(Integer integer) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Markdown.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Markdown.java
index 7e89253e002..5c82ce78858 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Markdown.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Markdown.java
@@ -183,7 +183,15 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Markdown build() {
-            return new Markdown(this);
+            Markdown markdown = new Markdown(this);
+            if (validating) {
+                validate(markdown);
+            }
+            return markdown;
+        }
+
+        protected void validate(Markdown markdown) {
+            super.validate(markdown);
         }
 
         protected Builder from(Markdown markdown) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/MarketingStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/MarketingStatus.java
index e8fde2f11e7..1baf075e233 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/MarketingStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/MarketingStatus.java
@@ -38,12 +38,11 @@ public class MarketingStatus extends BackboneElement {
 
     private MarketingStatus(Builder builder) {
         super(builder);
-        country = ValidationSupport.requireNonNull(builder.country, "country");
+        country = builder.country;
         jurisdiction = builder.jurisdiction;
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        dateRange = ValidationSupport.requireNonNull(builder.dateRange, "dateRange");
+        status = builder.status;
+        dateRange = builder.dateRange;
         restoreDate = builder.restoreDate;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -409,7 +408,19 @@ public Builder restoreDate(DateTime restoreDate) {
          */
         @Override
         public MarketingStatus build() {
-            return new MarketingStatus(this);
+            MarketingStatus marketingStatus = new MarketingStatus(this);
+            if (validating) {
+                validate(marketingStatus);
+            }
+            return marketingStatus;
+        }
+
+        protected void validate(MarketingStatus marketingStatus) {
+            super.validate(marketingStatus);
+            ValidationSupport.requireNonNull(marketingStatus.country, "country");
+            ValidationSupport.requireNonNull(marketingStatus.status, "status");
+            ValidationSupport.requireNonNull(marketingStatus.dateRange, "dateRange");
+            ValidationSupport.requireValueOrChildren(marketingStatus);
         }
 
         protected Builder from(MarketingStatus marketingStatus) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Meta.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Meta.java
index 73afcb64a18..c7598202dfb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Meta.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Meta.java
@@ -65,10 +65,9 @@ private Meta(Builder builder) {
         versionId = builder.versionId;
         lastUpdated = builder.lastUpdated;
         source = builder.source;
-        profile = Collections.unmodifiableList(ValidationSupport.checkList(builder.profile, "profile", Canonical.class));
-        security = Collections.unmodifiableList(ValidationSupport.checkList(builder.security, "security", Coding.class));
-        tag = Collections.unmodifiableList(ValidationSupport.checkList(builder.tag, "tag", Coding.class));
-        ValidationSupport.requireValueOrChildren(this);
+        profile = Collections.unmodifiableList(builder.profile);
+        security = Collections.unmodifiableList(builder.security);
+        tag = Collections.unmodifiableList(builder.tag);
     }
 
     /**
@@ -447,7 +446,19 @@ public Builder tag(Collection<Coding> tag) {
          */
         @Override
         public Meta build() {
-            return new Meta(this);
+            Meta meta = new Meta(this);
+            if (validating) {
+                validate(meta);
+            }
+            return meta;
+        }
+
+        protected void validate(Meta meta) {
+            super.validate(meta);
+            ValidationSupport.checkList(meta.profile, "profile", Canonical.class);
+            ValidationSupport.checkList(meta.security, "security", Coding.class);
+            ValidationSupport.checkList(meta.tag, "tag", Coding.class);
+            ValidationSupport.requireValueOrChildren(meta);
         }
 
         protected Builder from(Meta meta) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Money.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Money.java
index 1c4b2ee248b..190692fa563 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Money.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Money.java
@@ -37,7 +37,6 @@ private Money(Builder builder) {
         super(builder);
         value = builder.value;
         currency = builder.currency;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -222,7 +221,16 @@ public Builder currency(Code currency) {
          */
         @Override
         public Money build() {
-            return new Money(this);
+            Money money = new Money(this);
+            if (validating) {
+                validate(money);
+            }
+            return money;
+        }
+
+        protected void validate(Money money) {
+            super.validate(money);
+            ValidationSupport.requireValueOrChildren(money);
         }
 
         protected Builder from(Money money) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/MoneyQuantity.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/MoneyQuantity.java
index 789b17afe41..f75a052354e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/MoneyQuantity.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/MoneyQuantity.java
@@ -236,7 +236,15 @@ public Builder code(Code code) {
          */
         @Override
         public MoneyQuantity build() {
-            return new MoneyQuantity(this);
+            MoneyQuantity moneyQuantity = new MoneyQuantity(this);
+            if (validating) {
+                validate(moneyQuantity);
+            }
+            return moneyQuantity;
+        }
+
+        protected void validate(MoneyQuantity moneyQuantity) {
+            super.validate(moneyQuantity);
         }
 
         protected Builder from(MoneyQuantity moneyQuantity) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Narrative.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Narrative.java
index 14a67405e8d..da48282d66b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Narrative.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Narrative.java
@@ -53,9 +53,8 @@ public class Narrative extends Element {
 
     private Narrative(Builder builder) {
         super(builder);
-        status = ValidationSupport.requireNonNull(builder.status, "status");
-        div = ValidationSupport.requireNonNull(builder.div, "div");
-        ValidationSupport.requireValueOrChildren(this);
+        status = builder.status;
+        div = builder.div;
     }
 
     /**
@@ -252,7 +251,18 @@ public Builder div(Xhtml div) {
          */
         @Override
         public Narrative build() {
-            return new Narrative(this);
+            Narrative narrative = new Narrative(this);
+            if (validating) {
+                validate(narrative);
+            }
+            return narrative;
+        }
+
+        protected void validate(Narrative narrative) {
+            super.validate(narrative);
+            ValidationSupport.requireNonNull(narrative.status, "status");
+            ValidationSupport.requireNonNull(narrative.div, "div");
+            ValidationSupport.requireValueOrChildren(narrative);
         }
 
         protected Builder from(Narrative narrative) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Oid.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Oid.java
index afa25e51f6b..9465b118fb7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Oid.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Oid.java
@@ -24,7 +24,6 @@ public class Oid extends Uri {
 
     private Oid(Builder builder) {
         super(builder);
-        ValidationSupport.checkValue(value, PATTERN);
     }
 
     @Override
@@ -188,7 +187,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Oid build() {
-            return new Oid(this);
+            Oid oid = new Oid(this);
+            if (validating) {
+                validate(oid);
+            }
+            return oid;
+        }
+
+        protected void validate(Oid oid) {
+            super.validate(oid);
+            ValidationSupport.checkValue(oid.value, PATTERN);
         }
 
         protected Builder from(Oid oid) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/ParameterDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/ParameterDefinition.java
index 51d8c022191..1ac166839c1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/ParameterDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/ParameterDefinition.java
@@ -58,13 +58,12 @@ public class ParameterDefinition extends Element {
     private ParameterDefinition(Builder builder) {
         super(builder);
         name = builder.name;
-        use = ValidationSupport.requireNonNull(builder.use, "use");
+        use = builder.use;
         min = builder.min;
         max = builder.max;
         documentation = builder.documentation;
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        type = builder.type;
         profile = builder.profile;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -404,7 +403,18 @@ public Builder profile(Canonical profile) {
          */
         @Override
         public ParameterDefinition build() {
-            return new ParameterDefinition(this);
+            ParameterDefinition parameterDefinition = new ParameterDefinition(this);
+            if (validating) {
+                validate(parameterDefinition);
+            }
+            return parameterDefinition;
+        }
+
+        protected void validate(ParameterDefinition parameterDefinition) {
+            super.validate(parameterDefinition);
+            ValidationSupport.requireNonNull(parameterDefinition.use, "use");
+            ValidationSupport.requireNonNull(parameterDefinition.type, "type");
+            ValidationSupport.requireValueOrChildren(parameterDefinition);
         }
 
         protected Builder from(ParameterDefinition parameterDefinition) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Period.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Period.java
index 87630ecab53..cd50b53da0b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Period.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Period.java
@@ -37,7 +37,6 @@ private Period(Builder builder) {
         super(builder);
         start = builder.start;
         end = builder.end;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -226,7 +225,16 @@ public Builder end(DateTime end) {
          */
         @Override
         public Period build() {
-            return new Period(this);
+            Period period = new Period(this);
+            if (validating) {
+                validate(period);
+            }
+            return period;
+        }
+
+        protected void validate(Period period) {
+            super.validate(period);
+            ValidationSupport.requireValueOrChildren(period);
         }
 
         protected Builder from(Period period) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Population.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Population.java
index c92fd56b0ce..6bfe88ae768 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Population.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Population.java
@@ -33,11 +33,10 @@ public class Population extends BackboneElement {
 
     private Population(Builder builder) {
         super(builder);
-        age = ValidationSupport.choiceElement(builder.age, "age", Range.class, CodeableConcept.class);
+        age = builder.age;
         gender = builder.gender;
         race = builder.race;
         physiologicalCondition = builder.physiologicalCondition;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -337,7 +336,17 @@ public Builder physiologicalCondition(CodeableConcept physiologicalCondition) {
          */
         @Override
         public Population build() {
-            return new Population(this);
+            Population population = new Population(this);
+            if (validating) {
+                validate(population);
+            }
+            return population;
+        }
+
+        protected void validate(Population population) {
+            super.validate(population);
+            ValidationSupport.choiceElement(population.age, "age", Range.class, CodeableConcept.class);
+            ValidationSupport.requireValueOrChildren(population);
         }
 
         protected Builder from(Population population) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/PositiveInt.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/PositiveInt.java
index c818b0e1886..8fe3b6ddd7f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/PositiveInt.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/PositiveInt.java
@@ -23,8 +23,6 @@ public class PositiveInt extends Integer {
 
     private PositiveInt(Builder builder) {
         super(builder);
-        ValidationSupport.checkValue(value, MIN_VALUE);
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     @Override
@@ -208,7 +206,17 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public PositiveInt build() {
-            return new PositiveInt(this);
+            PositiveInt positiveInt = new PositiveInt(this);
+            if (validating) {
+                validate(positiveInt);
+            }
+            return positiveInt;
+        }
+
+        protected void validate(PositiveInt positiveInt) {
+            super.validate(positiveInt);
+            ValidationSupport.checkValue(positiveInt.value, MIN_VALUE);
+            ValidationSupport.requireValueOrChildren(positiveInt);
         }
 
         protected Builder from(PositiveInt positiveInt) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/ProdCharacteristic.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/ProdCharacteristic.java
index ea1dc2194c2..719392fa092 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/ProdCharacteristic.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/ProdCharacteristic.java
@@ -56,11 +56,10 @@ private ProdCharacteristic(Builder builder) {
         nominalVolume = builder.nominalVolume;
         externalDiameter = builder.externalDiameter;
         shape = builder.shape;
-        color = Collections.unmodifiableList(ValidationSupport.checkList(builder.color, "color", String.class));
-        imprint = Collections.unmodifiableList(ValidationSupport.checkList(builder.imprint, "imprint", String.class));
-        image = Collections.unmodifiableList(ValidationSupport.checkList(builder.image, "image", Attachment.class));
+        color = Collections.unmodifiableList(builder.color);
+        imprint = Collections.unmodifiableList(builder.imprint);
+        image = Collections.unmodifiableList(builder.image);
         scoring = builder.scoring;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -669,7 +668,19 @@ public Builder scoring(CodeableConcept scoring) {
          */
         @Override
         public ProdCharacteristic build() {
-            return new ProdCharacteristic(this);
+            ProdCharacteristic prodCharacteristic = new ProdCharacteristic(this);
+            if (validating) {
+                validate(prodCharacteristic);
+            }
+            return prodCharacteristic;
+        }
+
+        protected void validate(ProdCharacteristic prodCharacteristic) {
+            super.validate(prodCharacteristic);
+            ValidationSupport.checkList(prodCharacteristic.color, "color", String.class);
+            ValidationSupport.checkList(prodCharacteristic.imprint, "imprint", String.class);
+            ValidationSupport.checkList(prodCharacteristic.image, "image", Attachment.class);
+            ValidationSupport.requireValueOrChildren(prodCharacteristic);
         }
 
         protected Builder from(ProdCharacteristic prodCharacteristic) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/ProductShelfLife.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/ProductShelfLife.java
index 90e1a04e317..fccefe4f577 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/ProductShelfLife.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/ProductShelfLife.java
@@ -38,10 +38,9 @@ public class ProductShelfLife extends BackboneElement {
     private ProductShelfLife(Builder builder) {
         super(builder);
         identifier = builder.identifier;
-        type = ValidationSupport.requireNonNull(builder.type, "type");
-        period = ValidationSupport.requireNonNull(builder.period, "period");
-        specialPrecautionsForStorage = Collections.unmodifiableList(ValidationSupport.checkList(builder.specialPrecautionsForStorage, "specialPrecautionsForStorage", CodeableConcept.class));
-        ValidationSupport.requireValueOrChildren(this);
+        type = builder.type;
+        period = builder.period;
+        specialPrecautionsForStorage = Collections.unmodifiableList(builder.specialPrecautionsForStorage);
     }
 
     /**
@@ -385,7 +384,19 @@ public Builder specialPrecautionsForStorage(Collection<CodeableConcept> specialP
          */
         @Override
         public ProductShelfLife build() {
-            return new ProductShelfLife(this);
+            ProductShelfLife productShelfLife = new ProductShelfLife(this);
+            if (validating) {
+                validate(productShelfLife);
+            }
+            return productShelfLife;
+        }
+
+        protected void validate(ProductShelfLife productShelfLife) {
+            super.validate(productShelfLife);
+            ValidationSupport.requireNonNull(productShelfLife.type, "type");
+            ValidationSupport.requireNonNull(productShelfLife.period, "period");
+            ValidationSupport.checkList(productShelfLife.specialPrecautionsForStorage, "specialPrecautionsForStorage", CodeableConcept.class);
+            ValidationSupport.requireValueOrChildren(productShelfLife);
         }
 
         protected Builder from(ProductShelfLife productShelfLife) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Quantity.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Quantity.java
index 5ae6f0dae6a..a03291e72ab 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Quantity.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Quantity.java
@@ -56,7 +56,6 @@ protected Quantity(Builder builder) {
         unit = builder.unit;
         system = builder.system;
         code = builder.code;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -330,7 +329,16 @@ public Builder code(Code code) {
          */
         @Override
         public Quantity build() {
-            return new Quantity(this);
+            Quantity quantity = new Quantity(this);
+            if (validating) {
+                validate(quantity);
+            }
+            return quantity;
+        }
+
+        protected void validate(Quantity quantity) {
+            super.validate(quantity);
+            ValidationSupport.requireValueOrChildren(quantity);
         }
 
         protected Builder from(Quantity quantity) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Range.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Range.java
index 2b806adc410..dc7aee4c7d7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Range.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Range.java
@@ -37,7 +37,6 @@ private Range(Builder builder) {
         super(builder);
         low = builder.low;
         high = builder.high;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -222,7 +221,16 @@ public Builder high(SimpleQuantity high) {
          */
         @Override
         public Range build() {
-            return new Range(this);
+            Range range = new Range(this);
+            if (validating) {
+                validate(range);
+            }
+            return range;
+        }
+
+        protected void validate(Range range) {
+            super.validate(range);
+            ValidationSupport.requireValueOrChildren(range);
         }
 
         protected Builder from(Range range) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Ratio.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Ratio.java
index 3ae520d3334..6f89ec21ce7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Ratio.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Ratio.java
@@ -37,7 +37,6 @@ private Ratio(Builder builder) {
         super(builder);
         numerator = builder.numerator;
         denominator = builder.denominator;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -222,7 +221,16 @@ public Builder denominator(Quantity denominator) {
          */
         @Override
         public Ratio build() {
-            return new Ratio(this);
+            Ratio ratio = new Ratio(this);
+            if (validating) {
+                validate(ratio);
+            }
+            return ratio;
+        }
+
+        protected void validate(Ratio ratio) {
+            super.validate(ratio);
+            ValidationSupport.requireValueOrChildren(ratio);
         }
 
         protected Builder from(Ratio ratio) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Reference.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Reference.java
index fb01d42aec6..922ebc5bde0 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Reference.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Reference.java
@@ -59,7 +59,6 @@ private Reference(Builder builder) {
         type = builder.type;
         identifier = builder.identifier;
         display = builder.display;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -330,7 +329,16 @@ public Builder display(String display) {
          */
         @Override
         public Reference build() {
-            return new Reference(this);
+            Reference reference = new Reference(this);
+            if (validating) {
+                validate(reference);
+            }
+            return reference;
+        }
+
+        protected void validate(Reference reference) {
+            super.validate(reference);
+            ValidationSupport.requireValueOrChildren(reference);
         }
 
         protected Builder from(Reference reference) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/RelatedArtifact.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/RelatedArtifact.java
index 23cae9711bb..7bf82303471 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/RelatedArtifact.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/RelatedArtifact.java
@@ -48,14 +48,13 @@ public class RelatedArtifact extends Element {
 
     private RelatedArtifact(Builder builder) {
         super(builder);
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        type = builder.type;
         label = builder.label;
         display = builder.display;
         citation = builder.citation;
         url = builder.url;
         document = builder.document;
         resource = builder.resource;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -396,7 +395,17 @@ public Builder resource(Canonical resource) {
          */
         @Override
         public RelatedArtifact build() {
-            return new RelatedArtifact(this);
+            RelatedArtifact relatedArtifact = new RelatedArtifact(this);
+            if (validating) {
+                validate(relatedArtifact);
+            }
+            return relatedArtifact;
+        }
+
+        protected void validate(RelatedArtifact relatedArtifact) {
+            super.validate(relatedArtifact);
+            ValidationSupport.requireNonNull(relatedArtifact.type, "type");
+            ValidationSupport.requireValueOrChildren(relatedArtifact);
         }
 
         protected Builder from(RelatedArtifact relatedArtifact) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/SampledData.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/SampledData.java
index 14707106bcf..06575205d46 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/SampledData.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/SampledData.java
@@ -41,14 +41,13 @@ public class SampledData extends Element {
 
     private SampledData(Builder builder) {
         super(builder);
-        origin = ValidationSupport.requireNonNull(builder.origin, "origin");
-        period = ValidationSupport.requireNonNull(builder.period, "period");
+        origin = builder.origin;
+        period = builder.period;
         factor = builder.factor;
         lowerLimit = builder.lowerLimit;
         upperLimit = builder.upperLimit;
-        dimensions = ValidationSupport.requireNonNull(builder.dimensions, "dimensions");
+        dimensions = builder.dimensions;
         data = builder.data;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -401,7 +400,19 @@ public Builder data(String data) {
          */
         @Override
         public SampledData build() {
-            return new SampledData(this);
+            SampledData sampledData = new SampledData(this);
+            if (validating) {
+                validate(sampledData);
+            }
+            return sampledData;
+        }
+
+        protected void validate(SampledData sampledData) {
+            super.validate(sampledData);
+            ValidationSupport.requireNonNull(sampledData.origin, "origin");
+            ValidationSupport.requireNonNull(sampledData.period, "period");
+            ValidationSupport.requireNonNull(sampledData.dimensions, "dimensions");
+            ValidationSupport.requireValueOrChildren(sampledData);
         }
 
         protected Builder from(SampledData sampledData) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Signature.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Signature.java
index 3f947c721d8..4c4be1a088f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Signature.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Signature.java
@@ -75,16 +75,13 @@ public class Signature extends Element {
 
     private Signature(Builder builder) {
         super(builder);
-        type = Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder.type, "type", Coding.class));
-        when = ValidationSupport.requireNonNull(builder.when, "when");
-        who = ValidationSupport.requireNonNull(builder.who, "who");
+        type = Collections.unmodifiableList(builder.type);
+        when = builder.when;
+        who = builder.who;
         onBehalfOf = builder.onBehalfOf;
         targetFormat = builder.targetFormat;
         sigFormat = builder.sigFormat;
         data = builder.data;
-        ValidationSupport.checkReferenceType(who, "who", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Device", "Organization");
-        ValidationSupport.checkReferenceType(onBehalfOf, "onBehalfOf", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Device", "Organization");
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -478,7 +475,21 @@ public Builder data(Base64Binary data) {
          */
         @Override
         public Signature build() {
-            return new Signature(this);
+            Signature signature = new Signature(this);
+            if (validating) {
+                validate(signature);
+            }
+            return signature;
+        }
+
+        protected void validate(Signature signature) {
+            super.validate(signature);
+            ValidationSupport.checkNonEmptyList(signature.type, "type", Coding.class);
+            ValidationSupport.requireNonNull(signature.when, "when");
+            ValidationSupport.requireNonNull(signature.who, "who");
+            ValidationSupport.checkReferenceType(signature.who, "who", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Device", "Organization");
+            ValidationSupport.checkReferenceType(signature.onBehalfOf, "onBehalfOf", "Practitioner", "PractitionerRole", "RelatedPerson", "Patient", "Device", "Organization");
+            ValidationSupport.requireValueOrChildren(signature);
         }
 
         protected Builder from(Signature signature) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/SimpleQuantity.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/SimpleQuantity.java
index 82c28b54151..45b36de143e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/SimpleQuantity.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/SimpleQuantity.java
@@ -31,7 +31,6 @@
 public class SimpleQuantity extends Quantity {
     private SimpleQuantity(Builder builder) {
         super(builder);
-        ValidationSupport.prohibited(comparator, "comparator");
     }
 
     @Override
@@ -239,7 +238,16 @@ public Builder code(Code code) {
          */
         @Override
         public SimpleQuantity build() {
-            return new SimpleQuantity(this);
+            SimpleQuantity simpleQuantity = new SimpleQuantity(this);
+            if (validating) {
+                validate(simpleQuantity);
+            }
+            return simpleQuantity;
+        }
+
+        protected void validate(SimpleQuantity simpleQuantity) {
+            super.validate(simpleQuantity);
+            ValidationSupport.prohibited(simpleQuantity.comparator, "comparator");
         }
 
         protected Builder from(SimpleQuantity simpleQuantity) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/String.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/String.java
index 13ac85bab17..cd1a5402401 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/String.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/String.java
@@ -24,8 +24,6 @@ public class String extends Element {
     protected String(Builder builder) {
         super(builder);
         value = builder.value;
-        ValidationSupport.checkString(value);
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -206,7 +204,17 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public String build() {
-            return new String(this);
+            String string = new String(this);
+            if (validating) {
+                validate(string);
+            }
+            return string;
+        }
+
+        protected void validate(String string) {
+            super.validate(string);
+            ValidationSupport.checkString(string.value);
+            ValidationSupport.requireValueOrChildren(string);
         }
 
         protected Builder from(String string) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/SubstanceAmount.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/SubstanceAmount.java
index 2d74fc3c2af..e53c86065f8 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/SubstanceAmount.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/SubstanceAmount.java
@@ -36,11 +36,10 @@ public class SubstanceAmount extends BackboneElement {
 
     private SubstanceAmount(Builder builder) {
         super(builder);
-        amount = ValidationSupport.choiceElement(builder.amount, "amount", Quantity.class, Range.class, String.class);
+        amount = builder.amount;
         amountType = builder.amountType;
         amountText = builder.amountText;
         referenceRange = builder.referenceRange;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -356,7 +355,17 @@ public Builder referenceRange(ReferenceRange referenceRange) {
          */
         @Override
         public SubstanceAmount build() {
-            return new SubstanceAmount(this);
+            SubstanceAmount substanceAmount = new SubstanceAmount(this);
+            if (validating) {
+                validate(substanceAmount);
+            }
+            return substanceAmount;
+        }
+
+        protected void validate(SubstanceAmount substanceAmount) {
+            super.validate(substanceAmount);
+            ValidationSupport.choiceElement(substanceAmount.amount, "amount", Quantity.class, Range.class, String.class);
+            ValidationSupport.requireValueOrChildren(substanceAmount);
         }
 
         protected Builder from(SubstanceAmount substanceAmount) {
@@ -382,7 +391,6 @@ private ReferenceRange(Builder builder) {
             super(builder);
             lowLimit = builder.lowLimit;
             highLimit = builder.highLimit;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -616,7 +624,16 @@ public Builder highLimit(Quantity highLimit) {
              */
             @Override
             public ReferenceRange build() {
-                return new ReferenceRange(this);
+                ReferenceRange referenceRange = new ReferenceRange(this);
+                if (validating) {
+                    validate(referenceRange);
+                }
+                return referenceRange;
+            }
+
+            protected void validate(ReferenceRange referenceRange) {
+                super.validate(referenceRange);
+                ValidationSupport.requireValueOrChildren(referenceRange);
             }
 
             protected Builder from(ReferenceRange referenceRange) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Time.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Time.java
index 78beea93691..7cc22dcede4 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Time.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Time.java
@@ -35,7 +35,6 @@ public class Time extends Element {
     private Time(Builder builder) {
         super(builder);
         value = ModelSupport.truncateTime(builder.value, ChronoUnit.MICROS);
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -221,7 +220,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Time build() {
-            return new Time(this);
+            Time time = new Time(this);
+            if (validating) {
+                validate(time);
+            }
+            return time;
+        }
+
+        protected void validate(Time time) {
+            super.validate(time);
+            ValidationSupport.requireValueOrChildren(time);
         }
 
         protected Builder from(Time time) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Timing.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Timing.java
index 042c231402b..3257dc78117 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Timing.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Timing.java
@@ -119,10 +119,9 @@ public class Timing extends BackboneElement {
 
     private Timing(Builder builder) {
         super(builder);
-        event = Collections.unmodifiableList(ValidationSupport.checkList(builder.event, "event", DateTime.class));
+        event = Collections.unmodifiableList(builder.event);
         repeat = builder.repeat;
         code = builder.code;
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -415,7 +414,17 @@ public Builder code(CodeableConcept code) {
          */
         @Override
         public Timing build() {
-            return new Timing(this);
+            Timing timing = new Timing(this);
+            if (validating) {
+                validate(timing);
+            }
+            return timing;
+        }
+
+        protected void validate(Timing timing) {
+            super.validate(timing);
+            ValidationSupport.checkList(timing.event, "event", DateTime.class);
+            ValidationSupport.requireValueOrChildren(timing);
         }
 
         protected Builder from(Timing timing) {
@@ -488,7 +497,7 @@ public static class Repeat extends BackboneElement {
 
         private Repeat(Builder builder) {
             super(builder);
-            bounds = ValidationSupport.choiceElement(builder.bounds, "bounds", Duration.class, Range.class, Period.class);
+            bounds = builder.bounds;
             count = builder.count;
             countMax = builder.countMax;
             duration = builder.duration;
@@ -499,11 +508,10 @@ private Repeat(Builder builder) {
             period = builder.period;
             periodMax = builder.periodMax;
             periodUnit = builder.periodUnit;
-            dayOfWeek = Collections.unmodifiableList(ValidationSupport.checkList(builder.dayOfWeek, "dayOfWeek", DayOfWeek.class));
-            timeOfDay = Collections.unmodifiableList(ValidationSupport.checkList(builder.timeOfDay, "timeOfDay", Time.class));
-            when = Collections.unmodifiableList(ValidationSupport.checkList(builder.when, "when", EventTiming.class));
+            dayOfWeek = Collections.unmodifiableList(builder.dayOfWeek);
+            timeOfDay = Collections.unmodifiableList(builder.timeOfDay);
+            when = Collections.unmodifiableList(builder.when);
             offset = builder.offset;
-            ValidationSupport.requireValueOrChildren(this);
         }
 
         /**
@@ -1204,7 +1212,20 @@ public Builder offset(UnsignedInt offset) {
              */
             @Override
             public Repeat build() {
-                return new Repeat(this);
+                Repeat repeat = new Repeat(this);
+                if (validating) {
+                    validate(repeat);
+                }
+                return repeat;
+            }
+
+            protected void validate(Repeat repeat) {
+                super.validate(repeat);
+                ValidationSupport.choiceElement(repeat.bounds, "bounds", Duration.class, Range.class, Period.class);
+                ValidationSupport.checkList(repeat.dayOfWeek, "dayOfWeek", DayOfWeek.class);
+                ValidationSupport.checkList(repeat.timeOfDay, "timeOfDay", Time.class);
+                ValidationSupport.checkList(repeat.when, "when", EventTiming.class);
+                ValidationSupport.requireValueOrChildren(repeat);
             }
 
             protected Builder from(Repeat repeat) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/TriggerDefinition.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/TriggerDefinition.java
index 2028e797ef1..8bcd6db7dce 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/TriggerDefinition.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/TriggerDefinition.java
@@ -74,13 +74,11 @@ public class TriggerDefinition extends Element {
 
     private TriggerDefinition(Builder builder) {
         super(builder);
-        type = ValidationSupport.requireNonNull(builder.type, "type");
+        type = builder.type;
         name = builder.name;
-        timing = ValidationSupport.choiceElement(builder.timing, "timing", Timing.class, Reference.class, Date.class, DateTime.class);
-        data = Collections.unmodifiableList(ValidationSupport.checkList(builder.data, "data", DataRequirement.class));
+        timing = builder.timing;
+        data = Collections.unmodifiableList(builder.data);
         condition = builder.condition;
-        ValidationSupport.checkReferenceType(timing, "timing", "Schedule");
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -399,7 +397,20 @@ public Builder condition(Expression condition) {
          */
         @Override
         public TriggerDefinition build() {
-            return new TriggerDefinition(this);
+            TriggerDefinition triggerDefinition = new TriggerDefinition(this);
+            if (validating) {
+                validate(triggerDefinition);
+            }
+            return triggerDefinition;
+        }
+
+        protected void validate(TriggerDefinition triggerDefinition) {
+            super.validate(triggerDefinition);
+            ValidationSupport.requireNonNull(triggerDefinition.type, "type");
+            ValidationSupport.choiceElement(triggerDefinition.timing, "timing", Timing.class, Reference.class, Date.class, DateTime.class);
+            ValidationSupport.checkList(triggerDefinition.data, "data", DataRequirement.class);
+            ValidationSupport.checkReferenceType(triggerDefinition.timing, "timing", "Schedule");
+            ValidationSupport.requireValueOrChildren(triggerDefinition);
         }
 
         protected Builder from(TriggerDefinition triggerDefinition) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/UnsignedInt.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/UnsignedInt.java
index 64b90c3f67d..fd50f3d8668 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/UnsignedInt.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/UnsignedInt.java
@@ -23,8 +23,6 @@ public class UnsignedInt extends Integer {
 
     private UnsignedInt(Builder builder) {
         super(builder);
-        ValidationSupport.checkValue(value, MIN_VALUE);
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     @Override
@@ -208,7 +206,17 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public UnsignedInt build() {
-            return new UnsignedInt(this);
+            UnsignedInt unsignedInt = new UnsignedInt(this);
+            if (validating) {
+                validate(unsignedInt);
+            }
+            return unsignedInt;
+        }
+
+        protected void validate(UnsignedInt unsignedInt) {
+            super.validate(unsignedInt);
+            ValidationSupport.checkValue(unsignedInt.value, MIN_VALUE);
+            ValidationSupport.requireValueOrChildren(unsignedInt);
         }
 
         protected Builder from(UnsignedInt unsignedInt) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Uri.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Uri.java
index d0c69b01e88..3c093817edb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Uri.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Uri.java
@@ -24,8 +24,6 @@ public class Uri extends Element {
     protected Uri(Builder builder) {
         super(builder);
         value = builder.value;
-        ValidationSupport.checkUri(value);
-        ValidationSupport.requireValueOrChildren(this);
     }
 
     /**
@@ -206,7 +204,17 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Uri build() {
-            return new Uri(this);
+            Uri uri = new Uri(this);
+            if (validating) {
+                validate(uri);
+            }
+            return uri;
+        }
+
+        protected void validate(Uri uri) {
+            super.validate(uri);
+            ValidationSupport.checkUri(uri.value);
+            ValidationSupport.requireValueOrChildren(uri);
         }
 
         protected Builder from(Uri uri) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Url.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Url.java
index 52e72185eba..d1b5e1696a1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Url.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Url.java
@@ -183,7 +183,15 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Url build() {
-            return new Url(this);
+            Url url = new Url(this);
+            if (validating) {
+                validate(url);
+            }
+            return url;
+        }
+
+        protected void validate(Url url) {
+            super.validate(url);
         }
 
         protected Builder from(Url url) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/UsageContext.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/UsageContext.java
index e7aa5133cfc..4979c42569b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/UsageContext.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/UsageContext.java
@@ -59,10 +59,8 @@ public class UsageContext extends Element {
 
     private UsageContext(Builder builder) {
         super(builder);
-        code = ValidationSupport.requireNonNull(builder.code, "code");
-        value = ValidationSupport.requireChoiceElement(builder.value, "value", CodeableConcept.class, Quantity.class, Range.class, Reference.class);
-        ValidationSupport.checkReferenceType(value, "value", "PlanDefinition", "ResearchStudy", "InsurancePlan", "HealthcareService", "Group", "Location", "Organization");
-        ValidationSupport.requireValueOrChildren(this);
+        code = builder.code;
+        value = builder.value;
     }
 
     /**
@@ -278,7 +276,19 @@ public Builder value(Element value) {
          */
         @Override
         public UsageContext build() {
-            return new UsageContext(this);
+            UsageContext usageContext = new UsageContext(this);
+            if (validating) {
+                validate(usageContext);
+            }
+            return usageContext;
+        }
+
+        protected void validate(UsageContext usageContext) {
+            super.validate(usageContext);
+            ValidationSupport.requireNonNull(usageContext.code, "code");
+            ValidationSupport.requireChoiceElement(usageContext.value, "value", CodeableConcept.class, Quantity.class, Range.class, Reference.class);
+            ValidationSupport.checkReferenceType(usageContext.value, "value", "PlanDefinition", "ResearchStudy", "InsurancePlan", "HealthcareService", "Group", "Location", "Organization");
+            ValidationSupport.requireValueOrChildren(usageContext);
         }
 
         protected Builder from(UsageContext usageContext) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Uuid.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Uuid.java
index d8e0e376e15..75ecd0ee664 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Uuid.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Uuid.java
@@ -24,7 +24,6 @@ public class Uuid extends Uri {
 
     private Uuid(Builder builder) {
         super(builder);
-        ValidationSupport.checkValue(value, PATTERN);
     }
 
     @Override
@@ -188,7 +187,16 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Uuid build() {
-            return new Uuid(this);
+            Uuid uuid = new Uuid(this);
+            if (validating) {
+                validate(uuid);
+            }
+            return uuid;
+        }
+
+        protected void validate(Uuid uuid) {
+            super.validate(uuid);
+            ValidationSupport.checkValue(uuid.value, PATTERN);
         }
 
         protected Builder from(Uuid uuid) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/Xhtml.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/Xhtml.java
index f89633499c8..362b3b24f13 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/Xhtml.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/Xhtml.java
@@ -30,9 +30,7 @@ public class Xhtml extends Element {
 
     private Xhtml(Builder builder) {
         super(builder);
-        value = ValidationSupport.requireNonNull(builder.value, "value");
-        ValidationSupport.prohibited(extension, "extension");
-        ValidationSupport.checkXHTMLContent(value);
+        value = builder.value;
     }
 
     /**
@@ -238,7 +236,18 @@ public Builder value(java.lang.String value) {
          */
         @Override
         public Xhtml build() {
-            return new Xhtml(this);
+            Xhtml xhtml = new Xhtml(this);
+            if (validating) {
+                validate(xhtml);
+            }
+            return xhtml;
+        }
+
+        protected void validate(Xhtml xhtml) {
+            super.validate(xhtml);
+            ValidationSupport.requireNonNull(xhtml.value, "value");
+            ValidationSupport.prohibited(xhtml.extension, "extension");
+            ValidationSupport.checkXHTMLContent(xhtml.value);
         }
 
         protected Builder from(Xhtml xhtml) {
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AccountStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AccountStatus.java
index 1585b82cdb9..47259318524 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AccountStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AccountStatus.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public AccountStatus build() {
-            return new AccountStatus(this);
+            AccountStatus accountStatus = new AccountStatus(this);
+            if (validating) {
+                validate(accountStatus);
+            }
+            return accountStatus;
+        }
+
+        protected void validate(AccountStatus accountStatus) {
+            super.validate(accountStatus);
+        }
+
+        protected Builder from(AccountStatus accountStatus) {
+            super.from(accountStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionCardinalityBehavior.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionCardinalityBehavior.java
index 594f82e5484..e9f0b2ed042 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionCardinalityBehavior.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionCardinalityBehavior.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public ActionCardinalityBehavior build() {
-            return new ActionCardinalityBehavior(this);
+            ActionCardinalityBehavior actionCardinalityBehavior = new ActionCardinalityBehavior(this);
+            if (validating) {
+                validate(actionCardinalityBehavior);
+            }
+            return actionCardinalityBehavior;
+        }
+
+        protected void validate(ActionCardinalityBehavior actionCardinalityBehavior) {
+            super.validate(actionCardinalityBehavior);
+        }
+
+        protected Builder from(ActionCardinalityBehavior actionCardinalityBehavior) {
+            super.from(actionCardinalityBehavior);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionConditionKind.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionConditionKind.java
index fe1977de562..9ae16c52fc7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionConditionKind.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionConditionKind.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public ActionConditionKind build() {
-            return new ActionConditionKind(this);
+            ActionConditionKind actionConditionKind = new ActionConditionKind(this);
+            if (validating) {
+                validate(actionConditionKind);
+            }
+            return actionConditionKind;
+        }
+
+        protected void validate(ActionConditionKind actionConditionKind) {
+            super.validate(actionConditionKind);
+        }
+
+        protected Builder from(ActionConditionKind actionConditionKind) {
+            super.from(actionConditionKind);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionGroupingBehavior.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionGroupingBehavior.java
index e7e90add2d7..c47620b394a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionGroupingBehavior.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionGroupingBehavior.java
@@ -165,11 +165,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -224,7 +220,20 @@ public Builder value(Value value) {
 
         @Override
         public ActionGroupingBehavior build() {
-            return new ActionGroupingBehavior(this);
+            ActionGroupingBehavior actionGroupingBehavior = new ActionGroupingBehavior(this);
+            if (validating) {
+                validate(actionGroupingBehavior);
+            }
+            return actionGroupingBehavior;
+        }
+
+        protected void validate(ActionGroupingBehavior actionGroupingBehavior) {
+            super.validate(actionGroupingBehavior);
+        }
+
+        protected Builder from(ActionGroupingBehavior actionGroupingBehavior) {
+            super.from(actionGroupingBehavior);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionParticipantType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionParticipantType.java
index 520eca68d9b..6858387d16e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionParticipantType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionParticipantType.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ActionParticipantType build() {
-            return new ActionParticipantType(this);
+            ActionParticipantType actionParticipantType = new ActionParticipantType(this);
+            if (validating) {
+                validate(actionParticipantType);
+            }
+            return actionParticipantType;
+        }
+
+        protected void validate(ActionParticipantType actionParticipantType) {
+            super.validate(actionParticipantType);
+        }
+
+        protected Builder from(ActionParticipantType actionParticipantType) {
+            super.from(actionParticipantType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionPrecheckBehavior.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionPrecheckBehavior.java
index 8d4b555108b..3849be63d93 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionPrecheckBehavior.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionPrecheckBehavior.java
@@ -151,11 +151,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -210,7 +206,20 @@ public Builder value(Value value) {
 
         @Override
         public ActionPrecheckBehavior build() {
-            return new ActionPrecheckBehavior(this);
+            ActionPrecheckBehavior actionPrecheckBehavior = new ActionPrecheckBehavior(this);
+            if (validating) {
+                validate(actionPrecheckBehavior);
+            }
+            return actionPrecheckBehavior;
+        }
+
+        protected void validate(ActionPrecheckBehavior actionPrecheckBehavior) {
+            super.validate(actionPrecheckBehavior);
+        }
+
+        protected Builder from(ActionPrecheckBehavior actionPrecheckBehavior) {
+            super.from(actionPrecheckBehavior);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionRelationshipType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionRelationshipType.java
index 308a064b852..bd4c98a0d8f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionRelationshipType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionRelationshipType.java
@@ -224,11 +224,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -283,7 +279,20 @@ public Builder value(Value value) {
 
         @Override
         public ActionRelationshipType build() {
-            return new ActionRelationshipType(this);
+            ActionRelationshipType actionRelationshipType = new ActionRelationshipType(this);
+            if (validating) {
+                validate(actionRelationshipType);
+            }
+            return actionRelationshipType;
+        }
+
+        protected void validate(ActionRelationshipType actionRelationshipType) {
+            super.validate(actionRelationshipType);
+        }
+
+        protected Builder from(ActionRelationshipType actionRelationshipType) {
+            super.from(actionRelationshipType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionRequiredBehavior.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionRequiredBehavior.java
index 066ac6686aa..aa9701d55b9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionRequiredBehavior.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionRequiredBehavior.java
@@ -160,11 +160,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -219,7 +215,20 @@ public Builder value(Value value) {
 
         @Override
         public ActionRequiredBehavior build() {
-            return new ActionRequiredBehavior(this);
+            ActionRequiredBehavior actionRequiredBehavior = new ActionRequiredBehavior(this);
+            if (validating) {
+                validate(actionRequiredBehavior);
+            }
+            return actionRequiredBehavior;
+        }
+
+        protected void validate(ActionRequiredBehavior actionRequiredBehavior) {
+            super.validate(actionRequiredBehavior);
+        }
+
+        protected Builder from(ActionRequiredBehavior actionRequiredBehavior) {
+            super.from(actionRequiredBehavior);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionSelectionBehavior.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionSelectionBehavior.java
index 4a37743b56a..8c84d28335b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionSelectionBehavior.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActionSelectionBehavior.java
@@ -193,11 +193,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -252,7 +248,20 @@ public Builder value(Value value) {
 
         @Override
         public ActionSelectionBehavior build() {
-            return new ActionSelectionBehavior(this);
+            ActionSelectionBehavior actionSelectionBehavior = new ActionSelectionBehavior(this);
+            if (validating) {
+                validate(actionSelectionBehavior);
+            }
+            return actionSelectionBehavior;
+        }
+
+        protected void validate(ActionSelectionBehavior actionSelectionBehavior) {
+            super.validate(actionSelectionBehavior);
+        }
+
+        protected Builder from(ActionSelectionBehavior actionSelectionBehavior) {
+            super.from(actionSelectionBehavior);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActivityDefinitionKind.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActivityDefinitionKind.java
index b2b0b385d48..245e9bba5b3 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActivityDefinitionKind.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActivityDefinitionKind.java
@@ -291,11 +291,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -350,7 +346,20 @@ public Builder value(Value value) {
 
         @Override
         public ActivityDefinitionKind build() {
-            return new ActivityDefinitionKind(this);
+            ActivityDefinitionKind activityDefinitionKind = new ActivityDefinitionKind(this);
+            if (validating) {
+                validate(activityDefinitionKind);
+            }
+            return activityDefinitionKind;
+        }
+
+        protected void validate(ActivityDefinitionKind activityDefinitionKind) {
+            super.validate(activityDefinitionKind);
+        }
+
+        protected Builder from(ActivityDefinitionKind activityDefinitionKind) {
+            super.from(activityDefinitionKind);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActivityParticipantType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActivityParticipantType.java
index 0770899a77e..e5094b3c1fb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActivityParticipantType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ActivityParticipantType.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ActivityParticipantType build() {
-            return new ActivityParticipantType(this);
+            ActivityParticipantType activityParticipantType = new ActivityParticipantType(this);
+            if (validating) {
+                validate(activityParticipantType);
+            }
+            return activityParticipantType;
+        }
+
+        protected void validate(ActivityParticipantType activityParticipantType) {
+            super.validate(activityParticipantType);
+        }
+
+        protected Builder from(ActivityParticipantType activityParticipantType) {
+            super.from(activityParticipantType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AddressType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AddressType.java
index 5f6701a2a3f..c0b83142c13 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AddressType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AddressType.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public AddressType build() {
-            return new AddressType(this);
+            AddressType addressType = new AddressType(this);
+            if (validating) {
+                validate(addressType);
+            }
+            return addressType;
+        }
+
+        protected void validate(AddressType addressType) {
+            super.validate(addressType);
+        }
+
+        protected Builder from(AddressType addressType) {
+            super.from(addressType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AddressUse.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AddressUse.java
index c18e92a5122..3ab469208a3 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AddressUse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AddressUse.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public AddressUse build() {
-            return new AddressUse(this);
+            AddressUse addressUse = new AddressUse(this);
+            if (validating) {
+                validate(addressUse);
+            }
+            return addressUse;
+        }
+
+        protected void validate(AddressUse addressUse) {
+            super.validate(addressUse);
+        }
+
+        protected Builder from(AddressUse addressUse) {
+            super.from(addressUse);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AdministrativeGender.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AdministrativeGender.java
index 920549673ac..a96cea8c3ab 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AdministrativeGender.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AdministrativeGender.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public AdministrativeGender build() {
-            return new AdministrativeGender(this);
+            AdministrativeGender administrativeGender = new AdministrativeGender(this);
+            if (validating) {
+                validate(administrativeGender);
+            }
+            return administrativeGender;
+        }
+
+        protected void validate(AdministrativeGender administrativeGender) {
+            super.validate(administrativeGender);
+        }
+
+        protected Builder from(AdministrativeGender administrativeGender) {
+            super.from(administrativeGender);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AdverseEventActuality.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AdverseEventActuality.java
index 353859a217f..399e7423553 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AdverseEventActuality.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AdverseEventActuality.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public AdverseEventActuality build() {
-            return new AdverseEventActuality(this);
+            AdverseEventActuality adverseEventActuality = new AdverseEventActuality(this);
+            if (validating) {
+                validate(adverseEventActuality);
+            }
+            return adverseEventActuality;
+        }
+
+        protected void validate(AdverseEventActuality adverseEventActuality) {
+            super.validate(adverseEventActuality);
+        }
+
+        protected Builder from(AdverseEventActuality adverseEventActuality) {
+            super.from(adverseEventActuality);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AggregationMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AggregationMode.java
index e0b076225f6..703ebd4b2c9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AggregationMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AggregationMode.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public AggregationMode build() {
-            return new AggregationMode(this);
+            AggregationMode aggregationMode = new AggregationMode(this);
+            if (validating) {
+                validate(aggregationMode);
+            }
+            return aggregationMode;
+        }
+
+        protected void validate(AggregationMode aggregationMode) {
+            super.validate(aggregationMode);
+        }
+
+        protected Builder from(AggregationMode aggregationMode) {
+            super.from(aggregationMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceCategory.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceCategory.java
index 6b148d97002..864ef2b5a97 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceCategory.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceCategory.java
@@ -174,11 +174,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -233,7 +229,20 @@ public Builder value(Value value) {
 
         @Override
         public AllergyIntoleranceCategory build() {
-            return new AllergyIntoleranceCategory(this);
+            AllergyIntoleranceCategory allergyIntoleranceCategory = new AllergyIntoleranceCategory(this);
+            if (validating) {
+                validate(allergyIntoleranceCategory);
+            }
+            return allergyIntoleranceCategory;
+        }
+
+        protected void validate(AllergyIntoleranceCategory allergyIntoleranceCategory) {
+            super.validate(allergyIntoleranceCategory);
+        }
+
+        protected Builder from(AllergyIntoleranceCategory allergyIntoleranceCategory) {
+            super.from(allergyIntoleranceCategory);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceCriticality.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceCriticality.java
index 5d54a9be481..3e59a9d6100 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceCriticality.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceCriticality.java
@@ -160,11 +160,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -219,7 +215,20 @@ public Builder value(Value value) {
 
         @Override
         public AllergyIntoleranceCriticality build() {
-            return new AllergyIntoleranceCriticality(this);
+            AllergyIntoleranceCriticality allergyIntoleranceCriticality = new AllergyIntoleranceCriticality(this);
+            if (validating) {
+                validate(allergyIntoleranceCriticality);
+            }
+            return allergyIntoleranceCriticality;
+        }
+
+        protected void validate(AllergyIntoleranceCriticality allergyIntoleranceCriticality) {
+            super.validate(allergyIntoleranceCriticality);
+        }
+
+        protected Builder from(AllergyIntoleranceCriticality allergyIntoleranceCriticality) {
+            super.from(allergyIntoleranceCriticality);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceSeverity.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceSeverity.java
index fa3596776d3..bed10939072 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceSeverity.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceSeverity.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public AllergyIntoleranceSeverity build() {
-            return new AllergyIntoleranceSeverity(this);
+            AllergyIntoleranceSeverity allergyIntoleranceSeverity = new AllergyIntoleranceSeverity(this);
+            if (validating) {
+                validate(allergyIntoleranceSeverity);
+            }
+            return allergyIntoleranceSeverity;
+        }
+
+        protected void validate(AllergyIntoleranceSeverity allergyIntoleranceSeverity) {
+            super.validate(allergyIntoleranceSeverity);
+        }
+
+        protected Builder from(AllergyIntoleranceSeverity allergyIntoleranceSeverity) {
+            super.from(allergyIntoleranceSeverity);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceType.java
index a635e906402..a38642213b7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AllergyIntoleranceType.java
@@ -150,11 +150,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -209,7 +205,20 @@ public Builder value(Value value) {
 
         @Override
         public AllergyIntoleranceType build() {
-            return new AllergyIntoleranceType(this);
+            AllergyIntoleranceType allergyIntoleranceType = new AllergyIntoleranceType(this);
+            if (validating) {
+                validate(allergyIntoleranceType);
+            }
+            return allergyIntoleranceType;
+        }
+
+        protected void validate(AllergyIntoleranceType allergyIntoleranceType) {
+            super.validate(allergyIntoleranceType);
+        }
+
+        protected Builder from(AllergyIntoleranceType allergyIntoleranceType) {
+            super.from(allergyIntoleranceType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AppointmentStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AppointmentStatus.java
index 64c0811ccb5..5cee76daf6c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AppointmentStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AppointmentStatus.java
@@ -240,11 +240,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -299,7 +295,20 @@ public Builder value(Value value) {
 
         @Override
         public AppointmentStatus build() {
-            return new AppointmentStatus(this);
+            AppointmentStatus appointmentStatus = new AppointmentStatus(this);
+            if (validating) {
+                validate(appointmentStatus);
+            }
+            return appointmentStatus;
+        }
+
+        protected void validate(AppointmentStatus appointmentStatus) {
+            super.validate(appointmentStatus);
+        }
+
+        protected Builder from(AppointmentStatus appointmentStatus) {
+            super.from(appointmentStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionDirectionType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionDirectionType.java
index 9a163915981..0097ff842e6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionDirectionType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionDirectionType.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public AssertionDirectionType build() {
-            return new AssertionDirectionType(this);
+            AssertionDirectionType assertionDirectionType = new AssertionDirectionType(this);
+            if (validating) {
+                validate(assertionDirectionType);
+            }
+            return assertionDirectionType;
+        }
+
+        protected void validate(AssertionDirectionType assertionDirectionType) {
+            super.validate(assertionDirectionType);
+        }
+
+        protected Builder from(AssertionDirectionType assertionDirectionType) {
+            super.from(assertionDirectionType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionOperatorType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionOperatorType.java
index 5537b437174..c676720263d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionOperatorType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionOperatorType.java
@@ -246,11 +246,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -305,7 +301,20 @@ public Builder value(Value value) {
 
         @Override
         public AssertionOperatorType build() {
-            return new AssertionOperatorType(this);
+            AssertionOperatorType assertionOperatorType = new AssertionOperatorType(this);
+            if (validating) {
+                validate(assertionOperatorType);
+            }
+            return assertionOperatorType;
+        }
+
+        protected void validate(AssertionOperatorType assertionOperatorType) {
+            super.validate(assertionOperatorType);
+        }
+
+        protected Builder from(AssertionOperatorType assertionOperatorType) {
+            super.from(assertionOperatorType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionResponseTypes.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionResponseTypes.java
index f7806add475..e04a61da9ac 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionResponseTypes.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AssertionResponseTypes.java
@@ -257,11 +257,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -316,7 +312,20 @@ public Builder value(Value value) {
 
         @Override
         public AssertionResponseTypes build() {
-            return new AssertionResponseTypes(this);
+            AssertionResponseTypes assertionResponseTypes = new AssertionResponseTypes(this);
+            if (validating) {
+                validate(assertionResponseTypes);
+            }
+            return assertionResponseTypes;
+        }
+
+        protected void validate(AssertionResponseTypes assertionResponseTypes) {
+            super.validate(assertionResponseTypes);
+        }
+
+        protected Builder from(AssertionResponseTypes assertionResponseTypes) {
+            super.from(assertionResponseTypes);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventAction.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventAction.java
index a26a02452a4..e8c881de8bb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventAction.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventAction.java
@@ -181,11 +181,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -240,7 +236,20 @@ public Builder value(Value value) {
 
         @Override
         public AuditEventAction build() {
-            return new AuditEventAction(this);
+            AuditEventAction auditEventAction = new AuditEventAction(this);
+            if (validating) {
+                validate(auditEventAction);
+            }
+            return auditEventAction;
+        }
+
+        protected void validate(AuditEventAction auditEventAction) {
+            super.validate(auditEventAction);
+        }
+
+        protected Builder from(AuditEventAction auditEventAction) {
+            super.from(auditEventAction);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventAgentNetworkType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventAgentNetworkType.java
index 06818129751..2656d828090 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventAgentNetworkType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventAgentNetworkType.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public AuditEventAgentNetworkType build() {
-            return new AuditEventAgentNetworkType(this);
+            AuditEventAgentNetworkType auditEventAgentNetworkType = new AuditEventAgentNetworkType(this);
+            if (validating) {
+                validate(auditEventAgentNetworkType);
+            }
+            return auditEventAgentNetworkType;
+        }
+
+        protected void validate(AuditEventAgentNetworkType auditEventAgentNetworkType) {
+            super.validate(auditEventAgentNetworkType);
+        }
+
+        protected Builder from(AuditEventAgentNetworkType auditEventAgentNetworkType) {
+            super.from(auditEventAgentNetworkType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventOutcome.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventOutcome.java
index f30e30262da..e5aa14a7bf9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventOutcome.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/AuditEventOutcome.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public AuditEventOutcome build() {
-            return new AuditEventOutcome(this);
+            AuditEventOutcome auditEventOutcome = new AuditEventOutcome(this);
+            if (validating) {
+                validate(auditEventOutcome);
+            }
+            return auditEventOutcome;
+        }
+
+        protected void validate(AuditEventOutcome auditEventOutcome) {
+            super.validate(auditEventOutcome);
+        }
+
+        protected Builder from(AuditEventOutcome auditEventOutcome) {
+            super.from(auditEventOutcome);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BindingStrength.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BindingStrength.java
index 2dd89efd2b4..da07af45428 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BindingStrength.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BindingStrength.java
@@ -173,11 +173,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -232,7 +228,20 @@ public Builder value(Value value) {
 
         @Override
         public BindingStrength build() {
-            return new BindingStrength(this);
+            BindingStrength bindingStrength = new BindingStrength(this);
+            if (validating) {
+                validate(bindingStrength);
+            }
+            return bindingStrength;
+        }
+
+        protected void validate(BindingStrength bindingStrength) {
+            super.validate(bindingStrength);
+        }
+
+        protected Builder from(BindingStrength bindingStrength) {
+            super.from(bindingStrength);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductCategory.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductCategory.java
index f68dd91daf9..04230856240 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductCategory.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductCategory.java
@@ -181,11 +181,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -240,7 +236,20 @@ public Builder value(Value value) {
 
         @Override
         public BiologicallyDerivedProductCategory build() {
-            return new BiologicallyDerivedProductCategory(this);
+            BiologicallyDerivedProductCategory biologicallyDerivedProductCategory = new BiologicallyDerivedProductCategory(this);
+            if (validating) {
+                validate(biologicallyDerivedProductCategory);
+            }
+            return biologicallyDerivedProductCategory;
+        }
+
+        protected void validate(BiologicallyDerivedProductCategory biologicallyDerivedProductCategory) {
+            super.validate(biologicallyDerivedProductCategory);
+        }
+
+        protected Builder from(BiologicallyDerivedProductCategory biologicallyDerivedProductCategory) {
+            super.from(biologicallyDerivedProductCategory);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductStatus.java
index 61b8f6c9fa2..1a96d632c1e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductStatus.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public BiologicallyDerivedProductStatus build() {
-            return new BiologicallyDerivedProductStatus(this);
+            BiologicallyDerivedProductStatus biologicallyDerivedProductStatus = new BiologicallyDerivedProductStatus(this);
+            if (validating) {
+                validate(biologicallyDerivedProductStatus);
+            }
+            return biologicallyDerivedProductStatus;
+        }
+
+        protected void validate(BiologicallyDerivedProductStatus biologicallyDerivedProductStatus) {
+            super.validate(biologicallyDerivedProductStatus);
+        }
+
+        protected Builder from(BiologicallyDerivedProductStatus biologicallyDerivedProductStatus) {
+            super.from(biologicallyDerivedProductStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductStorageScale.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductStorageScale.java
index ff344862529..d4e633d5c93 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductStorageScale.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BiologicallyDerivedProductStorageScale.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public BiologicallyDerivedProductStorageScale build() {
-            return new BiologicallyDerivedProductStorageScale(this);
+            BiologicallyDerivedProductStorageScale biologicallyDerivedProductStorageScale = new BiologicallyDerivedProductStorageScale(this);
+            if (validating) {
+                validate(biologicallyDerivedProductStorageScale);
+            }
+            return biologicallyDerivedProductStorageScale;
+        }
+
+        protected void validate(BiologicallyDerivedProductStorageScale biologicallyDerivedProductStorageScale) {
+            super.validate(biologicallyDerivedProductStorageScale);
+        }
+
+        protected Builder from(BiologicallyDerivedProductStorageScale biologicallyDerivedProductStorageScale) {
+            super.from(biologicallyDerivedProductStorageScale);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BundleType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BundleType.java
index 33269815538..f2faefa087d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BundleType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/BundleType.java
@@ -226,11 +226,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -285,7 +281,20 @@ public Builder value(Value value) {
 
         @Override
         public BundleType build() {
-            return new BundleType(this);
+            BundleType bundleType = new BundleType(this);
+            if (validating) {
+                validate(bundleType);
+            }
+            return bundleType;
+        }
+
+        protected void validate(BundleType bundleType) {
+            super.validate(bundleType);
+        }
+
+        protected Builder from(BundleType bundleType) {
+            super.from(bundleType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CapabilityStatementKind.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CapabilityStatementKind.java
index db7556da9e9..8a9b11517c8 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CapabilityStatementKind.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CapabilityStatementKind.java
@@ -161,11 +161,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -220,7 +216,20 @@ public Builder value(Value value) {
 
         @Override
         public CapabilityStatementKind build() {
-            return new CapabilityStatementKind(this);
+            CapabilityStatementKind capabilityStatementKind = new CapabilityStatementKind(this);
+            if (validating) {
+                validate(capabilityStatementKind);
+            }
+            return capabilityStatementKind;
+        }
+
+        protected void validate(CapabilityStatementKind capabilityStatementKind) {
+            super.validate(capabilityStatementKind);
+        }
+
+        protected Builder from(CapabilityStatementKind capabilityStatementKind) {
+            super.from(capabilityStatementKind);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanActivityKind.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanActivityKind.java
index 40784d2aae1..3c6422b31d4 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanActivityKind.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanActivityKind.java
@@ -173,11 +173,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -232,7 +228,20 @@ public Builder value(Value value) {
 
         @Override
         public CarePlanActivityKind build() {
-            return new CarePlanActivityKind(this);
+            CarePlanActivityKind carePlanActivityKind = new CarePlanActivityKind(this);
+            if (validating) {
+                validate(carePlanActivityKind);
+            }
+            return carePlanActivityKind;
+        }
+
+        protected void validate(CarePlanActivityKind carePlanActivityKind) {
+            super.validate(carePlanActivityKind);
+        }
+
+        protected Builder from(CarePlanActivityKind carePlanActivityKind) {
+            super.from(carePlanActivityKind);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanActivityStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanActivityStatus.java
index b8460e8750e..44e535a0512 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanActivityStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanActivityStatus.java
@@ -225,11 +225,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -284,7 +280,20 @@ public Builder value(Value value) {
 
         @Override
         public CarePlanActivityStatus build() {
-            return new CarePlanActivityStatus(this);
+            CarePlanActivityStatus carePlanActivityStatus = new CarePlanActivityStatus(this);
+            if (validating) {
+                validate(carePlanActivityStatus);
+            }
+            return carePlanActivityStatus;
+        }
+
+        protected void validate(CarePlanActivityStatus carePlanActivityStatus) {
+            super.validate(carePlanActivityStatus);
+        }
+
+        protected Builder from(CarePlanActivityStatus carePlanActivityStatus) {
+            super.from(carePlanActivityStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanIntent.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanIntent.java
index 12435fe67ee..cf0b5ed69b5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanIntent.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanIntent.java
@@ -149,11 +149,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -208,7 +204,20 @@ public Builder value(Value value) {
 
         @Override
         public CarePlanIntent build() {
-            return new CarePlanIntent(this);
+            CarePlanIntent carePlanIntent = new CarePlanIntent(this);
+            if (validating) {
+                validate(carePlanIntent);
+            }
+            return carePlanIntent;
+        }
+
+        protected void validate(CarePlanIntent carePlanIntent) {
+            super.validate(carePlanIntent);
+        }
+
+        protected Builder from(CarePlanIntent carePlanIntent) {
+            super.from(carePlanIntent);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanStatus.java
index be4daa53aa7..3ab33e014df 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CarePlanStatus.java
@@ -207,11 +207,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -266,7 +262,20 @@ public Builder value(Value value) {
 
         @Override
         public CarePlanStatus build() {
-            return new CarePlanStatus(this);
+            CarePlanStatus carePlanStatus = new CarePlanStatus(this);
+            if (validating) {
+                validate(carePlanStatus);
+            }
+            return carePlanStatus;
+        }
+
+        protected void validate(CarePlanStatus carePlanStatus) {
+            super.validate(carePlanStatus);
+        }
+
+        protected Builder from(CarePlanStatus carePlanStatus) {
+            super.from(carePlanStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CareTeamStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CareTeamStatus.java
index 3b2cf591af3..fcf8600d1eb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CareTeamStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CareTeamStatus.java
@@ -181,11 +181,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -240,7 +236,20 @@ public Builder value(Value value) {
 
         @Override
         public CareTeamStatus build() {
-            return new CareTeamStatus(this);
+            CareTeamStatus careTeamStatus = new CareTeamStatus(this);
+            if (validating) {
+                validate(careTeamStatus);
+            }
+            return careTeamStatus;
+        }
+
+        protected void validate(CareTeamStatus careTeamStatus) {
+            super.validate(careTeamStatus);
+        }
+
+        protected Builder from(CareTeamStatus careTeamStatus) {
+            super.from(careTeamStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CatalogEntryRelationType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CatalogEntryRelationType.java
index d1291208d77..016c490c57b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CatalogEntryRelationType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CatalogEntryRelationType.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public CatalogEntryRelationType build() {
-            return new CatalogEntryRelationType(this);
+            CatalogEntryRelationType catalogEntryRelationType = new CatalogEntryRelationType(this);
+            if (validating) {
+                validate(catalogEntryRelationType);
+            }
+            return catalogEntryRelationType;
+        }
+
+        protected void validate(CatalogEntryRelationType catalogEntryRelationType) {
+            super.validate(catalogEntryRelationType);
+        }
+
+        protected Builder from(CatalogEntryRelationType catalogEntryRelationType) {
+            super.from(catalogEntryRelationType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ChargeItemDefinitionPriceComponentType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ChargeItemDefinitionPriceComponentType.java
index bb97bc4ed4f..04dabb0dd1d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ChargeItemDefinitionPriceComponentType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ChargeItemDefinitionPriceComponentType.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public ChargeItemDefinitionPriceComponentType build() {
-            return new ChargeItemDefinitionPriceComponentType(this);
+            ChargeItemDefinitionPriceComponentType chargeItemDefinitionPriceComponentType = new ChargeItemDefinitionPriceComponentType(this);
+            if (validating) {
+                validate(chargeItemDefinitionPriceComponentType);
+            }
+            return chargeItemDefinitionPriceComponentType;
+        }
+
+        protected void validate(ChargeItemDefinitionPriceComponentType chargeItemDefinitionPriceComponentType) {
+            super.validate(chargeItemDefinitionPriceComponentType);
+        }
+
+        protected Builder from(ChargeItemDefinitionPriceComponentType chargeItemDefinitionPriceComponentType) {
+            super.from(chargeItemDefinitionPriceComponentType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ChargeItemStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ChargeItemStatus.java
index 935ff88cae6..328d65e20ac 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ChargeItemStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ChargeItemStatus.java
@@ -205,11 +205,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -264,7 +260,20 @@ public Builder value(Value value) {
 
         @Override
         public ChargeItemStatus build() {
-            return new ChargeItemStatus(this);
+            ChargeItemStatus chargeItemStatus = new ChargeItemStatus(this);
+            if (validating) {
+                validate(chargeItemStatus);
+            }
+            return chargeItemStatus;
+        }
+
+        protected void validate(ChargeItemStatus chargeItemStatus) {
+            super.validate(chargeItemStatus);
+        }
+
+        protected Builder from(ChargeItemStatus chargeItemStatus) {
+            super.from(chargeItemStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClaimResponseStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClaimResponseStatus.java
index a991a13bc61..ba56cf499d2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClaimResponseStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClaimResponseStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ClaimResponseStatus build() {
-            return new ClaimResponseStatus(this);
+            ClaimResponseStatus claimResponseStatus = new ClaimResponseStatus(this);
+            if (validating) {
+                validate(claimResponseStatus);
+            }
+            return claimResponseStatus;
+        }
+
+        protected void validate(ClaimResponseStatus claimResponseStatus) {
+            super.validate(claimResponseStatus);
+        }
+
+        protected Builder from(ClaimResponseStatus claimResponseStatus) {
+            super.from(claimResponseStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClaimStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClaimStatus.java
index 6c6cfcf5b8f..ded2263c357 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClaimStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClaimStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ClaimStatus build() {
-            return new ClaimStatus(this);
+            ClaimStatus claimStatus = new ClaimStatus(this);
+            if (validating) {
+                validate(claimStatus);
+            }
+            return claimStatus;
+        }
+
+        protected void validate(ClaimStatus claimStatus) {
+            super.validate(claimStatus);
+        }
+
+        protected Builder from(ClaimStatus claimStatus) {
+            super.from(claimStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClinicalImpressionStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClinicalImpressionStatus.java
index bec781c8558..b26988e2d0c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClinicalImpressionStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ClinicalImpressionStatus.java
@@ -143,11 +143,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -202,7 +198,20 @@ public Builder value(Value value) {
 
         @Override
         public ClinicalImpressionStatus build() {
-            return new ClinicalImpressionStatus(this);
+            ClinicalImpressionStatus clinicalImpressionStatus = new ClinicalImpressionStatus(this);
+            if (validating) {
+                validate(clinicalImpressionStatus);
+            }
+            return clinicalImpressionStatus;
+        }
+
+        protected void validate(ClinicalImpressionStatus clinicalImpressionStatus) {
+            super.validate(clinicalImpressionStatus);
+        }
+
+        protected Builder from(ClinicalImpressionStatus clinicalImpressionStatus) {
+            super.from(clinicalImpressionStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSearchSupport.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSearchSupport.java
index 5a01f6d2973..2c22123f779 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSearchSupport.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSearchSupport.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public CodeSearchSupport build() {
-            return new CodeSearchSupport(this);
+            CodeSearchSupport codeSearchSupport = new CodeSearchSupport(this);
+            if (validating) {
+                validate(codeSearchSupport);
+            }
+            return codeSearchSupport;
+        }
+
+        protected void validate(CodeSearchSupport codeSearchSupport) {
+            super.validate(codeSearchSupport);
+        }
+
+        protected Builder from(CodeSearchSupport codeSearchSupport) {
+            super.from(codeSearchSupport);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSystemContentMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSystemContentMode.java
index 6fcb377b3ea..43a8a8c0974 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSystemContentMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSystemContentMode.java
@@ -185,11 +185,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -244,7 +240,20 @@ public Builder value(Value value) {
 
         @Override
         public CodeSystemContentMode build() {
-            return new CodeSystemContentMode(this);
+            CodeSystemContentMode codeSystemContentMode = new CodeSystemContentMode(this);
+            if (validating) {
+                validate(codeSystemContentMode);
+            }
+            return codeSystemContentMode;
+        }
+
+        protected void validate(CodeSystemContentMode codeSystemContentMode) {
+            super.validate(codeSystemContentMode);
+        }
+
+        protected Builder from(CodeSystemContentMode codeSystemContentMode) {
+            super.from(codeSystemContentMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSystemHierarchyMeaning.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSystemHierarchyMeaning.java
index 7c263cf73df..653c61b8f1b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSystemHierarchyMeaning.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CodeSystemHierarchyMeaning.java
@@ -176,11 +176,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -235,7 +231,20 @@ public Builder value(Value value) {
 
         @Override
         public CodeSystemHierarchyMeaning build() {
-            return new CodeSystemHierarchyMeaning(this);
+            CodeSystemHierarchyMeaning codeSystemHierarchyMeaning = new CodeSystemHierarchyMeaning(this);
+            if (validating) {
+                validate(codeSystemHierarchyMeaning);
+            }
+            return codeSystemHierarchyMeaning;
+        }
+
+        protected void validate(CodeSystemHierarchyMeaning codeSystemHierarchyMeaning) {
+            super.validate(codeSystemHierarchyMeaning);
+        }
+
+        protected Builder from(CodeSystemHierarchyMeaning codeSystemHierarchyMeaning) {
+            super.from(codeSystemHierarchyMeaning);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationPriority.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationPriority.java
index 985b66f3600..298cc970fb1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationPriority.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationPriority.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public CommunicationPriority build() {
-            return new CommunicationPriority(this);
+            CommunicationPriority communicationPriority = new CommunicationPriority(this);
+            if (validating) {
+                validate(communicationPriority);
+            }
+            return communicationPriority;
+        }
+
+        protected void validate(CommunicationPriority communicationPriority) {
+            super.validate(communicationPriority);
+        }
+
+        protected Builder from(CommunicationPriority communicationPriority) {
+            super.from(communicationPriority);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationRequestStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationRequestStatus.java
index 6fd641fb830..179b373f756 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationRequestStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationRequestStatus.java
@@ -207,11 +207,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -266,7 +262,20 @@ public Builder value(Value value) {
 
         @Override
         public CommunicationRequestStatus build() {
-            return new CommunicationRequestStatus(this);
+            CommunicationRequestStatus communicationRequestStatus = new CommunicationRequestStatus(this);
+            if (validating) {
+                validate(communicationRequestStatus);
+            }
+            return communicationRequestStatus;
+        }
+
+        protected void validate(CommunicationRequestStatus communicationRequestStatus) {
+            super.validate(communicationRequestStatus);
+        }
+
+        protected Builder from(CommunicationRequestStatus communicationRequestStatus) {
+            super.from(communicationRequestStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationStatus.java
index 6d5c97e099a..67ac8d09121 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CommunicationStatus.java
@@ -219,11 +219,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -278,7 +274,20 @@ public Builder value(Value value) {
 
         @Override
         public CommunicationStatus build() {
-            return new CommunicationStatus(this);
+            CommunicationStatus communicationStatus = new CommunicationStatus(this);
+            if (validating) {
+                validate(communicationStatus);
+            }
+            return communicationStatus;
+        }
+
+        protected void validate(CommunicationStatus communicationStatus) {
+            super.validate(communicationStatus);
+        }
+
+        protected Builder from(CommunicationStatus communicationStatus) {
+            super.from(communicationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompartmentCode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompartmentCode.java
index 5a8d2d61679..2884a0cd5e5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompartmentCode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompartmentCode.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public CompartmentCode build() {
-            return new CompartmentCode(this);
+            CompartmentCode compartmentCode = new CompartmentCode(this);
+            if (validating) {
+                validate(compartmentCode);
+            }
+            return compartmentCode;
+        }
+
+        protected void validate(CompartmentCode compartmentCode) {
+            super.validate(compartmentCode);
+        }
+
+        protected Builder from(CompartmentCode compartmentCode) {
+            super.from(compartmentCode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompartmentType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompartmentType.java
index 7fb61f3aeaf..66b3d516187 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompartmentType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompartmentType.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public CompartmentType build() {
-            return new CompartmentType(this);
+            CompartmentType compartmentType = new CompartmentType(this);
+            if (validating) {
+                validate(compartmentType);
+            }
+            return compartmentType;
+        }
+
+        protected void validate(CompartmentType compartmentType) {
+            super.validate(compartmentType);
+        }
+
+        protected Builder from(CompartmentType compartmentType) {
+            super.from(compartmentType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompositionAttestationMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompositionAttestationMode.java
index c51b199d0fa..79ef1869492 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompositionAttestationMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompositionAttestationMode.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public CompositionAttestationMode build() {
-            return new CompositionAttestationMode(this);
+            CompositionAttestationMode compositionAttestationMode = new CompositionAttestationMode(this);
+            if (validating) {
+                validate(compositionAttestationMode);
+            }
+            return compositionAttestationMode;
+        }
+
+        protected void validate(CompositionAttestationMode compositionAttestationMode) {
+            super.validate(compositionAttestationMode);
+        }
+
+        protected Builder from(CompositionAttestationMode compositionAttestationMode) {
+            super.from(compositionAttestationMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompositionStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompositionStatus.java
index 2043a0cecdd..9d058fdb42c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompositionStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CompositionStatus.java
@@ -173,11 +173,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -232,7 +228,20 @@ public Builder value(Value value) {
 
         @Override
         public CompositionStatus build() {
-            return new CompositionStatus(this);
+            CompositionStatus compositionStatus = new CompositionStatus(this);
+            if (validating) {
+                validate(compositionStatus);
+            }
+            return compositionStatus;
+        }
+
+        protected void validate(CompositionStatus compositionStatus) {
+            super.validate(compositionStatus);
+        }
+
+        protected Builder from(CompositionStatus compositionStatus) {
+            super.from(compositionStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptMapEquivalence.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptMapEquivalence.java
index 25b34e0449a..eeb28139ca5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptMapEquivalence.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptMapEquivalence.java
@@ -243,11 +243,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -302,7 +298,20 @@ public Builder value(Value value) {
 
         @Override
         public ConceptMapEquivalence build() {
-            return new ConceptMapEquivalence(this);
+            ConceptMapEquivalence conceptMapEquivalence = new ConceptMapEquivalence(this);
+            if (validating) {
+                validate(conceptMapEquivalence);
+            }
+            return conceptMapEquivalence;
+        }
+
+        protected void validate(ConceptMapEquivalence conceptMapEquivalence) {
+            super.validate(conceptMapEquivalence);
+        }
+
+        protected Builder from(ConceptMapEquivalence conceptMapEquivalence) {
+            super.from(conceptMapEquivalence);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptMapGroupUnmappedMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptMapGroupUnmappedMode.java
index 8330f6b5e40..ff1532d471e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptMapGroupUnmappedMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptMapGroupUnmappedMode.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public ConceptMapGroupUnmappedMode build() {
-            return new ConceptMapGroupUnmappedMode(this);
+            ConceptMapGroupUnmappedMode conceptMapGroupUnmappedMode = new ConceptMapGroupUnmappedMode(this);
+            if (validating) {
+                validate(conceptMapGroupUnmappedMode);
+            }
+            return conceptMapGroupUnmappedMode;
+        }
+
+        protected void validate(ConceptMapGroupUnmappedMode conceptMapGroupUnmappedMode) {
+            super.validate(conceptMapGroupUnmappedMode);
+        }
+
+        protected Builder from(ConceptMapGroupUnmappedMode conceptMapGroupUnmappedMode) {
+            super.from(conceptMapGroupUnmappedMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptSubsumptionOutcome.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptSubsumptionOutcome.java
index bb5815ae608..a787bf48d94 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptSubsumptionOutcome.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConceptSubsumptionOutcome.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ConceptSubsumptionOutcome build() {
-            return new ConceptSubsumptionOutcome(this);
+            ConceptSubsumptionOutcome conceptSubsumptionOutcome = new ConceptSubsumptionOutcome(this);
+            if (validating) {
+                validate(conceptSubsumptionOutcome);
+            }
+            return conceptSubsumptionOutcome;
+        }
+
+        protected void validate(ConceptSubsumptionOutcome conceptSubsumptionOutcome) {
+            super.validate(conceptSubsumptionOutcome);
+        }
+
+        protected Builder from(ConceptSubsumptionOutcome conceptSubsumptionOutcome) {
+            super.from(conceptSubsumptionOutcome);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConditionalDeleteStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConditionalDeleteStatus.java
index 9f6cf7e66f6..79ff6d2d3dd 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConditionalDeleteStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConditionalDeleteStatus.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public ConditionalDeleteStatus build() {
-            return new ConditionalDeleteStatus(this);
+            ConditionalDeleteStatus conditionalDeleteStatus = new ConditionalDeleteStatus(this);
+            if (validating) {
+                validate(conditionalDeleteStatus);
+            }
+            return conditionalDeleteStatus;
+        }
+
+        protected void validate(ConditionalDeleteStatus conditionalDeleteStatus) {
+            super.validate(conditionalDeleteStatus);
+        }
+
+        protected Builder from(ConditionalDeleteStatus conditionalDeleteStatus) {
+            super.from(conditionalDeleteStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConditionalReadStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConditionalReadStatus.java
index 65451db22bc..6ffa7bc33ac 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConditionalReadStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConditionalReadStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ConditionalReadStatus build() {
-            return new ConditionalReadStatus(this);
+            ConditionalReadStatus conditionalReadStatus = new ConditionalReadStatus(this);
+            if (validating) {
+                validate(conditionalReadStatus);
+            }
+            return conditionalReadStatus;
+        }
+
+        protected void validate(ConditionalReadStatus conditionalReadStatus) {
+            super.validate(conditionalReadStatus);
+        }
+
+        protected Builder from(ConditionalReadStatus conditionalReadStatus) {
+            super.from(conditionalReadStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentDataMeaning.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentDataMeaning.java
index af526368286..3bca9e5f326 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentDataMeaning.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentDataMeaning.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ConsentDataMeaning build() {
-            return new ConsentDataMeaning(this);
+            ConsentDataMeaning consentDataMeaning = new ConsentDataMeaning(this);
+            if (validating) {
+                validate(consentDataMeaning);
+            }
+            return consentDataMeaning;
+        }
+
+        protected void validate(ConsentDataMeaning consentDataMeaning) {
+            super.validate(consentDataMeaning);
+        }
+
+        protected Builder from(ConsentDataMeaning consentDataMeaning) {
+            super.from(consentDataMeaning);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentProvisionType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentProvisionType.java
index dd1e8383011..e65783eceba 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentProvisionType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentProvisionType.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public ConsentProvisionType build() {
-            return new ConsentProvisionType(this);
+            ConsentProvisionType consentProvisionType = new ConsentProvisionType(this);
+            if (validating) {
+                validate(consentProvisionType);
+            }
+            return consentProvisionType;
+        }
+
+        protected void validate(ConsentProvisionType consentProvisionType) {
+            super.validate(consentProvisionType);
+        }
+
+        protected Builder from(ConsentProvisionType consentProvisionType) {
+            super.from(consentProvisionType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentState.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentState.java
index a98114831e7..f9ffb7808c6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentState.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConsentState.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public ConsentState build() {
-            return new ConsentState(this);
+            ConsentState consentState = new ConsentState(this);
+            if (validating) {
+                validate(consentState);
+            }
+            return consentState;
+        }
+
+        protected void validate(ConsentState consentState) {
+            super.validate(consentState);
+        }
+
+        protected Builder from(ConsentState consentState) {
+            super.from(consentState);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConstraintSeverity.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConstraintSeverity.java
index 520de1a3a55..55fcb4e8b8e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConstraintSeverity.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ConstraintSeverity.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public ConstraintSeverity build() {
-            return new ConstraintSeverity(this);
+            ConstraintSeverity constraintSeverity = new ConstraintSeverity(this);
+            if (validating) {
+                validate(constraintSeverity);
+            }
+            return constraintSeverity;
+        }
+
+        protected void validate(ConstraintSeverity constraintSeverity) {
+            super.validate(constraintSeverity);
+        }
+
+        protected Builder from(ConstraintSeverity constraintSeverity) {
+            super.from(constraintSeverity);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContactPointSystem.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContactPointSystem.java
index 09565e09cab..95e0c7ec519 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContactPointSystem.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContactPointSystem.java
@@ -208,11 +208,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -267,7 +263,20 @@ public Builder value(Value value) {
 
         @Override
         public ContactPointSystem build() {
-            return new ContactPointSystem(this);
+            ContactPointSystem contactPointSystem = new ContactPointSystem(this);
+            if (validating) {
+                validate(contactPointSystem);
+            }
+            return contactPointSystem;
+        }
+
+        protected void validate(ContactPointSystem contactPointSystem) {
+            super.validate(contactPointSystem);
+        }
+
+        protected Builder from(ContactPointSystem contactPointSystem) {
+            super.from(contactPointSystem);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContactPointUse.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContactPointUse.java
index 2e213ca52a4..8fb05032310 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContactPointUse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContactPointUse.java
@@ -183,11 +183,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -242,7 +238,20 @@ public Builder value(Value value) {
 
         @Override
         public ContactPointUse build() {
-            return new ContactPointUse(this);
+            ContactPointUse contactPointUse = new ContactPointUse(this);
+            if (validating) {
+                validate(contactPointUse);
+            }
+            return contactPointUse;
+        }
+
+        protected void validate(ContactPointUse contactPointUse) {
+            super.validate(contactPointUse);
+        }
+
+        protected Builder from(ContactPointUse contactPointUse) {
+            super.from(contactPointUse);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContractPublicationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContractPublicationStatus.java
index c50eaad5201..fb3b1e9a925 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContractPublicationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContractPublicationStatus.java
@@ -323,11 +323,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -382,7 +378,20 @@ public Builder value(Value value) {
 
         @Override
         public ContractPublicationStatus build() {
-            return new ContractPublicationStatus(this);
+            ContractPublicationStatus contractPublicationStatus = new ContractPublicationStatus(this);
+            if (validating) {
+                validate(contractPublicationStatus);
+            }
+            return contractPublicationStatus;
+        }
+
+        protected void validate(ContractPublicationStatus contractPublicationStatus) {
+            super.validate(contractPublicationStatus);
+        }
+
+        protected Builder from(ContractPublicationStatus contractPublicationStatus) {
+            super.from(contractPublicationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContractStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContractStatus.java
index 1a50dc18d2f..35ae386e848 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContractStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContractStatus.java
@@ -323,11 +323,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -382,7 +378,20 @@ public Builder value(Value value) {
 
         @Override
         public ContractStatus build() {
-            return new ContractStatus(this);
+            ContractStatus contractStatus = new ContractStatus(this);
+            if (validating) {
+                validate(contractStatus);
+            }
+            return contractStatus;
+        }
+
+        protected void validate(ContractStatus contractStatus) {
+            super.validate(contractStatus);
+        }
+
+        protected Builder from(ContractStatus contractStatus) {
+            super.from(contractStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContributorType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContributorType.java
index 5a368f6c35d..b6193dad929 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContributorType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ContributorType.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ContributorType build() {
-            return new ContributorType(this);
+            ContributorType contributorType = new ContributorType(this);
+            if (validating) {
+                validate(contributorType);
+            }
+            return contributorType;
+        }
+
+        protected void validate(ContributorType contributorType) {
+            super.validate(contributorType);
+        }
+
+        protected Builder from(ContributorType contributorType) {
+            super.from(contributorType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CoverageStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CoverageStatus.java
index dfbf746eb76..08b4771aa22 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CoverageStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/CoverageStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public CoverageStatus build() {
-            return new CoverageStatus(this);
+            CoverageStatus coverageStatus = new CoverageStatus(this);
+            if (validating) {
+                validate(coverageStatus);
+            }
+            return coverageStatus;
+        }
+
+        protected void validate(CoverageStatus coverageStatus) {
+            super.validate(coverageStatus);
+        }
+
+        protected Builder from(CoverageStatus coverageStatus) {
+            super.from(coverageStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DataAbsentReason.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DataAbsentReason.java
index f95fb203d57..eff28436fff 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DataAbsentReason.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DataAbsentReason.java
@@ -290,11 +290,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -349,7 +345,20 @@ public Builder value(Value value) {
 
         @Override
         public DataAbsentReason build() {
-            return new DataAbsentReason(this);
+            DataAbsentReason dataAbsentReason = new DataAbsentReason(this);
+            if (validating) {
+                validate(dataAbsentReason);
+            }
+            return dataAbsentReason;
+        }
+
+        protected void validate(DataAbsentReason dataAbsentReason) {
+            super.validate(dataAbsentReason);
+        }
+
+        protected Builder from(DataAbsentReason dataAbsentReason) {
+            super.from(dataAbsentReason);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DayOfWeek.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DayOfWeek.java
index 030cb7651bf..e868fc1e1f7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DayOfWeek.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DayOfWeek.java
@@ -202,11 +202,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -261,7 +257,20 @@ public Builder value(Value value) {
 
         @Override
         public DayOfWeek build() {
-            return new DayOfWeek(this);
+            DayOfWeek dayOfWeek = new DayOfWeek(this);
+            if (validating) {
+                validate(dayOfWeek);
+            }
+            return dayOfWeek;
+        }
+
+        protected void validate(DayOfWeek dayOfWeek) {
+            super.validate(dayOfWeek);
+        }
+
+        protected Builder from(DayOfWeek dayOfWeek) {
+            super.from(dayOfWeek);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DaysOfWeek.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DaysOfWeek.java
index a8a4ef4da77..a4ddbac49eb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DaysOfWeek.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DaysOfWeek.java
@@ -202,11 +202,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -261,7 +257,20 @@ public Builder value(Value value) {
 
         @Override
         public DaysOfWeek build() {
-            return new DaysOfWeek(this);
+            DaysOfWeek daysOfWeek = new DaysOfWeek(this);
+            if (validating) {
+                validate(daysOfWeek);
+            }
+            return daysOfWeek;
+        }
+
+        protected void validate(DaysOfWeek daysOfWeek) {
+            super.validate(daysOfWeek);
+        }
+
+        protected Builder from(DaysOfWeek daysOfWeek) {
+            super.from(daysOfWeek);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DetectedIssueSeverity.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DetectedIssueSeverity.java
index 1fb1fbf3ef6..aeaf0491538 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DetectedIssueSeverity.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DetectedIssueSeverity.java
@@ -160,11 +160,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -219,7 +215,20 @@ public Builder value(Value value) {
 
         @Override
         public DetectedIssueSeverity build() {
-            return new DetectedIssueSeverity(this);
+            DetectedIssueSeverity detectedIssueSeverity = new DetectedIssueSeverity(this);
+            if (validating) {
+                validate(detectedIssueSeverity);
+            }
+            return detectedIssueSeverity;
+        }
+
+        protected void validate(DetectedIssueSeverity detectedIssueSeverity) {
+            super.validate(detectedIssueSeverity);
+        }
+
+        protected Builder from(DetectedIssueSeverity detectedIssueSeverity) {
+            super.from(detectedIssueSeverity);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DetectedIssueStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DetectedIssueStatus.java
index b9aaeed0806..5187d576447 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DetectedIssueStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DetectedIssueStatus.java
@@ -222,11 +222,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -281,7 +277,20 @@ public Builder value(Value value) {
 
         @Override
         public DetectedIssueStatus build() {
-            return new DetectedIssueStatus(this);
+            DetectedIssueStatus detectedIssueStatus = new DetectedIssueStatus(this);
+            if (validating) {
+                validate(detectedIssueStatus);
+            }
+            return detectedIssueStatus;
+        }
+
+        protected void validate(DetectedIssueStatus detectedIssueStatus) {
+            super.validate(detectedIssueStatus);
+        }
+
+        protected Builder from(DetectedIssueStatus detectedIssueStatus) {
+            super.from(detectedIssueStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCalibrationState.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCalibrationState.java
index 24e2ad8c66d..ad78e563d2b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCalibrationState.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCalibrationState.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public DeviceMetricCalibrationState build() {
-            return new DeviceMetricCalibrationState(this);
+            DeviceMetricCalibrationState deviceMetricCalibrationState = new DeviceMetricCalibrationState(this);
+            if (validating) {
+                validate(deviceMetricCalibrationState);
+            }
+            return deviceMetricCalibrationState;
+        }
+
+        protected void validate(DeviceMetricCalibrationState deviceMetricCalibrationState) {
+            super.validate(deviceMetricCalibrationState);
+        }
+
+        protected Builder from(DeviceMetricCalibrationState deviceMetricCalibrationState) {
+            super.from(deviceMetricCalibrationState);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCalibrationType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCalibrationType.java
index 9332e3b0d7a..8d4e470a56a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCalibrationType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCalibrationType.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public DeviceMetricCalibrationType build() {
-            return new DeviceMetricCalibrationType(this);
+            DeviceMetricCalibrationType deviceMetricCalibrationType = new DeviceMetricCalibrationType(this);
+            if (validating) {
+                validate(deviceMetricCalibrationType);
+            }
+            return deviceMetricCalibrationType;
+        }
+
+        protected void validate(DeviceMetricCalibrationType deviceMetricCalibrationType) {
+            super.validate(deviceMetricCalibrationType);
+        }
+
+        protected Builder from(DeviceMetricCalibrationType deviceMetricCalibrationType) {
+            super.from(deviceMetricCalibrationType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCategory.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCategory.java
index 888f1d77ade..c88e4549fe8 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCategory.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricCategory.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public DeviceMetricCategory build() {
-            return new DeviceMetricCategory(this);
+            DeviceMetricCategory deviceMetricCategory = new DeviceMetricCategory(this);
+            if (validating) {
+                validate(deviceMetricCategory);
+            }
+            return deviceMetricCategory;
+        }
+
+        protected void validate(DeviceMetricCategory deviceMetricCategory) {
+            super.validate(deviceMetricCategory);
+        }
+
+        protected Builder from(DeviceMetricCategory deviceMetricCategory) {
+            super.from(deviceMetricCategory);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricColor.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricColor.java
index 1077ef256ca..0fb70e7e6c9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricColor.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricColor.java
@@ -213,11 +213,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -272,7 +268,20 @@ public Builder value(Value value) {
 
         @Override
         public DeviceMetricColor build() {
-            return new DeviceMetricColor(this);
+            DeviceMetricColor deviceMetricColor = new DeviceMetricColor(this);
+            if (validating) {
+                validate(deviceMetricColor);
+            }
+            return deviceMetricColor;
+        }
+
+        protected void validate(DeviceMetricColor deviceMetricColor) {
+            super.validate(deviceMetricColor);
+        }
+
+        protected Builder from(DeviceMetricColor deviceMetricColor) {
+            super.from(deviceMetricColor);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricOperationalStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricOperationalStatus.java
index 3f06c862bf8..f4ac0bbcfbb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricOperationalStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceMetricOperationalStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public DeviceMetricOperationalStatus build() {
-            return new DeviceMetricOperationalStatus(this);
+            DeviceMetricOperationalStatus deviceMetricOperationalStatus = new DeviceMetricOperationalStatus(this);
+            if (validating) {
+                validate(deviceMetricOperationalStatus);
+            }
+            return deviceMetricOperationalStatus;
+        }
+
+        protected void validate(DeviceMetricOperationalStatus deviceMetricOperationalStatus) {
+            super.validate(deviceMetricOperationalStatus);
+        }
+
+        protected Builder from(DeviceMetricOperationalStatus deviceMetricOperationalStatus) {
+            super.from(deviceMetricOperationalStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceNameType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceNameType.java
index b3e9c1e56be..dccc3053a78 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceNameType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceNameType.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public DeviceNameType build() {
-            return new DeviceNameType(this);
+            DeviceNameType deviceNameType = new DeviceNameType(this);
+            if (validating) {
+                validate(deviceNameType);
+            }
+            return deviceNameType;
+        }
+
+        protected void validate(DeviceNameType deviceNameType) {
+            super.validate(deviceNameType);
+        }
+
+        protected Builder from(DeviceNameType deviceNameType) {
+            super.from(deviceNameType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceRequestStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceRequestStatus.java
index 63ebe97eba0..fad8d89b019 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceRequestStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceRequestStatus.java
@@ -207,11 +207,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -266,7 +262,20 @@ public Builder value(Value value) {
 
         @Override
         public DeviceRequestStatus build() {
-            return new DeviceRequestStatus(this);
+            DeviceRequestStatus deviceRequestStatus = new DeviceRequestStatus(this);
+            if (validating) {
+                validate(deviceRequestStatus);
+            }
+            return deviceRequestStatus;
+        }
+
+        protected void validate(DeviceRequestStatus deviceRequestStatus) {
+            super.validate(deviceRequestStatus);
+        }
+
+        protected Builder from(DeviceRequestStatus deviceRequestStatus) {
+            super.from(deviceRequestStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceUseStatementStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceUseStatementStatus.java
index 00093385d35..620d508f20d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceUseStatementStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DeviceUseStatementStatus.java
@@ -192,11 +192,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -251,7 +247,20 @@ public Builder value(Value value) {
 
         @Override
         public DeviceUseStatementStatus build() {
-            return new DeviceUseStatementStatus(this);
+            DeviceUseStatementStatus deviceUseStatementStatus = new DeviceUseStatementStatus(this);
+            if (validating) {
+                validate(deviceUseStatementStatus);
+            }
+            return deviceUseStatementStatus;
+        }
+
+        protected void validate(DeviceUseStatementStatus deviceUseStatementStatus) {
+            super.validate(deviceUseStatementStatus);
+        }
+
+        protected Builder from(DeviceUseStatementStatus deviceUseStatementStatus) {
+            super.from(deviceUseStatementStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DiagnosticReportStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DiagnosticReportStatus.java
index f2b7d098a83..c339eb3a950 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DiagnosticReportStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DiagnosticReportStatus.java
@@ -241,11 +241,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -300,7 +296,20 @@ public Builder value(Value value) {
 
         @Override
         public DiagnosticReportStatus build() {
-            return new DiagnosticReportStatus(this);
+            DiagnosticReportStatus diagnosticReportStatus = new DiagnosticReportStatus(this);
+            if (validating) {
+                validate(diagnosticReportStatus);
+            }
+            return diagnosticReportStatus;
+        }
+
+        protected void validate(DiagnosticReportStatus diagnosticReportStatus) {
+            super.validate(diagnosticReportStatus);
+        }
+
+        protected Builder from(DiagnosticReportStatus diagnosticReportStatus) {
+            super.from(diagnosticReportStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DiscriminatorType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DiscriminatorType.java
index 7ac33508a78..c0739246c0f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DiscriminatorType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DiscriminatorType.java
@@ -183,11 +183,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -242,7 +238,20 @@ public Builder value(Value value) {
 
         @Override
         public DiscriminatorType build() {
-            return new DiscriminatorType(this);
+            DiscriminatorType discriminatorType = new DiscriminatorType(this);
+            if (validating) {
+                validate(discriminatorType);
+            }
+            return discriminatorType;
+        }
+
+        protected void validate(DiscriminatorType discriminatorType) {
+            super.validate(discriminatorType);
+        }
+
+        protected Builder from(DiscriminatorType discriminatorType) {
+            super.from(discriminatorType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentConfidentiality.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentConfidentiality.java
index cb39210b59a..c1b4c6e19cb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentConfidentiality.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentConfidentiality.java
@@ -161,11 +161,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -220,7 +216,20 @@ public Builder value(Value value) {
 
         @Override
         public DocumentConfidentiality build() {
-            return new DocumentConfidentiality(this);
+            DocumentConfidentiality documentConfidentiality = new DocumentConfidentiality(this);
+            if (validating) {
+                validate(documentConfidentiality);
+            }
+            return documentConfidentiality;
+        }
+
+        protected void validate(DocumentConfidentiality documentConfidentiality) {
+            super.validate(documentConfidentiality);
+        }
+
+        protected Builder from(DocumentConfidentiality documentConfidentiality) {
+            super.from(documentConfidentiality);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentMode.java
index edabee58f9f..6da44266642 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentMode.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public DocumentMode build() {
-            return new DocumentMode(this);
+            DocumentMode documentMode = new DocumentMode(this);
+            if (validating) {
+                validate(documentMode);
+            }
+            return documentMode;
+        }
+
+        protected void validate(DocumentMode documentMode) {
+            super.validate(documentMode);
+        }
+
+        protected Builder from(DocumentMode documentMode) {
+            super.from(documentMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentReferenceStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentReferenceStatus.java
index f862be76ad3..c05b7ed0f8d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentReferenceStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentReferenceStatus.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public DocumentReferenceStatus build() {
-            return new DocumentReferenceStatus(this);
+            DocumentReferenceStatus documentReferenceStatus = new DocumentReferenceStatus(this);
+            if (validating) {
+                validate(documentReferenceStatus);
+            }
+            return documentReferenceStatus;
+        }
+
+        protected void validate(DocumentReferenceStatus documentReferenceStatus) {
+            super.validate(documentReferenceStatus);
+        }
+
+        protected Builder from(DocumentReferenceStatus documentReferenceStatus) {
+            super.from(documentReferenceStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentRelationshipType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentRelationshipType.java
index 6d61435332a..5f39cbfe591 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentRelationshipType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/DocumentRelationshipType.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public DocumentRelationshipType build() {
-            return new DocumentRelationshipType(this);
+            DocumentRelationshipType documentRelationshipType = new DocumentRelationshipType(this);
+            if (validating) {
+                validate(documentRelationshipType);
+            }
+            return documentRelationshipType;
+        }
+
+        protected void validate(DocumentRelationshipType documentRelationshipType) {
+            super.validate(documentRelationshipType);
+        }
+
+        protected Builder from(DocumentRelationshipType documentRelationshipType) {
+            super.from(documentRelationshipType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityRequestPurpose.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityRequestPurpose.java
index f3d69800a61..dd6c6da87fd 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityRequestPurpose.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityRequestPurpose.java
@@ -171,11 +171,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -230,7 +226,20 @@ public Builder value(Value value) {
 
         @Override
         public EligibilityRequestPurpose build() {
-            return new EligibilityRequestPurpose(this);
+            EligibilityRequestPurpose eligibilityRequestPurpose = new EligibilityRequestPurpose(this);
+            if (validating) {
+                validate(eligibilityRequestPurpose);
+            }
+            return eligibilityRequestPurpose;
+        }
+
+        protected void validate(EligibilityRequestPurpose eligibilityRequestPurpose) {
+            super.validate(eligibilityRequestPurpose);
+        }
+
+        protected Builder from(EligibilityRequestPurpose eligibilityRequestPurpose) {
+            super.from(eligibilityRequestPurpose);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityRequestStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityRequestStatus.java
index 11bd3fa0701..4bb7d39ab1a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityRequestStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityRequestStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public EligibilityRequestStatus build() {
-            return new EligibilityRequestStatus(this);
+            EligibilityRequestStatus eligibilityRequestStatus = new EligibilityRequestStatus(this);
+            if (validating) {
+                validate(eligibilityRequestStatus);
+            }
+            return eligibilityRequestStatus;
+        }
+
+        protected void validate(EligibilityRequestStatus eligibilityRequestStatus) {
+            super.validate(eligibilityRequestStatus);
+        }
+
+        protected Builder from(EligibilityRequestStatus eligibilityRequestStatus) {
+            super.from(eligibilityRequestStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityResponsePurpose.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityResponsePurpose.java
index f048a81fd37..147ce1c74a1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityResponsePurpose.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityResponsePurpose.java
@@ -171,11 +171,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -230,7 +226,20 @@ public Builder value(Value value) {
 
         @Override
         public EligibilityResponsePurpose build() {
-            return new EligibilityResponsePurpose(this);
+            EligibilityResponsePurpose eligibilityResponsePurpose = new EligibilityResponsePurpose(this);
+            if (validating) {
+                validate(eligibilityResponsePurpose);
+            }
+            return eligibilityResponsePurpose;
+        }
+
+        protected void validate(EligibilityResponsePurpose eligibilityResponsePurpose) {
+            super.validate(eligibilityResponsePurpose);
+        }
+
+        protected Builder from(EligibilityResponsePurpose eligibilityResponsePurpose) {
+            super.from(eligibilityResponsePurpose);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityResponseStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityResponseStatus.java
index 121dde385d5..0b260ee582c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityResponseStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EligibilityResponseStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public EligibilityResponseStatus build() {
-            return new EligibilityResponseStatus(this);
+            EligibilityResponseStatus eligibilityResponseStatus = new EligibilityResponseStatus(this);
+            if (validating) {
+                validate(eligibilityResponseStatus);
+            }
+            return eligibilityResponseStatus;
+        }
+
+        protected void validate(EligibilityResponseStatus eligibilityResponseStatus) {
+            super.validate(eligibilityResponseStatus);
+        }
+
+        protected Builder from(EligibilityResponseStatus eligibilityResponseStatus) {
+            super.from(eligibilityResponseStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnableWhenBehavior.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnableWhenBehavior.java
index ea048d3bbd7..fec75566891 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnableWhenBehavior.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnableWhenBehavior.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public EnableWhenBehavior build() {
-            return new EnableWhenBehavior(this);
+            EnableWhenBehavior enableWhenBehavior = new EnableWhenBehavior(this);
+            if (validating) {
+                validate(enableWhenBehavior);
+            }
+            return enableWhenBehavior;
+        }
+
+        protected void validate(EnableWhenBehavior enableWhenBehavior) {
+            super.validate(enableWhenBehavior);
+        }
+
+        protected Builder from(EnableWhenBehavior enableWhenBehavior) {
+            super.from(enableWhenBehavior);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EncounterLocationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EncounterLocationStatus.java
index 4924cefa70e..597d5135412 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EncounterLocationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EncounterLocationStatus.java
@@ -171,11 +171,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -230,7 +226,20 @@ public Builder value(Value value) {
 
         @Override
         public EncounterLocationStatus build() {
-            return new EncounterLocationStatus(this);
+            EncounterLocationStatus encounterLocationStatus = new EncounterLocationStatus(this);
+            if (validating) {
+                validate(encounterLocationStatus);
+            }
+            return encounterLocationStatus;
+        }
+
+        protected void validate(EncounterLocationStatus encounterLocationStatus) {
+            super.validate(encounterLocationStatus);
+        }
+
+        protected Builder from(EncounterLocationStatus encounterLocationStatus) {
+            super.from(encounterLocationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EncounterStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EncounterStatus.java
index f10218150f3..91ae757cb64 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EncounterStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EncounterStatus.java
@@ -225,11 +225,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -284,7 +280,20 @@ public Builder value(Value value) {
 
         @Override
         public EncounterStatus build() {
-            return new EncounterStatus(this);
+            EncounterStatus encounterStatus = new EncounterStatus(this);
+            if (validating) {
+                validate(encounterStatus);
+            }
+            return encounterStatus;
+        }
+
+        protected void validate(EncounterStatus encounterStatus) {
+            super.validate(encounterStatus);
+        }
+
+        protected Builder from(EncounterStatus encounterStatus) {
+            super.from(encounterStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EndpointStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EndpointStatus.java
index 3e6ab7c515f..ef6f0c44e3e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EndpointStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EndpointStatus.java
@@ -192,11 +192,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -251,7 +247,20 @@ public Builder value(Value value) {
 
         @Override
         public EndpointStatus build() {
-            return new EndpointStatus(this);
+            EndpointStatus endpointStatus = new EndpointStatus(this);
+            if (validating) {
+                validate(endpointStatus);
+            }
+            return endpointStatus;
+        }
+
+        protected void validate(EndpointStatus endpointStatus) {
+            super.validate(endpointStatus);
+        }
+
+        protected Builder from(EndpointStatus endpointStatus) {
+            super.from(endpointStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnrollmentRequestStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnrollmentRequestStatus.java
index e7474aa6a94..558edd6f2c1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnrollmentRequestStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnrollmentRequestStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public EnrollmentRequestStatus build() {
-            return new EnrollmentRequestStatus(this);
+            EnrollmentRequestStatus enrollmentRequestStatus = new EnrollmentRequestStatus(this);
+            if (validating) {
+                validate(enrollmentRequestStatus);
+            }
+            return enrollmentRequestStatus;
+        }
+
+        protected void validate(EnrollmentRequestStatus enrollmentRequestStatus) {
+            super.validate(enrollmentRequestStatus);
+        }
+
+        protected Builder from(EnrollmentRequestStatus enrollmentRequestStatus) {
+            super.from(enrollmentRequestStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnrollmentResponseStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnrollmentResponseStatus.java
index 2c23bd42037..b04ff9145da 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnrollmentResponseStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EnrollmentResponseStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public EnrollmentResponseStatus build() {
-            return new EnrollmentResponseStatus(this);
+            EnrollmentResponseStatus enrollmentResponseStatus = new EnrollmentResponseStatus(this);
+            if (validating) {
+                validate(enrollmentResponseStatus);
+            }
+            return enrollmentResponseStatus;
+        }
+
+        protected void validate(EnrollmentResponseStatus enrollmentResponseStatus) {
+            super.validate(enrollmentResponseStatus);
+        }
+
+        protected Builder from(EnrollmentResponseStatus enrollmentResponseStatus) {
+            super.from(enrollmentResponseStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EpisodeOfCareStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EpisodeOfCareStatus.java
index 8c1f9f3a7fa..b2de6fc5efa 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EpisodeOfCareStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EpisodeOfCareStatus.java
@@ -208,11 +208,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -267,7 +263,20 @@ public Builder value(Value value) {
 
         @Override
         public EpisodeOfCareStatus build() {
-            return new EpisodeOfCareStatus(this);
+            EpisodeOfCareStatus episodeOfCareStatus = new EpisodeOfCareStatus(this);
+            if (validating) {
+                validate(episodeOfCareStatus);
+            }
+            return episodeOfCareStatus;
+        }
+
+        protected void validate(EpisodeOfCareStatus episodeOfCareStatus) {
+            super.validate(episodeOfCareStatus);
+        }
+
+        protected Builder from(EpisodeOfCareStatus episodeOfCareStatus) {
+            super.from(episodeOfCareStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EventCapabilityMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EventCapabilityMode.java
index 96e8be8b84f..ffb40b88d06 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EventCapabilityMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EventCapabilityMode.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public EventCapabilityMode build() {
-            return new EventCapabilityMode(this);
+            EventCapabilityMode eventCapabilityMode = new EventCapabilityMode(this);
+            if (validating) {
+                validate(eventCapabilityMode);
+            }
+            return eventCapabilityMode;
+        }
+
+        protected void validate(EventCapabilityMode eventCapabilityMode) {
+            super.validate(eventCapabilityMode);
+        }
+
+        protected Builder from(EventCapabilityMode eventCapabilityMode) {
+            super.from(eventCapabilityMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EventTiming.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EventTiming.java
index abfc1bc0bc6..502f197218f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EventTiming.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EventTiming.java
@@ -353,11 +353,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -412,7 +408,20 @@ public Builder value(Value value) {
 
         @Override
         public EventTiming build() {
-            return new EventTiming(this);
+            EventTiming eventTiming = new EventTiming(this);
+            if (validating) {
+                validate(eventTiming);
+            }
+            return eventTiming;
+        }
+
+        protected void validate(EventTiming eventTiming) {
+            super.validate(eventTiming);
+        }
+
+        protected Builder from(EventTiming eventTiming) {
+            super.from(eventTiming);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EvidenceVariableType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EvidenceVariableType.java
index 68160025ecc..749adc5c346 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EvidenceVariableType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/EvidenceVariableType.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public EvidenceVariableType build() {
-            return new EvidenceVariableType(this);
+            EvidenceVariableType evidenceVariableType = new EvidenceVariableType(this);
+            if (validating) {
+                validate(evidenceVariableType);
+            }
+            return evidenceVariableType;
+        }
+
+        protected void validate(EvidenceVariableType evidenceVariableType) {
+            super.validate(evidenceVariableType);
+        }
+
+        protected Builder from(EvidenceVariableType evidenceVariableType) {
+            super.from(evidenceVariableType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExampleScenarioActorType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExampleScenarioActorType.java
index 8876d483047..06666c64cff 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExampleScenarioActorType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExampleScenarioActorType.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public ExampleScenarioActorType build() {
-            return new ExampleScenarioActorType(this);
+            ExampleScenarioActorType exampleScenarioActorType = new ExampleScenarioActorType(this);
+            if (validating) {
+                validate(exampleScenarioActorType);
+            }
+            return exampleScenarioActorType;
+        }
+
+        protected void validate(ExampleScenarioActorType exampleScenarioActorType) {
+            super.validate(exampleScenarioActorType);
+        }
+
+        protected Builder from(ExampleScenarioActorType exampleScenarioActorType) {
+            super.from(exampleScenarioActorType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExplanationOfBenefitStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExplanationOfBenefitStatus.java
index 529f9cd45f3..aad9fb10227 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExplanationOfBenefitStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExplanationOfBenefitStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ExplanationOfBenefitStatus build() {
-            return new ExplanationOfBenefitStatus(this);
+            ExplanationOfBenefitStatus explanationOfBenefitStatus = new ExplanationOfBenefitStatus(this);
+            if (validating) {
+                validate(explanationOfBenefitStatus);
+            }
+            return explanationOfBenefitStatus;
+        }
+
+        protected void validate(ExplanationOfBenefitStatus explanationOfBenefitStatus) {
+            super.validate(explanationOfBenefitStatus);
+        }
+
+        protected Builder from(ExplanationOfBenefitStatus explanationOfBenefitStatus) {
+            super.from(explanationOfBenefitStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExposureState.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExposureState.java
index 63eac3c1fea..b42ff6bc4be 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExposureState.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExposureState.java
@@ -148,11 +148,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -207,7 +203,20 @@ public Builder value(Value value) {
 
         @Override
         public ExposureState build() {
-            return new ExposureState(this);
+            ExposureState exposureState = new ExposureState(this);
+            if (validating) {
+                validate(exposureState);
+            }
+            return exposureState;
+        }
+
+        protected void validate(ExposureState exposureState) {
+            super.validate(exposureState);
+        }
+
+        protected Builder from(ExposureState exposureState) {
+            super.from(exposureState);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExtensionContextType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExtensionContextType.java
index d52258eee00..6fa764206de 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExtensionContextType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ExtensionContextType.java
@@ -161,11 +161,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -220,7 +216,20 @@ public Builder value(Value value) {
 
         @Override
         public ExtensionContextType build() {
-            return new ExtensionContextType(this);
+            ExtensionContextType extensionContextType = new ExtensionContextType(this);
+            if (validating) {
+                validate(extensionContextType);
+            }
+            return extensionContextType;
+        }
+
+        protected void validate(ExtensionContextType extensionContextType) {
+            super.validate(extensionContextType);
+        }
+
+        protected Builder from(ExtensionContextType extensionContextType) {
+            super.from(extensionContextType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRAllTypes.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRAllTypes.java
index c6e03a48304..c7103df4ab6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRAllTypes.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRAllTypes.java
@@ -2642,11 +2642,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -2701,7 +2697,20 @@ public Builder value(Value value) {
 
         @Override
         public FHIRAllTypes build() {
-            return new FHIRAllTypes(this);
+            FHIRAllTypes fHIRAllTypes = new FHIRAllTypes(this);
+            if (validating) {
+                validate(fHIRAllTypes);
+            }
+            return fHIRAllTypes;
+        }
+
+        protected void validate(FHIRAllTypes fHIRAllTypes) {
+            super.validate(fHIRAllTypes);
+        }
+
+        protected Builder from(FHIRAllTypes fHIRAllTypes) {
+            super.from(fHIRAllTypes);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRDefinedType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRDefinedType.java
index 652545cf496..7e9be246ddc 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRDefinedType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRDefinedType.java
@@ -2620,11 +2620,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -2679,7 +2675,20 @@ public Builder value(Value value) {
 
         @Override
         public FHIRDefinedType build() {
-            return new FHIRDefinedType(this);
+            FHIRDefinedType fHIRDefinedType = new FHIRDefinedType(this);
+            if (validating) {
+                validate(fHIRDefinedType);
+            }
+            return fHIRDefinedType;
+        }
+
+        protected void validate(FHIRDefinedType fHIRDefinedType) {
+            super.validate(fHIRDefinedType);
+        }
+
+        protected Builder from(FHIRDefinedType fHIRDefinedType) {
+            super.from(fHIRDefinedType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRDeviceStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRDeviceStatus.java
index 8bcfd3b6025..77d8c41eee2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRDeviceStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRDeviceStatus.java
@@ -171,11 +171,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -230,7 +226,20 @@ public Builder value(Value value) {
 
         @Override
         public FHIRDeviceStatus build() {
-            return new FHIRDeviceStatus(this);
+            FHIRDeviceStatus fHIRDeviceStatus = new FHIRDeviceStatus(this);
+            if (validating) {
+                validate(fHIRDeviceStatus);
+            }
+            return fHIRDeviceStatus;
+        }
+
+        protected void validate(FHIRDeviceStatus fHIRDeviceStatus) {
+            super.validate(fHIRDeviceStatus);
+        }
+
+        protected Builder from(FHIRDeviceStatus fHIRDeviceStatus) {
+            super.from(fHIRDeviceStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRResourceType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRResourceType.java
index 5e8c7e791cc..46d877d12b4 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRResourceType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRResourceType.java
@@ -1903,11 +1903,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -1962,7 +1958,20 @@ public Builder value(Value value) {
 
         @Override
         public FHIRResourceType build() {
-            return new FHIRResourceType(this);
+            FHIRResourceType fHIRResourceType = new FHIRResourceType(this);
+            if (validating) {
+                validate(fHIRResourceType);
+            }
+            return fHIRResourceType;
+        }
+
+        protected void validate(FHIRResourceType fHIRResourceType) {
+            super.validate(fHIRResourceType);
+        }
+
+        protected Builder from(FHIRResourceType fHIRResourceType) {
+            super.from(fHIRResourceType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRSubstanceStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRSubstanceStatus.java
index 1e4923e279b..f95b31554f8 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRSubstanceStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRSubstanceStatus.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public FHIRSubstanceStatus build() {
-            return new FHIRSubstanceStatus(this);
+            FHIRSubstanceStatus fHIRSubstanceStatus = new FHIRSubstanceStatus(this);
+            if (validating) {
+                validate(fHIRSubstanceStatus);
+            }
+            return fHIRSubstanceStatus;
+        }
+
+        protected void validate(FHIRSubstanceStatus fHIRSubstanceStatus) {
+            super.validate(fHIRSubstanceStatus);
+        }
+
+        protected Builder from(FHIRSubstanceStatus fHIRSubstanceStatus) {
+            super.from(fHIRSubstanceStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRVersion.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRVersion.java
index 36cc730dcea..aca067c125b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRVersion.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FHIRVersion.java
@@ -367,11 +367,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -426,7 +422,20 @@ public Builder value(Value value) {
 
         @Override
         public FHIRVersion build() {
-            return new FHIRVersion(this);
+            FHIRVersion fHIRVersion = new FHIRVersion(this);
+            if (validating) {
+                validate(fHIRVersion);
+            }
+            return fHIRVersion;
+        }
+
+        protected void validate(FHIRVersion fHIRVersion) {
+            super.validate(fHIRVersion);
+        }
+
+        protected Builder from(FHIRVersion fHIRVersion) {
+            super.from(fHIRVersion);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FamilyHistoryStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FamilyHistoryStatus.java
index 2391234867c..8adacf27ca1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FamilyHistoryStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FamilyHistoryStatus.java
@@ -170,11 +170,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -229,7 +225,20 @@ public Builder value(Value value) {
 
         @Override
         public FamilyHistoryStatus build() {
-            return new FamilyHistoryStatus(this);
+            FamilyHistoryStatus familyHistoryStatus = new FamilyHistoryStatus(this);
+            if (validating) {
+                validate(familyHistoryStatus);
+            }
+            return familyHistoryStatus;
+        }
+
+        protected void validate(FamilyHistoryStatus familyHistoryStatus) {
+            super.validate(familyHistoryStatus);
+        }
+
+        protected Builder from(FamilyHistoryStatus familyHistoryStatus) {
+            super.from(familyHistoryStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FilterOperator.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FilterOperator.java
index 272f1fda708..8d11e6f9595 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FilterOperator.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FilterOperator.java
@@ -230,11 +230,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -289,7 +285,20 @@ public Builder value(Value value) {
 
         @Override
         public FilterOperator build() {
-            return new FilterOperator(this);
+            FilterOperator filterOperator = new FilterOperator(this);
+            if (validating) {
+                validate(filterOperator);
+            }
+            return filterOperator;
+        }
+
+        protected void validate(FilterOperator filterOperator) {
+            super.validate(filterOperator);
+        }
+
+        protected Builder from(FilterOperator filterOperator) {
+            super.from(filterOperator);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FlagStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FlagStatus.java
index aa11c5f02b5..d2f75458695 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FlagStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/FlagStatus.java
@@ -159,11 +159,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -218,7 +214,20 @@ public Builder value(Value value) {
 
         @Override
         public FlagStatus build() {
-            return new FlagStatus(this);
+            FlagStatus flagStatus = new FlagStatus(this);
+            if (validating) {
+                validate(flagStatus);
+            }
+            return flagStatus;
+        }
+
+        protected void validate(FlagStatus flagStatus) {
+            super.validate(flagStatus);
+        }
+
+        protected Builder from(FlagStatus flagStatus) {
+            super.from(flagStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GoalLifecycleStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GoalLifecycleStatus.java
index 0e35a0daf29..5880173bedf 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GoalLifecycleStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GoalLifecycleStatus.java
@@ -224,11 +224,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -283,7 +279,20 @@ public Builder value(Value value) {
 
         @Override
         public GoalLifecycleStatus build() {
-            return new GoalLifecycleStatus(this);
+            GoalLifecycleStatus goalLifecycleStatus = new GoalLifecycleStatus(this);
+            if (validating) {
+                validate(goalLifecycleStatus);
+            }
+            return goalLifecycleStatus;
+        }
+
+        protected void validate(GoalLifecycleStatus goalLifecycleStatus) {
+            super.validate(goalLifecycleStatus);
+        }
+
+        protected Builder from(GoalLifecycleStatus goalLifecycleStatus) {
+            super.from(goalLifecycleStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GraphCompartmentRule.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GraphCompartmentRule.java
index 97c46bd14cc..281235480be 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GraphCompartmentRule.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GraphCompartmentRule.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public GraphCompartmentRule build() {
-            return new GraphCompartmentRule(this);
+            GraphCompartmentRule graphCompartmentRule = new GraphCompartmentRule(this);
+            if (validating) {
+                validate(graphCompartmentRule);
+            }
+            return graphCompartmentRule;
+        }
+
+        protected void validate(GraphCompartmentRule graphCompartmentRule) {
+            super.validate(graphCompartmentRule);
+        }
+
+        protected Builder from(GraphCompartmentRule graphCompartmentRule) {
+            super.from(graphCompartmentRule);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GraphCompartmentUse.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GraphCompartmentUse.java
index b0fe235d7e5..bca647afed2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GraphCompartmentUse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GraphCompartmentUse.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public GraphCompartmentUse build() {
-            return new GraphCompartmentUse(this);
+            GraphCompartmentUse graphCompartmentUse = new GraphCompartmentUse(this);
+            if (validating) {
+                validate(graphCompartmentUse);
+            }
+            return graphCompartmentUse;
+        }
+
+        protected void validate(GraphCompartmentUse graphCompartmentUse) {
+            super.validate(graphCompartmentUse);
+        }
+
+        protected Builder from(GraphCompartmentUse graphCompartmentUse) {
+            super.from(graphCompartmentUse);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GroupMeasure.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GroupMeasure.java
index fe85d27430b..059f8c97e1a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GroupMeasure.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GroupMeasure.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public GroupMeasure build() {
-            return new GroupMeasure(this);
+            GroupMeasure groupMeasure = new GroupMeasure(this);
+            if (validating) {
+                validate(groupMeasure);
+            }
+            return groupMeasure;
+        }
+
+        protected void validate(GroupMeasure groupMeasure) {
+            super.validate(groupMeasure);
+        }
+
+        protected Builder from(GroupMeasure groupMeasure) {
+            super.from(groupMeasure);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GroupType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GroupType.java
index 3bb88439fa3..0901ee21265 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GroupType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GroupType.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public GroupType build() {
-            return new GroupType(this);
+            GroupType groupType = new GroupType(this);
+            if (validating) {
+                validate(groupType);
+            }
+            return groupType;
+        }
+
+        protected void validate(GroupType groupType) {
+            super.validate(groupType);
+        }
+
+        protected Builder from(GroupType groupType) {
+            super.from(groupType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuidanceResponseStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuidanceResponseStatus.java
index 7d8eaf38c0b..0bc5ac4a215 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuidanceResponseStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuidanceResponseStatus.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public GuidanceResponseStatus build() {
-            return new GuidanceResponseStatus(this);
+            GuidanceResponseStatus guidanceResponseStatus = new GuidanceResponseStatus(this);
+            if (validating) {
+                validate(guidanceResponseStatus);
+            }
+            return guidanceResponseStatus;
+        }
+
+        protected void validate(GuidanceResponseStatus guidanceResponseStatus) {
+            super.validate(guidanceResponseStatus);
+        }
+
+        protected Builder from(GuidanceResponseStatus guidanceResponseStatus) {
+            super.from(guidanceResponseStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuidePageGeneration.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuidePageGeneration.java
index 9b56d32e939..b9ff5620737 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuidePageGeneration.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuidePageGeneration.java
@@ -171,11 +171,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -230,7 +226,20 @@ public Builder value(Value value) {
 
         @Override
         public GuidePageGeneration build() {
-            return new GuidePageGeneration(this);
+            GuidePageGeneration guidePageGeneration = new GuidePageGeneration(this);
+            if (validating) {
+                validate(guidePageGeneration);
+            }
+            return guidePageGeneration;
+        }
+
+        protected void validate(GuidePageGeneration guidePageGeneration) {
+            super.validate(guidePageGeneration);
+        }
+
+        protected Builder from(GuidePageGeneration guidePageGeneration) {
+            super.from(guidePageGeneration);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuideParameterCode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuideParameterCode.java
index b126fe8540b..877fc7f3639 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuideParameterCode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/GuideParameterCode.java
@@ -247,11 +247,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -306,7 +302,20 @@ public Builder value(Value value) {
 
         @Override
         public GuideParameterCode build() {
-            return new GuideParameterCode(this);
+            GuideParameterCode guideParameterCode = new GuideParameterCode(this);
+            if (validating) {
+                validate(guideParameterCode);
+            }
+            return guideParameterCode;
+        }
+
+        protected void validate(GuideParameterCode guideParameterCode) {
+            super.validate(guideParameterCode);
+        }
+
+        protected Builder from(GuideParameterCode guideParameterCode) {
+            super.from(guideParameterCode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/HTTPVerb.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/HTTPVerb.java
index 67396191a82..5b8e62a5bdc 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/HTTPVerb.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/HTTPVerb.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public HTTPVerb build() {
-            return new HTTPVerb(this);
+            HTTPVerb hTTPVerb = new HTTPVerb(this);
+            if (validating) {
+                validate(hTTPVerb);
+            }
+            return hTTPVerb;
+        }
+
+        protected void validate(HTTPVerb hTTPVerb) {
+            super.validate(hTTPVerb);
+        }
+
+        protected Builder from(HTTPVerb hTTPVerb) {
+            super.from(hTTPVerb);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IdentifierUse.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IdentifierUse.java
index 67655246b34..f5411bbdb26 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IdentifierUse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IdentifierUse.java
@@ -184,11 +184,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -243,7 +239,20 @@ public Builder value(Value value) {
 
         @Override
         public IdentifierUse build() {
-            return new IdentifierUse(this);
+            IdentifierUse identifierUse = new IdentifierUse(this);
+            if (validating) {
+                validate(identifierUse);
+            }
+            return identifierUse;
+        }
+
+        protected void validate(IdentifierUse identifierUse) {
+            super.validate(identifierUse);
+        }
+
+        protected Builder from(IdentifierUse identifierUse) {
+            super.from(identifierUse);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IdentityAssuranceLevel.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IdentityAssuranceLevel.java
index 83515caf58b..574e90c8753 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IdentityAssuranceLevel.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IdentityAssuranceLevel.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public IdentityAssuranceLevel build() {
-            return new IdentityAssuranceLevel(this);
+            IdentityAssuranceLevel identityAssuranceLevel = new IdentityAssuranceLevel(this);
+            if (validating) {
+                validate(identityAssuranceLevel);
+            }
+            return identityAssuranceLevel;
+        }
+
+        protected void validate(IdentityAssuranceLevel identityAssuranceLevel) {
+            super.validate(identityAssuranceLevel);
+        }
+
+        protected Builder from(IdentityAssuranceLevel identityAssuranceLevel) {
+            super.from(identityAssuranceLevel);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImagingStudyStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImagingStudyStatus.java
index 84ef700d83e..84cc223b4f0 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImagingStudyStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImagingStudyStatus.java
@@ -184,11 +184,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -243,7 +239,20 @@ public Builder value(Value value) {
 
         @Override
         public ImagingStudyStatus build() {
-            return new ImagingStudyStatus(this);
+            ImagingStudyStatus imagingStudyStatus = new ImagingStudyStatus(this);
+            if (validating) {
+                validate(imagingStudyStatus);
+            }
+            return imagingStudyStatus;
+        }
+
+        protected void validate(ImagingStudyStatus imagingStudyStatus) {
+            super.validate(imagingStudyStatus);
+        }
+
+        protected Builder from(ImagingStudyStatus imagingStudyStatus) {
+            super.from(imagingStudyStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImmunizationEvaluationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImmunizationEvaluationStatus.java
index f3e3d62eb01..502370838fe 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImmunizationEvaluationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImmunizationEvaluationStatus.java
@@ -137,11 +137,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -196,7 +192,20 @@ public Builder value(Value value) {
 
         @Override
         public ImmunizationEvaluationStatus build() {
-            return new ImmunizationEvaluationStatus(this);
+            ImmunizationEvaluationStatus immunizationEvaluationStatus = new ImmunizationEvaluationStatus(this);
+            if (validating) {
+                validate(immunizationEvaluationStatus);
+            }
+            return immunizationEvaluationStatus;
+        }
+
+        protected void validate(ImmunizationEvaluationStatus immunizationEvaluationStatus) {
+            super.validate(immunizationEvaluationStatus);
+        }
+
+        protected Builder from(ImmunizationEvaluationStatus immunizationEvaluationStatus) {
+            super.from(immunizationEvaluationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImmunizationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImmunizationStatus.java
index 4b153d763d0..38b4aaa7a27 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImmunizationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ImmunizationStatus.java
@@ -143,11 +143,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -202,7 +198,20 @@ public Builder value(Value value) {
 
         @Override
         public ImmunizationStatus build() {
-            return new ImmunizationStatus(this);
+            ImmunizationStatus immunizationStatus = new ImmunizationStatus(this);
+            if (validating) {
+                validate(immunizationStatus);
+            }
+            return immunizationStatus;
+        }
+
+        protected void validate(ImmunizationStatus immunizationStatus) {
+            super.validate(immunizationStatus);
+        }
+
+        protected Builder from(ImmunizationStatus immunizationStatus) {
+            super.from(immunizationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/InvoicePriceComponentType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/InvoicePriceComponentType.java
index d96930be3f5..3082e4cd7b5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/InvoicePriceComponentType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/InvoicePriceComponentType.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public InvoicePriceComponentType build() {
-            return new InvoicePriceComponentType(this);
+            InvoicePriceComponentType invoicePriceComponentType = new InvoicePriceComponentType(this);
+            if (validating) {
+                validate(invoicePriceComponentType);
+            }
+            return invoicePriceComponentType;
+        }
+
+        protected void validate(InvoicePriceComponentType invoicePriceComponentType) {
+            super.validate(invoicePriceComponentType);
+        }
+
+        protected Builder from(InvoicePriceComponentType invoicePriceComponentType) {
+            super.from(invoicePriceComponentType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/InvoiceStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/InvoiceStatus.java
index 8186078aa9c..a528451f105 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/InvoiceStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/InvoiceStatus.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public InvoiceStatus build() {
-            return new InvoiceStatus(this);
+            InvoiceStatus invoiceStatus = new InvoiceStatus(this);
+            if (validating) {
+                validate(invoiceStatus);
+            }
+            return invoiceStatus;
+        }
+
+        protected void validate(InvoiceStatus invoiceStatus) {
+            super.validate(invoiceStatus);
+        }
+
+        protected Builder from(InvoiceStatus invoiceStatus) {
+            super.from(invoiceStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IssueSeverity.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IssueSeverity.java
index 24e46396884..17159f70c29 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IssueSeverity.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IssueSeverity.java
@@ -170,11 +170,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -229,7 +225,20 @@ public Builder value(Value value) {
 
         @Override
         public IssueSeverity build() {
-            return new IssueSeverity(this);
+            IssueSeverity issueSeverity = new IssueSeverity(this);
+            if (validating) {
+                validate(issueSeverity);
+            }
+            return issueSeverity;
+        }
+
+        protected void validate(IssueSeverity issueSeverity) {
+            super.validate(issueSeverity);
+        }
+
+        protected Builder from(IssueSeverity issueSeverity) {
+            super.from(issueSeverity);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IssueType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IssueType.java
index 20d5e24f02f..c1a755df5f1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IssueType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/IssueType.java
@@ -476,11 +476,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -535,7 +531,20 @@ public Builder value(Value value) {
 
         @Override
         public IssueType build() {
-            return new IssueType(this);
+            IssueType issueType = new IssueType(this);
+            if (validating) {
+                validate(issueType);
+            }
+            return issueType;
+        }
+
+        protected void validate(IssueType issueType) {
+            super.validate(issueType);
+        }
+
+        protected Builder from(IssueType issueType) {
+            super.from(issueType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LinkType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LinkType.java
index 0c3dc1d9108..ace7f8e5154 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LinkType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LinkType.java
@@ -177,11 +177,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -236,7 +232,20 @@ public Builder value(Value value) {
 
         @Override
         public LinkType build() {
-            return new LinkType(this);
+            LinkType linkType = new LinkType(this);
+            if (validating) {
+                validate(linkType);
+            }
+            return linkType;
+        }
+
+        protected void validate(LinkType linkType) {
+            super.validate(linkType);
+        }
+
+        protected Builder from(LinkType linkType) {
+            super.from(linkType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LinkageType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LinkageType.java
index cb7e46defdd..c531b396360 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LinkageType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LinkageType.java
@@ -161,11 +161,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -220,7 +216,20 @@ public Builder value(Value value) {
 
         @Override
         public LinkageType build() {
-            return new LinkageType(this);
+            LinkageType linkageType = new LinkageType(this);
+            if (validating) {
+                validate(linkageType);
+            }
+            return linkageType;
+        }
+
+        protected void validate(LinkageType linkageType) {
+            super.validate(linkageType);
+        }
+
+        protected Builder from(LinkageType linkageType) {
+            super.from(linkageType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ListMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ListMode.java
index 2350a8bf45a..d464d63b797 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ListMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ListMode.java
@@ -160,11 +160,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -219,7 +215,20 @@ public Builder value(Value value) {
 
         @Override
         public ListMode build() {
-            return new ListMode(this);
+            ListMode listMode = new ListMode(this);
+            if (validating) {
+                validate(listMode);
+            }
+            return listMode;
+        }
+
+        protected void validate(ListMode listMode) {
+            super.validate(listMode);
+        }
+
+        protected Builder from(ListMode listMode) {
+            super.from(listMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ListStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ListStatus.java
index 1c0351400b6..0f7dc20b40e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ListStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ListStatus.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public ListStatus build() {
-            return new ListStatus(this);
+            ListStatus listStatus = new ListStatus(this);
+            if (validating) {
+                validate(listStatus);
+            }
+            return listStatus;
+        }
+
+        protected void validate(ListStatus listStatus) {
+            super.validate(listStatus);
+        }
+
+        protected Builder from(ListStatus listStatus) {
+            super.from(listStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LocationMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LocationMode.java
index e29ddfbb194..b0b54d2af01 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LocationMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LocationMode.java
@@ -148,11 +148,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -207,7 +203,20 @@ public Builder value(Value value) {
 
         @Override
         public LocationMode build() {
-            return new LocationMode(this);
+            LocationMode locationMode = new LocationMode(this);
+            if (validating) {
+                validate(locationMode);
+            }
+            return locationMode;
+        }
+
+        protected void validate(LocationMode locationMode) {
+            super.validate(locationMode);
+        }
+
+        protected Builder from(LocationMode locationMode) {
+            super.from(locationMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LocationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LocationStatus.java
index 660ca940fcf..02842fae548 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LocationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/LocationStatus.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public LocationStatus build() {
-            return new LocationStatus(this);
+            LocationStatus locationStatus = new LocationStatus(this);
+            if (validating) {
+                validate(locationStatus);
+            }
+            return locationStatus;
+        }
+
+        protected void validate(LocationStatus locationStatus) {
+            super.validate(locationStatus);
+        }
+
+        protected Builder from(LocationStatus locationStatus) {
+            super.from(locationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MeasureReportStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MeasureReportStatus.java
index e8ea54e3300..d4319d88801 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MeasureReportStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MeasureReportStatus.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public MeasureReportStatus build() {
-            return new MeasureReportStatus(this);
+            MeasureReportStatus measureReportStatus = new MeasureReportStatus(this);
+            if (validating) {
+                validate(measureReportStatus);
+            }
+            return measureReportStatus;
+        }
+
+        protected void validate(MeasureReportStatus measureReportStatus) {
+            super.validate(measureReportStatus);
+        }
+
+        protected Builder from(MeasureReportStatus measureReportStatus) {
+            super.from(measureReportStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MeasureReportType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MeasureReportType.java
index 8570efd1db4..0df25b9a3c8 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MeasureReportType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MeasureReportType.java
@@ -170,11 +170,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -229,7 +225,20 @@ public Builder value(Value value) {
 
         @Override
         public MeasureReportType build() {
-            return new MeasureReportType(this);
+            MeasureReportType measureReportType = new MeasureReportType(this);
+            if (validating) {
+                validate(measureReportType);
+            }
+            return measureReportType;
+        }
+
+        protected void validate(MeasureReportType measureReportType) {
+            super.validate(measureReportType);
+        }
+
+        protected Builder from(MeasureReportType measureReportType) {
+            super.from(measureReportType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MediaStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MediaStatus.java
index 2e451703b5c..50c40565ca5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MediaStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MediaStatus.java
@@ -219,11 +219,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -278,7 +274,20 @@ public Builder value(Value value) {
 
         @Override
         public MediaStatus build() {
-            return new MediaStatus(this);
+            MediaStatus mediaStatus = new MediaStatus(this);
+            if (validating) {
+                validate(mediaStatus);
+            }
+            return mediaStatus;
+        }
+
+        protected void validate(MediaStatus mediaStatus) {
+            super.validate(mediaStatus);
+        }
+
+        protected Builder from(MediaStatus mediaStatus) {
+            super.from(mediaStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationAdministrationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationAdministrationStatus.java
index 0ad300398a2..31f2752969b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationAdministrationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationAdministrationStatus.java
@@ -205,11 +205,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -264,7 +260,20 @@ public Builder value(Value value) {
 
         @Override
         public MedicationAdministrationStatus build() {
-            return new MedicationAdministrationStatus(this);
+            MedicationAdministrationStatus medicationAdministrationStatus = new MedicationAdministrationStatus(this);
+            if (validating) {
+                validate(medicationAdministrationStatus);
+            }
+            return medicationAdministrationStatus;
+        }
+
+        protected void validate(MedicationAdministrationStatus medicationAdministrationStatus) {
+            super.validate(medicationAdministrationStatus);
+        }
+
+        protected Builder from(MedicationAdministrationStatus medicationAdministrationStatus) {
+            super.from(medicationAdministrationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationDispenseStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationDispenseStatus.java
index c1853fc892d..fc45bda4658 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationDispenseStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationDispenseStatus.java
@@ -227,11 +227,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -286,7 +282,20 @@ public Builder value(Value value) {
 
         @Override
         public MedicationDispenseStatus build() {
-            return new MedicationDispenseStatus(this);
+            MedicationDispenseStatus medicationDispenseStatus = new MedicationDispenseStatus(this);
+            if (validating) {
+                validate(medicationDispenseStatus);
+            }
+            return medicationDispenseStatus;
+        }
+
+        protected void validate(MedicationDispenseStatus medicationDispenseStatus) {
+            super.validate(medicationDispenseStatus);
+        }
+
+        protected Builder from(MedicationDispenseStatus medicationDispenseStatus) {
+            super.from(medicationDispenseStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationKnowledgeStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationKnowledgeStatus.java
index a679e957e46..b2b6bb2d903 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationKnowledgeStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationKnowledgeStatus.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public MedicationKnowledgeStatus build() {
-            return new MedicationKnowledgeStatus(this);
+            MedicationKnowledgeStatus medicationKnowledgeStatus = new MedicationKnowledgeStatus(this);
+            if (validating) {
+                validate(medicationKnowledgeStatus);
+            }
+            return medicationKnowledgeStatus;
+        }
+
+        protected void validate(MedicationKnowledgeStatus medicationKnowledgeStatus) {
+            super.validate(medicationKnowledgeStatus);
+        }
+
+        protected Builder from(MedicationKnowledgeStatus medicationKnowledgeStatus) {
+            super.from(medicationKnowledgeStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestIntent.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestIntent.java
index 36f9dbbe830..f046b580dd7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestIntent.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestIntent.java
@@ -217,11 +217,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -276,7 +272,20 @@ public Builder value(Value value) {
 
         @Override
         public MedicationRequestIntent build() {
-            return new MedicationRequestIntent(this);
+            MedicationRequestIntent medicationRequestIntent = new MedicationRequestIntent(this);
+            if (validating) {
+                validate(medicationRequestIntent);
+            }
+            return medicationRequestIntent;
+        }
+
+        protected void validate(MedicationRequestIntent medicationRequestIntent) {
+            super.validate(medicationRequestIntent);
+        }
+
+        protected Builder from(MedicationRequestIntent medicationRequestIntent) {
+            super.from(medicationRequestIntent);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestPriority.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestPriority.java
index a8df3295f85..bc0216e979b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestPriority.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestPriority.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public MedicationRequestPriority build() {
-            return new MedicationRequestPriority(this);
+            MedicationRequestPriority medicationRequestPriority = new MedicationRequestPriority(this);
+            if (validating) {
+                validate(medicationRequestPriority);
+            }
+            return medicationRequestPriority;
+        }
+
+        protected void validate(MedicationRequestPriority medicationRequestPriority) {
+            super.validate(medicationRequestPriority);
+        }
+
+        protected Builder from(MedicationRequestPriority medicationRequestPriority) {
+            super.from(medicationRequestPriority);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestStatus.java
index ca6cd89a002..7cd128140b5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationRequestStatus.java
@@ -220,11 +220,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -279,7 +275,20 @@ public Builder value(Value value) {
 
         @Override
         public MedicationRequestStatus build() {
-            return new MedicationRequestStatus(this);
+            MedicationRequestStatus medicationRequestStatus = new MedicationRequestStatus(this);
+            if (validating) {
+                validate(medicationRequestStatus);
+            }
+            return medicationRequestStatus;
+        }
+
+        protected void validate(MedicationRequestStatus medicationRequestStatus) {
+            super.validate(medicationRequestStatus);
+        }
+
+        protected Builder from(MedicationRequestStatus medicationRequestStatus) {
+            super.from(medicationRequestStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationStatementStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationStatementStatus.java
index 5ae2a1c6d06..7e9219743f2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationStatementStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationStatementStatus.java
@@ -216,11 +216,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -275,7 +271,20 @@ public Builder value(Value value) {
 
         @Override
         public MedicationStatementStatus build() {
-            return new MedicationStatementStatus(this);
+            MedicationStatementStatus medicationStatementStatus = new MedicationStatementStatus(this);
+            if (validating) {
+                validate(medicationStatementStatus);
+            }
+            return medicationStatementStatus;
+        }
+
+        protected void validate(MedicationStatementStatus medicationStatementStatus) {
+            super.validate(medicationStatementStatus);
+        }
+
+        protected Builder from(MedicationStatementStatus medicationStatementStatus) {
+            super.from(medicationStatementStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationStatus.java
index d469dd0c1bb..01b7b55811b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MedicationStatus.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public MedicationStatus build() {
-            return new MedicationStatus(this);
+            MedicationStatus medicationStatus = new MedicationStatus(this);
+            if (validating) {
+                validate(medicationStatus);
+            }
+            return medicationStatus;
+        }
+
+        protected void validate(MedicationStatus medicationStatus) {
+            super.validate(medicationStatus);
+        }
+
+        protected Builder from(MedicationStatus medicationStatus) {
+            super.from(medicationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MessageHeaderResponseRequest.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MessageHeaderResponseRequest.java
index aea06374620..60b1663464b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MessageHeaderResponseRequest.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MessageHeaderResponseRequest.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public MessageHeaderResponseRequest build() {
-            return new MessageHeaderResponseRequest(this);
+            MessageHeaderResponseRequest messageHeaderResponseRequest = new MessageHeaderResponseRequest(this);
+            if (validating) {
+                validate(messageHeaderResponseRequest);
+            }
+            return messageHeaderResponseRequest;
+        }
+
+        protected void validate(MessageHeaderResponseRequest messageHeaderResponseRequest) {
+            super.validate(messageHeaderResponseRequest);
+        }
+
+        protected Builder from(MessageHeaderResponseRequest messageHeaderResponseRequest) {
+            super.from(messageHeaderResponseRequest);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MessageSignificanceCategory.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MessageSignificanceCategory.java
index c8c08e2b2e2..8afbbb81ba7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MessageSignificanceCategory.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/MessageSignificanceCategory.java
@@ -161,11 +161,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -220,7 +216,20 @@ public Builder value(Value value) {
 
         @Override
         public MessageSignificanceCategory build() {
-            return new MessageSignificanceCategory(this);
+            MessageSignificanceCategory messageSignificanceCategory = new MessageSignificanceCategory(this);
+            if (validating) {
+                validate(messageSignificanceCategory);
+            }
+            return messageSignificanceCategory;
+        }
+
+        protected void validate(MessageSignificanceCategory messageSignificanceCategory) {
+            super.validate(messageSignificanceCategory);
+        }
+
+        protected Builder from(MessageSignificanceCategory messageSignificanceCategory) {
+            super.from(messageSignificanceCategory);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NameUse.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NameUse.java
index 1fa810ca14b..9d9d804dfff 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NameUse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NameUse.java
@@ -207,11 +207,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -266,7 +262,20 @@ public Builder value(Value value) {
 
         @Override
         public NameUse build() {
-            return new NameUse(this);
+            NameUse nameUse = new NameUse(this);
+            if (validating) {
+                validate(nameUse);
+            }
+            return nameUse;
+        }
+
+        protected void validate(NameUse nameUse) {
+            super.validate(nameUse);
+        }
+
+        protected Builder from(NameUse nameUse) {
+            super.from(nameUse);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NamingSystemIdentifierType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NamingSystemIdentifierType.java
index 1a280920569..4fc4baeaafd 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NamingSystemIdentifierType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NamingSystemIdentifierType.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public NamingSystemIdentifierType build() {
-            return new NamingSystemIdentifierType(this);
+            NamingSystemIdentifierType namingSystemIdentifierType = new NamingSystemIdentifierType(this);
+            if (validating) {
+                validate(namingSystemIdentifierType);
+            }
+            return namingSystemIdentifierType;
+        }
+
+        protected void validate(NamingSystemIdentifierType namingSystemIdentifierType) {
+            super.validate(namingSystemIdentifierType);
+        }
+
+        protected Builder from(NamingSystemIdentifierType namingSystemIdentifierType) {
+            super.from(namingSystemIdentifierType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NamingSystemType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NamingSystemType.java
index 8e81e030479..abb5eaf6e80 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NamingSystemType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NamingSystemType.java
@@ -159,11 +159,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -218,7 +214,20 @@ public Builder value(Value value) {
 
         @Override
         public NamingSystemType build() {
-            return new NamingSystemType(this);
+            NamingSystemType namingSystemType = new NamingSystemType(this);
+            if (validating) {
+                validate(namingSystemType);
+            }
+            return namingSystemType;
+        }
+
+        protected void validate(NamingSystemType namingSystemType) {
+            super.validate(namingSystemType);
+        }
+
+        protected Builder from(NamingSystemType namingSystemType) {
+            super.from(namingSystemType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NarrativeStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NarrativeStatus.java
index 7e1fef83ab0..95f5374d370 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NarrativeStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NarrativeStatus.java
@@ -171,11 +171,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -230,7 +226,20 @@ public Builder value(Value value) {
 
         @Override
         public NarrativeStatus build() {
-            return new NarrativeStatus(this);
+            NarrativeStatus narrativeStatus = new NarrativeStatus(this);
+            if (validating) {
+                validate(narrativeStatus);
+            }
+            return narrativeStatus;
+        }
+
+        protected void validate(NarrativeStatus narrativeStatus) {
+            super.validate(narrativeStatus);
+        }
+
+        protected Builder from(NarrativeStatus narrativeStatus) {
+            super.from(narrativeStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NoteType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NoteType.java
index 812fb1c88b1..a59a6394489 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NoteType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NoteType.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public NoteType build() {
-            return new NoteType(this);
+            NoteType noteType = new NoteType(this);
+            if (validating) {
+                validate(noteType);
+            }
+            return noteType;
+        }
+
+        protected void validate(NoteType noteType) {
+            super.validate(noteType);
+        }
+
+        protected Builder from(NoteType noteType) {
+            super.from(noteType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NutritionOrderIntent.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NutritionOrderIntent.java
index 1bf7b51f5ea..42698f526e0 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NutritionOrderIntent.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NutritionOrderIntent.java
@@ -230,11 +230,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -289,7 +285,20 @@ public Builder value(Value value) {
 
         @Override
         public NutritionOrderIntent build() {
-            return new NutritionOrderIntent(this);
+            NutritionOrderIntent nutritionOrderIntent = new NutritionOrderIntent(this);
+            if (validating) {
+                validate(nutritionOrderIntent);
+            }
+            return nutritionOrderIntent;
+        }
+
+        protected void validate(NutritionOrderIntent nutritionOrderIntent) {
+            super.validate(nutritionOrderIntent);
+        }
+
+        protected Builder from(NutritionOrderIntent nutritionOrderIntent) {
+            super.from(nutritionOrderIntent);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NutritionOrderStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NutritionOrderStatus.java
index e3399858bfc..316102cc62a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NutritionOrderStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/NutritionOrderStatus.java
@@ -207,11 +207,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -266,7 +262,20 @@ public Builder value(Value value) {
 
         @Override
         public NutritionOrderStatus build() {
-            return new NutritionOrderStatus(this);
+            NutritionOrderStatus nutritionOrderStatus = new NutritionOrderStatus(this);
+            if (validating) {
+                validate(nutritionOrderStatus);
+            }
+            return nutritionOrderStatus;
+        }
+
+        protected void validate(NutritionOrderStatus nutritionOrderStatus) {
+            super.validate(nutritionOrderStatus);
+        }
+
+        protected Builder from(NutritionOrderStatus nutritionOrderStatus) {
+            super.from(nutritionOrderStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationDataType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationDataType.java
index 9d0498d4910..4403db2b8e9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationDataType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationDataType.java
@@ -246,11 +246,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -305,7 +301,20 @@ public Builder value(Value value) {
 
         @Override
         public ObservationDataType build() {
-            return new ObservationDataType(this);
+            ObservationDataType observationDataType = new ObservationDataType(this);
+            if (validating) {
+                validate(observationDataType);
+            }
+            return observationDataType;
+        }
+
+        protected void validate(ObservationDataType observationDataType) {
+            super.validate(observationDataType);
+        }
+
+        protected Builder from(ObservationDataType observationDataType) {
+            super.from(observationDataType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationRangeCategory.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationRangeCategory.java
index cb30ac4eb61..ff99df51dbd 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationRangeCategory.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationRangeCategory.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public ObservationRangeCategory build() {
-            return new ObservationRangeCategory(this);
+            ObservationRangeCategory observationRangeCategory = new ObservationRangeCategory(this);
+            if (validating) {
+                validate(observationRangeCategory);
+            }
+            return observationRangeCategory;
+        }
+
+        protected void validate(ObservationRangeCategory observationRangeCategory) {
+            super.validate(observationRangeCategory);
+        }
+
+        protected Builder from(ObservationRangeCategory observationRangeCategory) {
+            super.from(observationRangeCategory);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationStatus.java
index 6462b2d9df4..acba402dde6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ObservationStatus.java
@@ -222,11 +222,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -281,7 +277,20 @@ public Builder value(Value value) {
 
         @Override
         public ObservationStatus build() {
-            return new ObservationStatus(this);
+            ObservationStatus observationStatus = new ObservationStatus(this);
+            if (validating) {
+                validate(observationStatus);
+            }
+            return observationStatus;
+        }
+
+        protected void validate(ObservationStatus observationStatus) {
+            super.validate(observationStatus);
+        }
+
+        protected Builder from(ObservationStatus observationStatus) {
+            super.from(observationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OperationKind.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OperationKind.java
index b49fc110441..142dcd6dbba 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OperationKind.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OperationKind.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public OperationKind build() {
-            return new OperationKind(this);
+            OperationKind operationKind = new OperationKind(this);
+            if (validating) {
+                validate(operationKind);
+            }
+            return operationKind;
+        }
+
+        protected void validate(OperationKind operationKind) {
+            super.validate(operationKind);
+        }
+
+        protected Builder from(OperationKind operationKind) {
+            super.from(operationKind);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OperationParameterUse.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OperationParameterUse.java
index 718eeb705ca..a17445e5e10 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OperationParameterUse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OperationParameterUse.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public OperationParameterUse build() {
-            return new OperationParameterUse(this);
+            OperationParameterUse operationParameterUse = new OperationParameterUse(this);
+            if (validating) {
+                validate(operationParameterUse);
+            }
+            return operationParameterUse;
+        }
+
+        protected void validate(OperationParameterUse operationParameterUse) {
+            super.validate(operationParameterUse);
+        }
+
+        protected Builder from(OperationParameterUse operationParameterUse) {
+            super.from(operationParameterUse);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OrientationType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OrientationType.java
index c74226590ad..1833edf07f1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OrientationType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/OrientationType.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public OrientationType build() {
-            return new OrientationType(this);
+            OrientationType orientationType = new OrientationType(this);
+            if (validating) {
+                validate(orientationType);
+            }
+            return orientationType;
+        }
+
+        protected void validate(OrientationType orientationType) {
+            super.validate(orientationType);
+        }
+
+        protected Builder from(OrientationType orientationType) {
+            super.from(orientationType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParameterUse.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParameterUse.java
index c8ce391382c..d7c16c98194 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParameterUse.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParameterUse.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public ParameterUse build() {
-            return new ParameterUse(this);
+            ParameterUse parameterUse = new ParameterUse(this);
+            if (validating) {
+                validate(parameterUse);
+            }
+            return parameterUse;
+        }
+
+        protected void validate(ParameterUse parameterUse) {
+            super.validate(parameterUse);
+        }
+
+        protected Builder from(ParameterUse parameterUse) {
+            super.from(parameterUse);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipantRequired.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipantRequired.java
index e9243b2e64c..d01e6b45f9b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipantRequired.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipantRequired.java
@@ -159,11 +159,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -218,7 +214,20 @@ public Builder value(Value value) {
 
         @Override
         public ParticipantRequired build() {
-            return new ParticipantRequired(this);
+            ParticipantRequired participantRequired = new ParticipantRequired(this);
+            if (validating) {
+                validate(participantRequired);
+            }
+            return participantRequired;
+        }
+
+        protected void validate(ParticipantRequired participantRequired) {
+            super.validate(participantRequired);
+        }
+
+        protected Builder from(ParticipantRequired participantRequired) {
+            super.from(participantRequired);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipantStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipantStatus.java
index b1e1f1e55c9..906a8506ad2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipantStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipantStatus.java
@@ -171,11 +171,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -230,7 +226,20 @@ public Builder value(Value value) {
 
         @Override
         public ParticipantStatus build() {
-            return new ParticipantStatus(this);
+            ParticipantStatus participantStatus = new ParticipantStatus(this);
+            if (validating) {
+                validate(participantStatus);
+            }
+            return participantStatus;
+        }
+
+        protected void validate(ParticipantStatus participantStatus) {
+            super.validate(participantStatus);
+        }
+
+        protected Builder from(ParticipantStatus participantStatus) {
+            super.from(participantStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipationStatus.java
index 58ea2396f77..5048cc629d6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ParticipationStatus.java
@@ -171,11 +171,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -230,7 +226,20 @@ public Builder value(Value value) {
 
         @Override
         public ParticipationStatus build() {
-            return new ParticipationStatus(this);
+            ParticipationStatus participationStatus = new ParticipationStatus(this);
+            if (validating) {
+                validate(participationStatus);
+            }
+            return participationStatus;
+        }
+
+        protected void validate(ParticipationStatus participationStatus) {
+            super.validate(participationStatus);
+        }
+
+        protected Builder from(ParticipationStatus participationStatus) {
+            super.from(participationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PaymentNoticeStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PaymentNoticeStatus.java
index 07b1b5d5bc5..f0e6798518a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PaymentNoticeStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PaymentNoticeStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public PaymentNoticeStatus build() {
-            return new PaymentNoticeStatus(this);
+            PaymentNoticeStatus paymentNoticeStatus = new PaymentNoticeStatus(this);
+            if (validating) {
+                validate(paymentNoticeStatus);
+            }
+            return paymentNoticeStatus;
+        }
+
+        protected void validate(PaymentNoticeStatus paymentNoticeStatus) {
+            super.validate(paymentNoticeStatus);
+        }
+
+        protected Builder from(PaymentNoticeStatus paymentNoticeStatus) {
+            super.from(paymentNoticeStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PaymentReconciliationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PaymentReconciliationStatus.java
index e2b42585864..2608422b773 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PaymentReconciliationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PaymentReconciliationStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public PaymentReconciliationStatus build() {
-            return new PaymentReconciliationStatus(this);
+            PaymentReconciliationStatus paymentReconciliationStatus = new PaymentReconciliationStatus(this);
+            if (validating) {
+                validate(paymentReconciliationStatus);
+            }
+            return paymentReconciliationStatus;
+        }
+
+        protected void validate(PaymentReconciliationStatus paymentReconciliationStatus) {
+            super.validate(paymentReconciliationStatus);
+        }
+
+        protected Builder from(PaymentReconciliationStatus paymentReconciliationStatus) {
+            super.from(paymentReconciliationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ProcedureStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ProcedureStatus.java
index d300c1a3c8b..6d9b96fbdd1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ProcedureStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ProcedureStatus.java
@@ -219,11 +219,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -278,7 +274,20 @@ public Builder value(Value value) {
 
         @Override
         public ProcedureStatus build() {
-            return new ProcedureStatus(this);
+            ProcedureStatus procedureStatus = new ProcedureStatus(this);
+            if (validating) {
+                validate(procedureStatus);
+            }
+            return procedureStatus;
+        }
+
+        protected void validate(ProcedureStatus procedureStatus) {
+            super.validate(procedureStatus);
+        }
+
+        protected Builder from(ProcedureStatus procedureStatus) {
+            super.from(procedureStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PropertyRepresentation.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PropertyRepresentation.java
index 1b6877d4598..a3890b4b023 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PropertyRepresentation.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PropertyRepresentation.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public PropertyRepresentation build() {
-            return new PropertyRepresentation(this);
+            PropertyRepresentation propertyRepresentation = new PropertyRepresentation(this);
+            if (validating) {
+                validate(propertyRepresentation);
+            }
+            return propertyRepresentation;
+        }
+
+        protected void validate(PropertyRepresentation propertyRepresentation) {
+            super.validate(propertyRepresentation);
+        }
+
+        protected Builder from(PropertyRepresentation propertyRepresentation) {
+            super.from(propertyRepresentation);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PropertyType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PropertyType.java
index d92edbdb2c6..7ca68c65b71 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PropertyType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PropertyType.java
@@ -203,11 +203,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -262,7 +258,20 @@ public Builder value(Value value) {
 
         @Override
         public PropertyType build() {
-            return new PropertyType(this);
+            PropertyType propertyType = new PropertyType(this);
+            if (validating) {
+                validate(propertyType);
+            }
+            return propertyType;
+        }
+
+        protected void validate(PropertyType propertyType) {
+            super.validate(propertyType);
+        }
+
+        protected Builder from(PropertyType propertyType) {
+            super.from(propertyType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ProvenanceEntityRole.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ProvenanceEntityRole.java
index 622cbbba5f8..51a36740356 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ProvenanceEntityRole.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ProvenanceEntityRole.java
@@ -183,11 +183,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -242,7 +238,20 @@ public Builder value(Value value) {
 
         @Override
         public ProvenanceEntityRole build() {
-            return new ProvenanceEntityRole(this);
+            ProvenanceEntityRole provenanceEntityRole = new ProvenanceEntityRole(this);
+            if (validating) {
+                validate(provenanceEntityRole);
+            }
+            return provenanceEntityRole;
+        }
+
+        protected void validate(ProvenanceEntityRole provenanceEntityRole) {
+            super.validate(provenanceEntityRole);
+        }
+
+        protected Builder from(ProvenanceEntityRole provenanceEntityRole) {
+            super.from(provenanceEntityRole);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PublicationStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PublicationStatus.java
index 3bdfbf18628..5dca13a535b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PublicationStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/PublicationStatus.java
@@ -170,11 +170,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -229,7 +225,20 @@ public Builder value(Value value) {
 
         @Override
         public PublicationStatus build() {
-            return new PublicationStatus(this);
+            PublicationStatus publicationStatus = new PublicationStatus(this);
+            if (validating) {
+                validate(publicationStatus);
+            }
+            return publicationStatus;
+        }
+
+        protected void validate(PublicationStatus publicationStatus) {
+            super.validate(publicationStatus);
+        }
+
+        protected Builder from(PublicationStatus publicationStatus) {
+            super.from(publicationStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QualityType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QualityType.java
index 63c8b1d462e..66ba0f1e3d3 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QualityType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QualityType.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public QualityType build() {
-            return new QualityType(this);
+            QualityType qualityType = new QualityType(this);
+            if (validating) {
+                validate(qualityType);
+            }
+            return qualityType;
+        }
+
+        protected void validate(QualityType qualityType) {
+            super.validate(qualityType);
+        }
+
+        protected Builder from(QualityType qualityType) {
+            super.from(qualityType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuantityComparator.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuantityComparator.java
index dba672411e0..0fb14ffdeed 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuantityComparator.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuantityComparator.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public QuantityComparator build() {
-            return new QuantityComparator(this);
+            QuantityComparator quantityComparator = new QuantityComparator(this);
+            if (validating) {
+                validate(quantityComparator);
+            }
+            return quantityComparator;
+        }
+
+        protected void validate(QuantityComparator quantityComparator) {
+            super.validate(quantityComparator);
+        }
+
+        protected Builder from(QuantityComparator quantityComparator) {
+            super.from(quantityComparator);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireItemOperator.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireItemOperator.java
index e3c67782390..b58657ac02a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireItemOperator.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireItemOperator.java
@@ -202,11 +202,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -261,7 +257,20 @@ public Builder value(Value value) {
 
         @Override
         public QuestionnaireItemOperator build() {
-            return new QuestionnaireItemOperator(this);
+            QuestionnaireItemOperator questionnaireItemOperator = new QuestionnaireItemOperator(this);
+            if (validating) {
+                validate(questionnaireItemOperator);
+            }
+            return questionnaireItemOperator;
+        }
+
+        protected void validate(QuestionnaireItemOperator questionnaireItemOperator) {
+            super.validate(questionnaireItemOperator);
+        }
+
+        protected Builder from(QuestionnaireItemOperator questionnaireItemOperator) {
+            super.from(questionnaireItemOperator);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireItemType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireItemType.java
index 2c2328e53b8..05d965d34ea 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireItemType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireItemType.java
@@ -317,11 +317,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -376,7 +372,20 @@ public Builder value(Value value) {
 
         @Override
         public QuestionnaireItemType build() {
-            return new QuestionnaireItemType(this);
+            QuestionnaireItemType questionnaireItemType = new QuestionnaireItemType(this);
+            if (validating) {
+                validate(questionnaireItemType);
+            }
+            return questionnaireItemType;
+        }
+
+        protected void validate(QuestionnaireItemType questionnaireItemType) {
+            super.validate(questionnaireItemType);
+        }
+
+        protected Builder from(QuestionnaireItemType questionnaireItemType) {
+            super.from(questionnaireItemType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireResponseStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireResponseStatus.java
index 1dcdc758296..a607590a851 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireResponseStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/QuestionnaireResponseStatus.java
@@ -183,11 +183,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -242,7 +238,20 @@ public Builder value(Value value) {
 
         @Override
         public QuestionnaireResponseStatus build() {
-            return new QuestionnaireResponseStatus(this);
+            QuestionnaireResponseStatus questionnaireResponseStatus = new QuestionnaireResponseStatus(this);
+            if (validating) {
+                validate(questionnaireResponseStatus);
+            }
+            return questionnaireResponseStatus;
+        }
+
+        protected void validate(QuestionnaireResponseStatus questionnaireResponseStatus) {
+            super.validate(questionnaireResponseStatus);
+        }
+
+        protected Builder from(QuestionnaireResponseStatus questionnaireResponseStatus) {
+            super.from(questionnaireResponseStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferenceHandlingPolicy.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferenceHandlingPolicy.java
index 707c8aeaf39..f0bf7a56bf9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferenceHandlingPolicy.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferenceHandlingPolicy.java
@@ -183,11 +183,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -242,7 +238,20 @@ public Builder value(Value value) {
 
         @Override
         public ReferenceHandlingPolicy build() {
-            return new ReferenceHandlingPolicy(this);
+            ReferenceHandlingPolicy referenceHandlingPolicy = new ReferenceHandlingPolicy(this);
+            if (validating) {
+                validate(referenceHandlingPolicy);
+            }
+            return referenceHandlingPolicy;
+        }
+
+        protected void validate(ReferenceHandlingPolicy referenceHandlingPolicy) {
+            super.validate(referenceHandlingPolicy);
+        }
+
+        protected Builder from(ReferenceHandlingPolicy referenceHandlingPolicy) {
+            super.from(referenceHandlingPolicy);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferenceVersionRules.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferenceVersionRules.java
index 7390dc2a3ff..84379d40ead 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferenceVersionRules.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferenceVersionRules.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public ReferenceVersionRules build() {
-            return new ReferenceVersionRules(this);
+            ReferenceVersionRules referenceVersionRules = new ReferenceVersionRules(this);
+            if (validating) {
+                validate(referenceVersionRules);
+            }
+            return referenceVersionRules;
+        }
+
+        protected void validate(ReferenceVersionRules referenceVersionRules) {
+            super.validate(referenceVersionRules);
+        }
+
+        protected Builder from(ReferenceVersionRules referenceVersionRules) {
+            super.from(referenceVersionRules);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferredDocumentStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferredDocumentStatus.java
index cfc2459658c..2d7acdc7c7b 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferredDocumentStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ReferredDocumentStatus.java
@@ -173,11 +173,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -232,7 +228,20 @@ public Builder value(Value value) {
 
         @Override
         public ReferredDocumentStatus build() {
-            return new ReferredDocumentStatus(this);
+            ReferredDocumentStatus referredDocumentStatus = new ReferredDocumentStatus(this);
+            if (validating) {
+                validate(referredDocumentStatus);
+            }
+            return referredDocumentStatus;
+        }
+
+        protected void validate(ReferredDocumentStatus referredDocumentStatus) {
+            super.validate(referredDocumentStatus);
+        }
+
+        protected Builder from(ReferredDocumentStatus referredDocumentStatus) {
+            super.from(referredDocumentStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RelatedArtifactType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RelatedArtifactType.java
index 0a2a252bfc4..2d42d54f103 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RelatedArtifactType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RelatedArtifactType.java
@@ -221,11 +221,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -280,7 +276,20 @@ public Builder value(Value value) {
 
         @Override
         public RelatedArtifactType build() {
-            return new RelatedArtifactType(this);
+            RelatedArtifactType relatedArtifactType = new RelatedArtifactType(this);
+            if (validating) {
+                validate(relatedArtifactType);
+            }
+            return relatedArtifactType;
+        }
+
+        protected void validate(RelatedArtifactType relatedArtifactType) {
+            super.validate(relatedArtifactType);
+        }
+
+        protected Builder from(RelatedArtifactType relatedArtifactType) {
+            super.from(relatedArtifactType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RemittanceOutcome.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RemittanceOutcome.java
index 54d05302e50..c5cbeb854f0 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RemittanceOutcome.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RemittanceOutcome.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public RemittanceOutcome build() {
-            return new RemittanceOutcome(this);
+            RemittanceOutcome remittanceOutcome = new RemittanceOutcome(this);
+            if (validating) {
+                validate(remittanceOutcome);
+            }
+            return remittanceOutcome;
+        }
+
+        protected void validate(RemittanceOutcome remittanceOutcome) {
+            super.validate(remittanceOutcome);
+        }
+
+        protected Builder from(RemittanceOutcome remittanceOutcome) {
+            super.from(remittanceOutcome);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RepositoryType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RepositoryType.java
index 8dc2d9c67bc..d088d945e6d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RepositoryType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RepositoryType.java
@@ -181,11 +181,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -240,7 +236,20 @@ public Builder value(Value value) {
 
         @Override
         public RepositoryType build() {
-            return new RepositoryType(this);
+            RepositoryType repositoryType = new RepositoryType(this);
+            if (validating) {
+                validate(repositoryType);
+            }
+            return repositoryType;
+        }
+
+        protected void validate(RepositoryType repositoryType) {
+            super.validate(repositoryType);
+        }
+
+        protected Builder from(RepositoryType repositoryType) {
+            super.from(repositoryType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestIntent.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestIntent.java
index a839df955e6..a2a9fa74803 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestIntent.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestIntent.java
@@ -230,11 +230,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -289,7 +285,20 @@ public Builder value(Value value) {
 
         @Override
         public RequestIntent build() {
-            return new RequestIntent(this);
+            RequestIntent requestIntent = new RequestIntent(this);
+            if (validating) {
+                validate(requestIntent);
+            }
+            return requestIntent;
+        }
+
+        protected void validate(RequestIntent requestIntent) {
+            super.validate(requestIntent);
+        }
+
+        protected Builder from(RequestIntent requestIntent) {
+            super.from(requestIntent);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestPriority.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestPriority.java
index d4d350c3aa1..7e56c0712fc 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestPriority.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestPriority.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public RequestPriority build() {
-            return new RequestPriority(this);
+            RequestPriority requestPriority = new RequestPriority(this);
+            if (validating) {
+                validate(requestPriority);
+            }
+            return requestPriority;
+        }
+
+        protected void validate(RequestPriority requestPriority) {
+            super.validate(requestPriority);
+        }
+
+        protected Builder from(RequestPriority requestPriority) {
+            super.from(requestPriority);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestStatus.java
index de68db66e16..d2e631ca496 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RequestStatus.java
@@ -207,11 +207,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -266,7 +262,20 @@ public Builder value(Value value) {
 
         @Override
         public RequestStatus build() {
-            return new RequestStatus(this);
+            RequestStatus requestStatus = new RequestStatus(this);
+            if (validating) {
+                validate(requestStatus);
+            }
+            return requestStatus;
+        }
+
+        protected void validate(RequestStatus requestStatus) {
+            super.validate(requestStatus);
+        }
+
+        protected Builder from(RequestStatus requestStatus) {
+            super.from(requestStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchElementType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchElementType.java
index 4515712b838..bd457731382 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchElementType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchElementType.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public ResearchElementType build() {
-            return new ResearchElementType(this);
+            ResearchElementType researchElementType = new ResearchElementType(this);
+            if (validating) {
+                validate(researchElementType);
+            }
+            return researchElementType;
+        }
+
+        protected void validate(ResearchElementType researchElementType) {
+            super.validate(researchElementType);
+        }
+
+        protected Builder from(ResearchElementType researchElementType) {
+            super.from(researchElementType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchStudyStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchStudyStatus.java
index 889ccea39a4..ada08af6be6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchStudyStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchStudyStatus.java
@@ -250,11 +250,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -309,7 +305,20 @@ public Builder value(Value value) {
 
         @Override
         public ResearchStudyStatus build() {
-            return new ResearchStudyStatus(this);
+            ResearchStudyStatus researchStudyStatus = new ResearchStudyStatus(this);
+            if (validating) {
+                validate(researchStudyStatus);
+            }
+            return researchStudyStatus;
+        }
+
+        protected void validate(ResearchStudyStatus researchStudyStatus) {
+            super.validate(researchStudyStatus);
+        }
+
+        protected Builder from(ResearchStudyStatus researchStudyStatus) {
+            super.from(researchStudyStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchSubjectStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchSubjectStatus.java
index 6c72949338e..ca67a9f2ff6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchSubjectStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResearchSubjectStatus.java
@@ -276,11 +276,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -335,7 +331,20 @@ public Builder value(Value value) {
 
         @Override
         public ResearchSubjectStatus build() {
-            return new ResearchSubjectStatus(this);
+            ResearchSubjectStatus researchSubjectStatus = new ResearchSubjectStatus(this);
+            if (validating) {
+                validate(researchSubjectStatus);
+            }
+            return researchSubjectStatus;
+        }
+
+        protected void validate(ResearchSubjectStatus researchSubjectStatus) {
+            super.validate(researchSubjectStatus);
+        }
+
+        protected Builder from(ResearchSubjectStatus researchSubjectStatus) {
+            super.from(researchSubjectStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResourceType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResourceType.java
index 38ffc7f04e6..129d3cf0870 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResourceType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResourceType.java
@@ -1903,11 +1903,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -1962,7 +1958,20 @@ public Builder value(Value value) {
 
         @Override
         public ResourceType build() {
-            return new ResourceType(this);
+            ResourceType resourceType = new ResourceType(this);
+            if (validating) {
+                validate(resourceType);
+            }
+            return resourceType;
+        }
+
+        protected void validate(ResourceType resourceType) {
+            super.validate(resourceType);
+        }
+
+        protected Builder from(ResourceType resourceType) {
+            super.from(resourceType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResourceVersionPolicy.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResourceVersionPolicy.java
index c259854ed4f..821634db4a7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResourceVersionPolicy.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResourceVersionPolicy.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public ResourceVersionPolicy build() {
-            return new ResourceVersionPolicy(this);
+            ResourceVersionPolicy resourceVersionPolicy = new ResourceVersionPolicy(this);
+            if (validating) {
+                validate(resourceVersionPolicy);
+            }
+            return resourceVersionPolicy;
+        }
+
+        protected void validate(ResourceVersionPolicy resourceVersionPolicy) {
+            super.validate(resourceVersionPolicy);
+        }
+
+        protected Builder from(ResourceVersionPolicy resourceVersionPolicy) {
+            super.from(resourceVersionPolicy);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResponseType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResponseType.java
index 6ae0513c1c3..859f7652b95 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResponseType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ResponseType.java
@@ -160,11 +160,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -219,7 +215,20 @@ public Builder value(Value value) {
 
         @Override
         public ResponseType build() {
-            return new ResponseType(this);
+            ResponseType responseType = new ResponseType(this);
+            if (validating) {
+                validate(responseType);
+            }
+            return responseType;
+        }
+
+        protected void validate(ResponseType responseType) {
+            super.validate(responseType);
+        }
+
+        protected Builder from(ResponseType responseType) {
+            super.from(responseType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RestfulCapabilityMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RestfulCapabilityMode.java
index 4719bd60b4f..43cc0fa860f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RestfulCapabilityMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RestfulCapabilityMode.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public RestfulCapabilityMode build() {
-            return new RestfulCapabilityMode(this);
+            RestfulCapabilityMode restfulCapabilityMode = new RestfulCapabilityMode(this);
+            if (validating) {
+                validate(restfulCapabilityMode);
+            }
+            return restfulCapabilityMode;
+        }
+
+        protected void validate(RestfulCapabilityMode restfulCapabilityMode) {
+            super.validate(restfulCapabilityMode);
+        }
+
+        protected Builder from(RestfulCapabilityMode restfulCapabilityMode) {
+            super.from(restfulCapabilityMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RiskAssessmentStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RiskAssessmentStatus.java
index 766be64ba5f..fc58f85e18f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RiskAssessmentStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/RiskAssessmentStatus.java
@@ -222,11 +222,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -281,7 +277,20 @@ public Builder value(Value value) {
 
         @Override
         public RiskAssessmentStatus build() {
-            return new RiskAssessmentStatus(this);
+            RiskAssessmentStatus riskAssessmentStatus = new RiskAssessmentStatus(this);
+            if (validating) {
+                validate(riskAssessmentStatus);
+            }
+            return riskAssessmentStatus;
+        }
+
+        protected void validate(RiskAssessmentStatus riskAssessmentStatus) {
+            super.validate(riskAssessmentStatus);
+        }
+
+        protected Builder from(RiskAssessmentStatus riskAssessmentStatus) {
+            super.from(riskAssessmentStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SPDXLicense.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SPDXLicense.java
index 7da4c2f1910..d94f620479f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SPDXLicense.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SPDXLicense.java
@@ -3931,11 +3931,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -3990,7 +3986,20 @@ public Builder value(Value value) {
 
         @Override
         public SPDXLicense build() {
-            return new SPDXLicense(this);
+            SPDXLicense sPDXLicense = new SPDXLicense(this);
+            if (validating) {
+                validate(sPDXLicense);
+            }
+            return sPDXLicense;
+        }
+
+        protected void validate(SPDXLicense sPDXLicense) {
+            super.validate(sPDXLicense);
+        }
+
+        protected Builder from(SPDXLicense sPDXLicense) {
+            super.from(sPDXLicense);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchComparator.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchComparator.java
index edff2be8100..aa6a7fbfd8a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchComparator.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchComparator.java
@@ -224,11 +224,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -283,7 +279,20 @@ public Builder value(Value value) {
 
         @Override
         public SearchComparator build() {
-            return new SearchComparator(this);
+            SearchComparator searchComparator = new SearchComparator(this);
+            if (validating) {
+                validate(searchComparator);
+            }
+            return searchComparator;
+        }
+
+        protected void validate(SearchComparator searchComparator) {
+            super.validate(searchComparator);
+        }
+
+        protected Builder from(SearchComparator searchComparator) {
+            super.from(searchComparator);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchEntryMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchEntryMode.java
index d56ae84fa2c..45a4835c70a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchEntryMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchEntryMode.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public SearchEntryMode build() {
-            return new SearchEntryMode(this);
+            SearchEntryMode searchEntryMode = new SearchEntryMode(this);
+            if (validating) {
+                validate(searchEntryMode);
+            }
+            return searchEntryMode;
+        }
+
+        protected void validate(SearchEntryMode searchEntryMode) {
+            super.validate(searchEntryMode);
+        }
+
+        protected Builder from(SearchEntryMode searchEntryMode) {
+            super.from(searchEntryMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchModifierCode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchModifierCode.java
index b32da9d1ef8..0a453a5f2db 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchModifierCode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchModifierCode.java
@@ -266,11 +266,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -325,7 +321,20 @@ public Builder value(Value value) {
 
         @Override
         public SearchModifierCode build() {
-            return new SearchModifierCode(this);
+            SearchModifierCode searchModifierCode = new SearchModifierCode(this);
+            if (validating) {
+                validate(searchModifierCode);
+            }
+            return searchModifierCode;
+        }
+
+        protected void validate(SearchModifierCode searchModifierCode) {
+            super.validate(searchModifierCode);
+        }
+
+        protected Builder from(SearchModifierCode searchModifierCode) {
+            super.from(searchModifierCode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchParamType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchParamType.java
index 5ff33cadc6b..a97eac83a42 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchParamType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SearchParamType.java
@@ -228,11 +228,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -287,7 +283,20 @@ public Builder value(Value value) {
 
         @Override
         public SearchParamType build() {
-            return new SearchParamType(this);
+            SearchParamType searchParamType = new SearchParamType(this);
+            if (validating) {
+                validate(searchParamType);
+            }
+            return searchParamType;
+        }
+
+        protected void validate(SearchParamType searchParamType) {
+            super.validate(searchParamType);
+        }
+
+        protected Builder from(SearchParamType searchParamType) {
+            super.from(searchParamType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SectionMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SectionMode.java
index aca5694732e..38b01d7cd10 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SectionMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SectionMode.java
@@ -160,11 +160,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -219,7 +215,20 @@ public Builder value(Value value) {
 
         @Override
         public SectionMode build() {
-            return new SectionMode(this);
+            SectionMode sectionMode = new SectionMode(this);
+            if (validating) {
+                validate(sectionMode);
+            }
+            return sectionMode;
+        }
+
+        protected void validate(SectionMode sectionMode) {
+            super.validate(sectionMode);
+        }
+
+        protected Builder from(SectionMode sectionMode) {
+            super.from(sectionMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SequenceType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SequenceType.java
index ed495c1f7b4..f24bf40620f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SequenceType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SequenceType.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public SequenceType build() {
-            return new SequenceType(this);
+            SequenceType sequenceType = new SequenceType(this);
+            if (validating) {
+                validate(sequenceType);
+            }
+            return sequenceType;
+        }
+
+        protected void validate(SequenceType sequenceType) {
+            super.validate(sequenceType);
+        }
+
+        protected Builder from(SequenceType sequenceType) {
+            super.from(sequenceType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestIntent.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestIntent.java
index 67e01894f2d..dd18c4b982c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestIntent.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestIntent.java
@@ -230,11 +230,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -289,7 +285,20 @@ public Builder value(Value value) {
 
         @Override
         public ServiceRequestIntent build() {
-            return new ServiceRequestIntent(this);
+            ServiceRequestIntent serviceRequestIntent = new ServiceRequestIntent(this);
+            if (validating) {
+                validate(serviceRequestIntent);
+            }
+            return serviceRequestIntent;
+        }
+
+        protected void validate(ServiceRequestIntent serviceRequestIntent) {
+            super.validate(serviceRequestIntent);
+        }
+
+        protected Builder from(ServiceRequestIntent serviceRequestIntent) {
+            super.from(serviceRequestIntent);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestPriority.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestPriority.java
index 38f0d545abd..7bf63b64a7c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestPriority.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestPriority.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public ServiceRequestPriority build() {
-            return new ServiceRequestPriority(this);
+            ServiceRequestPriority serviceRequestPriority = new ServiceRequestPriority(this);
+            if (validating) {
+                validate(serviceRequestPriority);
+            }
+            return serviceRequestPriority;
+        }
+
+        protected void validate(ServiceRequestPriority serviceRequestPriority) {
+            super.validate(serviceRequestPriority);
+        }
+
+        protected Builder from(ServiceRequestPriority serviceRequestPriority) {
+            super.from(serviceRequestPriority);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestStatus.java
index 6e522143a36..e00e974a18f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/ServiceRequestStatus.java
@@ -207,11 +207,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -266,7 +262,20 @@ public Builder value(Value value) {
 
         @Override
         public ServiceRequestStatus build() {
-            return new ServiceRequestStatus(this);
+            ServiceRequestStatus serviceRequestStatus = new ServiceRequestStatus(this);
+            if (validating) {
+                validate(serviceRequestStatus);
+            }
+            return serviceRequestStatus;
+        }
+
+        protected void validate(ServiceRequestStatus serviceRequestStatus) {
+            super.validate(serviceRequestStatus);
+        }
+
+        protected Builder from(ServiceRequestStatus serviceRequestStatus) {
+            super.from(serviceRequestStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SlicingRules.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SlicingRules.java
index 68f19d58dae..cd2a3e52383 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SlicingRules.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SlicingRules.java
@@ -159,11 +159,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -218,7 +214,20 @@ public Builder value(Value value) {
 
         @Override
         public SlicingRules build() {
-            return new SlicingRules(this);
+            SlicingRules slicingRules = new SlicingRules(this);
+            if (validating) {
+                validate(slicingRules);
+            }
+            return slicingRules;
+        }
+
+        protected void validate(SlicingRules slicingRules) {
+            super.validate(slicingRules);
+        }
+
+        protected Builder from(SlicingRules slicingRules) {
+            super.from(slicingRules);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SlotStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SlotStatus.java
index f6da3cd0abe..8af0e91d605 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SlotStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SlotStatus.java
@@ -181,11 +181,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -240,7 +236,20 @@ public Builder value(Value value) {
 
         @Override
         public SlotStatus build() {
-            return new SlotStatus(this);
+            SlotStatus slotStatus = new SlotStatus(this);
+            if (validating) {
+                validate(slotStatus);
+            }
+            return slotStatus;
+        }
+
+        protected void validate(SlotStatus slotStatus) {
+            super.validate(slotStatus);
+        }
+
+        protected Builder from(SlotStatus slotStatus) {
+            super.from(slotStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SortDirection.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SortDirection.java
index 7eaac807e3f..35e750ce7d6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SortDirection.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SortDirection.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public SortDirection build() {
-            return new SortDirection(this);
+            SortDirection sortDirection = new SortDirection(this);
+            if (validating) {
+                validate(sortDirection);
+            }
+            return sortDirection;
+        }
+
+        protected void validate(SortDirection sortDirection) {
+            super.validate(sortDirection);
+        }
+
+        protected Builder from(SortDirection sortDirection) {
+            super.from(sortDirection);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SpecimenContainedPreference.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SpecimenContainedPreference.java
index 348002bb4a4..65905c751cc 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SpecimenContainedPreference.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SpecimenContainedPreference.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public SpecimenContainedPreference build() {
-            return new SpecimenContainedPreference(this);
+            SpecimenContainedPreference specimenContainedPreference = new SpecimenContainedPreference(this);
+            if (validating) {
+                validate(specimenContainedPreference);
+            }
+            return specimenContainedPreference;
+        }
+
+        protected void validate(SpecimenContainedPreference specimenContainedPreference) {
+            super.validate(specimenContainedPreference);
+        }
+
+        protected Builder from(SpecimenContainedPreference specimenContainedPreference) {
+            super.from(specimenContainedPreference);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SpecimenStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SpecimenStatus.java
index e146b00dced..3f2eee0d0ab 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SpecimenStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SpecimenStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public SpecimenStatus build() {
-            return new SpecimenStatus(this);
+            SpecimenStatus specimenStatus = new SpecimenStatus(this);
+            if (validating) {
+                validate(specimenStatus);
+            }
+            return specimenStatus;
+        }
+
+        protected void validate(SpecimenStatus specimenStatus) {
+            super.validate(specimenStatus);
+        }
+
+        protected Builder from(SpecimenStatus specimenStatus) {
+            super.from(specimenStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StandardsStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StandardsStatus.java
index b6cd7e0d298..eddc4b7d3de 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StandardsStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StandardsStatus.java
@@ -208,11 +208,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -267,7 +263,20 @@ public Builder value(Value value) {
 
         @Override
         public StandardsStatus build() {
-            return new StandardsStatus(this);
+            StandardsStatus standardsStatus = new StandardsStatus(this);
+            if (validating) {
+                validate(standardsStatus);
+            }
+            return standardsStatus;
+        }
+
+        protected void validate(StandardsStatus standardsStatus) {
+            super.validate(standardsStatus);
+        }
+
+        protected Builder from(StandardsStatus standardsStatus) {
+            super.from(standardsStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/Status.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/Status.java
index 57f2110fab5..7bf4a973156 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/Status.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/Status.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public Status build() {
-            return new Status(this);
+            Status status = new Status(this);
+            if (validating) {
+                validate(status);
+            }
+            return status;
+        }
+
+        protected void validate(Status status) {
+            super.validate(status);
+        }
+
+        protected Builder from(Status status) {
+            super.from(status);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StrandType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StrandType.java
index c28e671828b..6b7231002b8 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StrandType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StrandType.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public StrandType build() {
-            return new StrandType(this);
+            StrandType strandType = new StrandType(this);
+            if (validating) {
+                validate(strandType);
+            }
+            return strandType;
+        }
+
+        protected void validate(StrandType strandType) {
+            super.validate(strandType);
+        }
+
+        protected Builder from(StrandType strandType) {
+            super.from(strandType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureDefinitionKind.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureDefinitionKind.java
index 8a8275e7dde..488f53ca6b7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureDefinitionKind.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureDefinitionKind.java
@@ -176,11 +176,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -235,7 +231,20 @@ public Builder value(Value value) {
 
         @Override
         public StructureDefinitionKind build() {
-            return new StructureDefinitionKind(this);
+            StructureDefinitionKind structureDefinitionKind = new StructureDefinitionKind(this);
+            if (validating) {
+                validate(structureDefinitionKind);
+            }
+            return structureDefinitionKind;
+        }
+
+        protected void validate(StructureDefinitionKind structureDefinitionKind) {
+            super.validate(structureDefinitionKind);
+        }
+
+        protected Builder from(StructureDefinitionKind structureDefinitionKind) {
+            super.from(structureDefinitionKind);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapContextType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapContextType.java
index dcea6174509..b3e9da506b5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapContextType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapContextType.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public StructureMapContextType build() {
-            return new StructureMapContextType(this);
+            StructureMapContextType structureMapContextType = new StructureMapContextType(this);
+            if (validating) {
+                validate(structureMapContextType);
+            }
+            return structureMapContextType;
+        }
+
+        protected void validate(StructureMapContextType structureMapContextType) {
+            super.validate(structureMapContextType);
+        }
+
+        protected Builder from(StructureMapContextType structureMapContextType) {
+            super.from(structureMapContextType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapGroupTypeMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapGroupTypeMode.java
index 9273464c979..2960ec479bd 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapGroupTypeMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapGroupTypeMode.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public StructureMapGroupTypeMode build() {
-            return new StructureMapGroupTypeMode(this);
+            StructureMapGroupTypeMode structureMapGroupTypeMode = new StructureMapGroupTypeMode(this);
+            if (validating) {
+                validate(structureMapGroupTypeMode);
+            }
+            return structureMapGroupTypeMode;
+        }
+
+        protected void validate(StructureMapGroupTypeMode structureMapGroupTypeMode) {
+            super.validate(structureMapGroupTypeMode);
+        }
+
+        protected Builder from(StructureMapGroupTypeMode structureMapGroupTypeMode) {
+            super.from(structureMapGroupTypeMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapInputMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapInputMode.java
index febcad82778..412e4c56895 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapInputMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapInputMode.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public StructureMapInputMode build() {
-            return new StructureMapInputMode(this);
+            StructureMapInputMode structureMapInputMode = new StructureMapInputMode(this);
+            if (validating) {
+                validate(structureMapInputMode);
+            }
+            return structureMapInputMode;
+        }
+
+        protected void validate(StructureMapInputMode structureMapInputMode) {
+            super.validate(structureMapInputMode);
+        }
+
+        protected Builder from(StructureMapInputMode structureMapInputMode) {
+            super.from(structureMapInputMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapModelMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapModelMode.java
index f2819855a84..5ea800ef0fb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapModelMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapModelMode.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public StructureMapModelMode build() {
-            return new StructureMapModelMode(this);
+            StructureMapModelMode structureMapModelMode = new StructureMapModelMode(this);
+            if (validating) {
+                validate(structureMapModelMode);
+            }
+            return structureMapModelMode;
+        }
+
+        protected void validate(StructureMapModelMode structureMapModelMode) {
+            super.validate(structureMapModelMode);
+        }
+
+        protected Builder from(StructureMapModelMode structureMapModelMode) {
+            super.from(structureMapModelMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapSourceListMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapSourceListMode.java
index 11175de5961..603b373a9c3 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapSourceListMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapSourceListMode.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public StructureMapSourceListMode build() {
-            return new StructureMapSourceListMode(this);
+            StructureMapSourceListMode structureMapSourceListMode = new StructureMapSourceListMode(this);
+            if (validating) {
+                validate(structureMapSourceListMode);
+            }
+            return structureMapSourceListMode;
+        }
+
+        protected void validate(StructureMapSourceListMode structureMapSourceListMode) {
+            super.validate(structureMapSourceListMode);
+        }
+
+        protected Builder from(StructureMapSourceListMode structureMapSourceListMode) {
+            super.from(structureMapSourceListMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapTargetListMode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapTargetListMode.java
index 039da9b81ce..fb357b54d68 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapTargetListMode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapTargetListMode.java
@@ -172,11 +172,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -231,7 +227,20 @@ public Builder value(Value value) {
 
         @Override
         public StructureMapTargetListMode build() {
-            return new StructureMapTargetListMode(this);
+            StructureMapTargetListMode structureMapTargetListMode = new StructureMapTargetListMode(this);
+            if (validating) {
+                validate(structureMapTargetListMode);
+            }
+            return structureMapTargetListMode;
+        }
+
+        protected void validate(StructureMapTargetListMode structureMapTargetListMode) {
+            super.validate(structureMapTargetListMode);
+        }
+
+        protected Builder from(StructureMapTargetListMode structureMapTargetListMode) {
+            super.from(structureMapTargetListMode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapTransform.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapTransform.java
index 59d3ef7488c..d16c8a7a426 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapTransform.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/StructureMapTransform.java
@@ -316,11 +316,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -375,7 +371,20 @@ public Builder value(Value value) {
 
         @Override
         public StructureMapTransform build() {
-            return new StructureMapTransform(this);
+            StructureMapTransform structureMapTransform = new StructureMapTransform(this);
+            if (validating) {
+                validate(structureMapTransform);
+            }
+            return structureMapTransform;
+        }
+
+        protected void validate(StructureMapTransform structureMapTransform) {
+            super.validate(structureMapTransform);
+        }
+
+        protected Builder from(StructureMapTransform structureMapTransform) {
+            super.from(structureMapTransform);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SubscriptionChannelType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SubscriptionChannelType.java
index 44e9245f42f..1e44daf85cb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SubscriptionChannelType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SubscriptionChannelType.java
@@ -183,11 +183,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -242,7 +238,20 @@ public Builder value(Value value) {
 
         @Override
         public SubscriptionChannelType build() {
-            return new SubscriptionChannelType(this);
+            SubscriptionChannelType subscriptionChannelType = new SubscriptionChannelType(this);
+            if (validating) {
+                validate(subscriptionChannelType);
+            }
+            return subscriptionChannelType;
+        }
+
+        protected void validate(SubscriptionChannelType subscriptionChannelType) {
+            super.validate(subscriptionChannelType);
+        }
+
+        protected Builder from(SubscriptionChannelType subscriptionChannelType) {
+            super.from(subscriptionChannelType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SubscriptionStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SubscriptionStatus.java
index ad13b75e689..a859326f966 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SubscriptionStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SubscriptionStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public SubscriptionStatus build() {
-            return new SubscriptionStatus(this);
+            SubscriptionStatus subscriptionStatus = new SubscriptionStatus(this);
+            if (validating) {
+                validate(subscriptionStatus);
+            }
+            return subscriptionStatus;
+        }
+
+        protected void validate(SubscriptionStatus subscriptionStatus) {
+            super.validate(subscriptionStatus);
+        }
+
+        protected Builder from(SubscriptionStatus subscriptionStatus) {
+            super.from(subscriptionStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SupplyDeliveryStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SupplyDeliveryStatus.java
index 1ded69dec38..8237933641d 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SupplyDeliveryStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SupplyDeliveryStatus.java
@@ -170,11 +170,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -229,7 +225,20 @@ public Builder value(Value value) {
 
         @Override
         public SupplyDeliveryStatus build() {
-            return new SupplyDeliveryStatus(this);
+            SupplyDeliveryStatus supplyDeliveryStatus = new SupplyDeliveryStatus(this);
+            if (validating) {
+                validate(supplyDeliveryStatus);
+            }
+            return supplyDeliveryStatus;
+        }
+
+        protected void validate(SupplyDeliveryStatus supplyDeliveryStatus) {
+            super.validate(supplyDeliveryStatus);
+        }
+
+        protected Builder from(SupplyDeliveryStatus supplyDeliveryStatus) {
+            super.from(supplyDeliveryStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SupplyRequestStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SupplyRequestStatus.java
index e573e38f7dd..a61a13589dd 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SupplyRequestStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SupplyRequestStatus.java
@@ -206,11 +206,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -265,7 +261,20 @@ public Builder value(Value value) {
 
         @Override
         public SupplyRequestStatus build() {
-            return new SupplyRequestStatus(this);
+            SupplyRequestStatus supplyRequestStatus = new SupplyRequestStatus(this);
+            if (validating) {
+                validate(supplyRequestStatus);
+            }
+            return supplyRequestStatus;
+        }
+
+        protected void validate(SupplyRequestStatus supplyRequestStatus) {
+            super.validate(supplyRequestStatus);
+        }
+
+        protected Builder from(SupplyRequestStatus supplyRequestStatus) {
+            super.from(supplyRequestStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SystemRestfulInteraction.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SystemRestfulInteraction.java
index 7fa46d34532..b9b2dd0df1e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SystemRestfulInteraction.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/SystemRestfulInteraction.java
@@ -149,11 +149,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -208,7 +204,20 @@ public Builder value(Value value) {
 
         @Override
         public SystemRestfulInteraction build() {
-            return new SystemRestfulInteraction(this);
+            SystemRestfulInteraction systemRestfulInteraction = new SystemRestfulInteraction(this);
+            if (validating) {
+                validate(systemRestfulInteraction);
+            }
+            return systemRestfulInteraction;
+        }
+
+        protected void validate(SystemRestfulInteraction systemRestfulInteraction) {
+            super.validate(systemRestfulInteraction);
+        }
+
+        protected Builder from(SystemRestfulInteraction systemRestfulInteraction) {
+            super.from(systemRestfulInteraction);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskIntent.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskIntent.java
index 98d26841f89..84038eaf796 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskIntent.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskIntent.java
@@ -185,11 +185,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -244,7 +240,20 @@ public Builder value(Value value) {
 
         @Override
         public TaskIntent build() {
-            return new TaskIntent(this);
+            TaskIntent taskIntent = new TaskIntent(this);
+            if (validating) {
+                validate(taskIntent);
+            }
+            return taskIntent;
+        }
+
+        protected void validate(TaskIntent taskIntent) {
+            super.validate(taskIntent);
+        }
+
+        protected Builder from(TaskIntent taskIntent) {
+            super.from(taskIntent);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskPriority.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskPriority.java
index f9c9aacb46e..1bc155965c7 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskPriority.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskPriority.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public TaskPriority build() {
-            return new TaskPriority(this);
+            TaskPriority taskPriority = new TaskPriority(this);
+            if (validating) {
+                validate(taskPriority);
+            }
+            return taskPriority;
+        }
+
+        protected void validate(TaskPriority taskPriority) {
+            super.validate(taskPriority);
+        }
+
+        protected Builder from(TaskPriority taskPriority) {
+            super.from(taskPriority);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskStatus.java
index 93904f7412b..03f4b32c275 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TaskStatus.java
@@ -259,11 +259,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -318,7 +314,20 @@ public Builder value(Value value) {
 
         @Override
         public TaskStatus build() {
-            return new TaskStatus(this);
+            TaskStatus taskStatus = new TaskStatus(this);
+            if (validating) {
+                validate(taskStatus);
+            }
+            return taskStatus;
+        }
+
+        protected void validate(TaskStatus taskStatus) {
+            super.validate(taskStatus);
+        }
+
+        protected Builder from(TaskStatus taskStatus) {
+            super.from(taskStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportActionResult.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportActionResult.java
index 72d6f9bb2cb..c21caa5c448 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportActionResult.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportActionResult.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public TestReportActionResult build() {
-            return new TestReportActionResult(this);
+            TestReportActionResult testReportActionResult = new TestReportActionResult(this);
+            if (validating) {
+                validate(testReportActionResult);
+            }
+            return testReportActionResult;
+        }
+
+        protected void validate(TestReportActionResult testReportActionResult) {
+            super.validate(testReportActionResult);
+        }
+
+        protected Builder from(TestReportActionResult testReportActionResult) {
+            super.from(testReportActionResult);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportParticipantType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportParticipantType.java
index 9fe601c26ad..fff2c53ef2f 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportParticipantType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportParticipantType.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public TestReportParticipantType build() {
-            return new TestReportParticipantType(this);
+            TestReportParticipantType testReportParticipantType = new TestReportParticipantType(this);
+            if (validating) {
+                validate(testReportParticipantType);
+            }
+            return testReportParticipantType;
+        }
+
+        protected void validate(TestReportParticipantType testReportParticipantType) {
+            super.validate(testReportParticipantType);
+        }
+
+        protected Builder from(TestReportParticipantType testReportParticipantType) {
+            super.from(testReportParticipantType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportResult.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportResult.java
index c58cc009b56..d5c8ec10969 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportResult.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportResult.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public TestReportResult build() {
-            return new TestReportResult(this);
+            TestReportResult testReportResult = new TestReportResult(this);
+            if (validating) {
+                validate(testReportResult);
+            }
+            return testReportResult;
+        }
+
+        protected void validate(TestReportResult testReportResult) {
+            super.validate(testReportResult);
+        }
+
+        protected Builder from(TestReportResult testReportResult) {
+            super.from(testReportResult);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportStatus.java
index d667304dcff..084c3c421b6 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestReportStatus.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public TestReportStatus build() {
-            return new TestReportStatus(this);
+            TestReportStatus testReportStatus = new TestReportStatus(this);
+            if (validating) {
+                validate(testReportStatus);
+            }
+            return testReportStatus;
+        }
+
+        protected void validate(TestReportStatus testReportStatus) {
+            super.validate(testReportStatus);
+        }
+
+        protected Builder from(TestReportStatus testReportStatus) {
+            super.from(testReportStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestScriptRequestMethodCode.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestScriptRequestMethodCode.java
index 275c42de83c..3eb5eaee3e1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestScriptRequestMethodCode.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TestScriptRequestMethodCode.java
@@ -202,11 +202,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -261,7 +257,20 @@ public Builder value(Value value) {
 
         @Override
         public TestScriptRequestMethodCode build() {
-            return new TestScriptRequestMethodCode(this);
+            TestScriptRequestMethodCode testScriptRequestMethodCode = new TestScriptRequestMethodCode(this);
+            if (validating) {
+                validate(testScriptRequestMethodCode);
+            }
+            return testScriptRequestMethodCode;
+        }
+
+        protected void validate(TestScriptRequestMethodCode testScriptRequestMethodCode) {
+            super.validate(testScriptRequestMethodCode);
+        }
+
+        protected Builder from(TestScriptRequestMethodCode testScriptRequestMethodCode) {
+            super.from(testScriptRequestMethodCode);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TriggerType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TriggerType.java
index e3b527b06b4..e4e81c5cc5c 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TriggerType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TriggerType.java
@@ -215,11 +215,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -274,7 +270,20 @@ public Builder value(Value value) {
 
         @Override
         public TriggerType build() {
-            return new TriggerType(this);
+            TriggerType triggerType = new TriggerType(this);
+            if (validating) {
+                validate(triggerType);
+            }
+            return triggerType;
+        }
+
+        protected void validate(TriggerType triggerType) {
+            super.validate(triggerType);
+        }
+
+        protected Builder from(TriggerType triggerType) {
+            super.from(triggerType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TypeDerivationRule.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TypeDerivationRule.java
index 29709fbb3cc..aa232ce5709 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TypeDerivationRule.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TypeDerivationRule.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public TypeDerivationRule build() {
-            return new TypeDerivationRule(this);
+            TypeDerivationRule typeDerivationRule = new TypeDerivationRule(this);
+            if (validating) {
+                validate(typeDerivationRule);
+            }
+            return typeDerivationRule;
+        }
+
+        protected void validate(TypeDerivationRule typeDerivationRule) {
+            super.validate(typeDerivationRule);
+        }
+
+        protected Builder from(TypeDerivationRule typeDerivationRule) {
+            super.from(typeDerivationRule);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TypeRestfulInteraction.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TypeRestfulInteraction.java
index c5acfce0c3d..022def3d7a5 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TypeRestfulInteraction.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/TypeRestfulInteraction.java
@@ -179,11 +179,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -238,7 +234,20 @@ public Builder value(Value value) {
 
         @Override
         public TypeRestfulInteraction build() {
-            return new TypeRestfulInteraction(this);
+            TypeRestfulInteraction typeRestfulInteraction = new TypeRestfulInteraction(this);
+            if (validating) {
+                validate(typeRestfulInteraction);
+            }
+            return typeRestfulInteraction;
+        }
+
+        protected void validate(TypeRestfulInteraction typeRestfulInteraction) {
+            super.validate(typeRestfulInteraction);
+        }
+
+        protected Builder from(TypeRestfulInteraction typeRestfulInteraction) {
+            super.from(typeRestfulInteraction);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/UDIEntryType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/UDIEntryType.java
index 4339ff109a9..3626bf20e8a 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/UDIEntryType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/UDIEntryType.java
@@ -191,11 +191,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -250,7 +246,20 @@ public Builder value(Value value) {
 
         @Override
         public UDIEntryType build() {
-            return new UDIEntryType(this);
+            UDIEntryType uDIEntryType = new UDIEntryType(this);
+            if (validating) {
+                validate(uDIEntryType);
+            }
+            return uDIEntryType;
+        }
+
+        protected void validate(UDIEntryType uDIEntryType) {
+            super.validate(uDIEntryType);
+        }
+
+        protected Builder from(UDIEntryType uDIEntryType) {
+            super.from(uDIEntryType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/UnitsOfTime.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/UnitsOfTime.java
index 8890495e88c..3ed48e655b1 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/UnitsOfTime.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/UnitsOfTime.java
@@ -188,11 +188,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -247,7 +243,20 @@ public Builder value(Value value) {
 
         @Override
         public UnitsOfTime build() {
-            return new UnitsOfTime(this);
+            UnitsOfTime unitsOfTime = new UnitsOfTime(this);
+            if (validating) {
+                validate(unitsOfTime);
+            }
+            return unitsOfTime;
+        }
+
+        protected void validate(UnitsOfTime unitsOfTime) {
+            super.validate(unitsOfTime);
+        }
+
+        protected Builder from(UnitsOfTime unitsOfTime) {
+            super.from(unitsOfTime);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/Use.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/Use.java
index 11a7e897181..436f29c920e 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/Use.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/Use.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public Use build() {
-            return new Use(this);
+            Use use = new Use(this);
+            if (validating) {
+                validate(use);
+            }
+            return use;
+        }
+
+        protected void validate(Use use) {
+            super.validate(use);
+        }
+
+        protected Builder from(Use use) {
+            super.from(use);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VariableType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VariableType.java
index 809bd9a0a2c..a8617c35716 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VariableType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VariableType.java
@@ -158,11 +158,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -217,7 +213,20 @@ public Builder value(Value value) {
 
         @Override
         public VariableType build() {
-            return new VariableType(this);
+            VariableType variableType = new VariableType(this);
+            if (validating) {
+                validate(variableType);
+            }
+            return variableType;
+        }
+
+        protected void validate(VariableType variableType) {
+            super.validate(variableType);
+        }
+
+        protected Builder from(VariableType variableType) {
+            super.from(variableType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionBase.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionBase.java
index 1a528192b40..3f158d3dca9 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionBase.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionBase.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public VisionBase build() {
-            return new VisionBase(this);
+            VisionBase visionBase = new VisionBase(this);
+            if (validating) {
+                validate(visionBase);
+            }
+            return visionBase;
+        }
+
+        protected void validate(VisionBase visionBase) {
+            super.validate(visionBase);
+        }
+
+        protected Builder from(VisionBase visionBase) {
+            super.from(visionBase);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionEyes.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionEyes.java
index 955f30a434a..43e7ba238ad 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionEyes.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionEyes.java
@@ -147,11 +147,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -206,7 +202,20 @@ public Builder value(Value value) {
 
         @Override
         public VisionEyes build() {
-            return new VisionEyes(this);
+            VisionEyes visionEyes = new VisionEyes(this);
+            if (validating) {
+                validate(visionEyes);
+            }
+            return visionEyes;
+        }
+
+        protected void validate(VisionEyes visionEyes) {
+            super.validate(visionEyes);
+        }
+
+        protected Builder from(VisionEyes visionEyes) {
+            super.from(visionEyes);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionStatus.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionStatus.java
index 2644af43a9a..4925bfc01eb 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionStatus.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/VisionStatus.java
@@ -169,11 +169,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -228,7 +224,20 @@ public Builder value(Value value) {
 
         @Override
         public VisionStatus build() {
-            return new VisionStatus(this);
+            VisionStatus visionStatus = new VisionStatus(this);
+            if (validating) {
+                validate(visionStatus);
+            }
+            return visionStatus;
+        }
+
+        protected void validate(VisionStatus visionStatus) {
+            super.validate(visionStatus);
+        }
+
+        protected Builder from(VisionStatus visionStatus) {
+            super.from(visionStatus);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/XPathUsageType.java b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/XPathUsageType.java
index 921b2dc4981..7c9412fa3d2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/type/code/XPathUsageType.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/type/code/XPathUsageType.java
@@ -180,11 +180,7 @@ public int hashCode() {
     }
 
     public Builder toBuilder() {
-        Builder builder = new Builder();
-        builder.id(id);
-        builder.extension(extension);
-        builder.value(value);
-        return builder;
+        return new Builder().from(this);
     }
 
     public static Builder builder() {
@@ -239,7 +235,20 @@ public Builder value(Value value) {
 
         @Override
         public XPathUsageType build() {
-            return new XPathUsageType(this);
+            XPathUsageType xPathUsageType = new XPathUsageType(this);
+            if (validating) {
+                validate(xPathUsageType);
+            }
+            return xPathUsageType;
+        }
+
+        protected void validate(XPathUsageType xPathUsageType) {
+            super.validate(xPathUsageType);
+        }
+
+        protected Builder from(XPathUsageType xPathUsageType) {
+            super.from(xPathUsageType);
+            return this;
         }
     }
 
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/util/ElementFilter.java b/fhir-model/src/main/java/com/ibm/fhir/model/util/ElementFilter.java
index 7b38d63b5a4..3f288a8d281 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/util/ElementFilter.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/util/ElementFilter.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2018,2019
+ * (C) Copyright IBM Corp. 2018, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -13,10 +13,10 @@
 import java.util.Set;
 import java.util.function.Function;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
 
 public class ElementFilter implements Function<JsonObject, JsonObject> {
     private static final JsonBuilderFactory BUILDER_FACTORY = Json.createBuilderFactory(null);
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/util/FHIRUtil.java b/fhir-model/src/main/java/com/ibm/fhir/model/util/FHIRUtil.java
index eee838df30d..c1bced088b2 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/util/FHIRUtil.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/util/FHIRUtil.java
@@ -34,11 +34,11 @@
 import java.util.stream.Collectors;
 
 import javax.crypto.KeyGenerator;
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
-import javax.json.JsonValue;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
+import jakarta.json.JsonValue;
 
 import com.ibm.fhir.exception.FHIRException;
 import com.ibm.fhir.exception.FHIROperationException;
diff --git a/fhir-model/src/main/java/com/ibm/fhir/model/util/JsonSupport.java b/fhir-model/src/main/java/com/ibm/fhir/model/util/JsonSupport.java
index 24193f88dfa..c01da44e3c4 100644
--- a/fhir-model/src/main/java/com/ibm/fhir/model/util/JsonSupport.java
+++ b/fhir-model/src/main/java/com/ibm/fhir/model/util/JsonSupport.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -23,12 +23,12 @@
 import java.util.Set;
 import java.util.stream.Collectors;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonString;
-import javax.json.JsonValue;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonString;
+import jakarta.json.JsonValue;
 
 import com.ibm.fhir.model.format.Format;
 import com.ibm.fhir.model.generator.FHIRGenerator;
diff --git a/fhir-model/src/test/java/com/ibm/fhir/model/patch/test/FHIRJsonPatchTest.java b/fhir-model/src/test/java/com/ibm/fhir/model/patch/test/FHIRJsonPatchTest.java
index bfdecc45290..f72500e278d 100644
--- a/fhir-model/src/test/java/com/ibm/fhir/model/patch/test/FHIRJsonPatchTest.java
+++ b/fhir-model/src/test/java/com/ibm/fhir/model/patch/test/FHIRJsonPatchTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -17,8 +17,8 @@
 import java.util.List;
 import java.util.UUID;
 
-import javax.json.Json;
-import javax.json.JsonObject;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
 
 import org.testng.Assert;
 import org.testng.annotations.BeforeClass;
diff --git a/fhir-model/src/test/java/com/ibm/fhir/model/test/FHIRParserTest.java b/fhir-model/src/test/java/com/ibm/fhir/model/test/FHIRParserTest.java
index 7cde5a8afc5..8946b48fad2 100644
--- a/fhir-model/src/test/java/com/ibm/fhir/model/test/FHIRParserTest.java
+++ b/fhir-model/src/test/java/com/ibm/fhir/model/test/FHIRParserTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2020
+ * (C) Copyright IBM Corp. 2020, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -11,6 +11,7 @@
 import static org.testng.Assert.fail;
 
 import java.io.InputStream;
+import java.io.StringReader;
 
 import org.testng.annotations.Test;
 
@@ -23,12 +24,9 @@ public class FHIRParserTest {
     public void testUnrecognizedElements1() throws Exception {
         String value = "handling=strict";
         if (value.startsWith("handling=")) {
-
             value = value.substring("handling=".length());
             System.out.println(value);
         }
-
-
         try (InputStream in = FHIRParserTest.class.getClassLoader().getResourceAsStream("JSON/observation-unrecognized-elements.json")) {
             FHIRParser.parser(Format.JSON).parse(in);
             fail();
@@ -41,10 +39,21 @@ public void testUnrecognizedElements1() throws Exception {
     public void testUnrecognizedElements2() throws Exception {
         try (InputStream in = FHIRParserTest.class.getClassLoader().getResourceAsStream("JSON/observation-unrecognized-elements.json")) {
             FHIRParser parser = FHIRParser.parser(Format.JSON);
-            parser.setProperty(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, true);
+            parser.setIgnoringUnrecognizedElements(true);
             assertNotNull(parser.parse(in));
         } catch (FHIRParserException e) {
             fail();
         }
     }
+
+    @Test
+    public void testRejectDuplicateKeys() throws Exception {
+        try {
+            String jsonString = "{\"resourceType\":\"Patient\",\"id\":\"1\",\"id\":\"2\"}";
+            FHIRParser parser = FHIRParser.parser(Format.JSON);
+            parser.parse(new StringReader(jsonString));
+        } catch (FHIRParserException e) {
+            assertTrue(e.getMessage().startsWith("Duplicate key 'id' is not allowed"));
+        }
+    }
 }
\ No newline at end of file
diff --git a/fhir-model/src/test/java/com/ibm/fhir/model/test/IgnoringUnrecognizedElementsTest.java b/fhir-model/src/test/java/com/ibm/fhir/model/test/IgnoringUnrecognizedElementsTest.java
new file mode 100644
index 00000000000..2b2a89596e2
--- /dev/null
+++ b/fhir-model/src/test/java/com/ibm/fhir/model/test/IgnoringUnrecognizedElementsTest.java
@@ -0,0 +1,64 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.model.test;
+
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.assertNotNull;
+import static org.testng.Assert.assertTrue;
+
+import java.io.StringReader;
+
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.parser.FHIRParser;
+import com.ibm.fhir.model.parser.exception.FHIRParserException;
+import com.ibm.fhir.model.resource.Patient;
+
+public class IgnoringUnrecognizedElementsTest {
+    @Test
+    public void testIgnoringUnrecognizedElements1() {
+        try {
+            String xmlString = "<Patient xmlns=\"http://hl7.org/fhir\"><hamburger/></Patient>";
+            FHIRParser parser = FHIRParser.parser(Format.XML);
+            parser.parse(new StringReader(xmlString));
+        } catch (FHIRParserException e) {
+            assertTrue(e.getCause() instanceof IllegalArgumentException);
+            assertEquals(e.getCause().getMessage(), "Unrecognized element: 'hamburger'");
+        }
+    }
+
+    @Test
+    public void testIgnoringUnrecognizedElements2() {
+        try {
+            String jsonString = "{\"resourceType\":\"Patient\",\"hamburger\":true}";
+            FHIRParser parser = FHIRParser.parser(Format.JSON);
+            parser.parse(new StringReader(jsonString));
+        } catch (Exception e) {
+            assertTrue(e.getCause() instanceof IllegalArgumentException);
+            assertEquals(e.getCause().getMessage(), "Unrecognized element: 'hamburger'");
+        }
+    }
+
+    @Test
+    public void testIgnoringUnrecognizedElements3() throws Exception {
+        String xmlString = "<Patient xmlns=\"http://hl7.org/fhir\"><hamburger/></Patient>";
+        FHIRParser parser = FHIRParser.parser(Format.XML);
+        parser.setIgnoringUnrecognizedElements(true);
+        Patient patient = parser.parse(new StringReader(xmlString));
+        assertNotNull(patient);
+    }
+
+    @Test
+    public void testIgnoringUnrecognizedElements4() throws Exception {
+        String jsonString = "{\"resourceType\":\"Patient\",\"hamburger\":true}";
+        FHIRParser parser = FHIRParser.parser(Format.JSON);
+        parser.setIgnoringUnrecognizedElements(true);
+        Patient patient = parser.parse(new StringReader(jsonString));
+        assertNotNull(patient);
+    }
+}
diff --git a/fhir-model/src/test/java/com/ibm/fhir/model/test/TestUtil.java b/fhir-model/src/test/java/com/ibm/fhir/model/test/TestUtil.java
index 52c90bfa423..46f9277549b 100644
--- a/fhir-model/src/test/java/com/ibm/fhir/model/test/TestUtil.java
+++ b/fhir-model/src/test/java/com/ibm/fhir/model/test/TestUtil.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -20,11 +20,11 @@
 import java.util.List;
 import java.util.Properties;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
 
 import org.json.JSONException;
 import org.skyscreamer.jsonassert.JSONAssert;
diff --git a/fhir-notification/pom.xml b/fhir-notification/pom.xml
index 7fe4781ffb7..99e8c936ad2 100644
--- a/fhir-notification/pom.xml
+++ b/fhir-notification/pom.xml
@@ -4,7 +4,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
@@ -25,5 +25,10 @@
             <artifactId>jakarta.ws.rs-api</artifactId>
             <scope>provided</scope>
         </dependency>
+        <dependency>
+            <groupId>org.testng</groupId>
+            <artifactId>testng</artifactId>
+            <scope>test</scope>
+        </dependency>
     </dependencies>
 </project>
diff --git a/fhir-notification/src/main/java/com/ibm/fhir/notification/util/FHIRNotificationUtil.java b/fhir-notification/src/main/java/com/ibm/fhir/notification/util/FHIRNotificationUtil.java
index ae47e50a5a8..083caeb7937 100644
--- a/fhir-notification/src/main/java/com/ibm/fhir/notification/util/FHIRNotificationUtil.java
+++ b/fhir-notification/src/main/java/com/ibm/fhir/notification/util/FHIRNotificationUtil.java
@@ -7,35 +7,62 @@
 package com.ibm.fhir.notification.util;
 
 import java.io.StringReader;
+import java.util.Arrays;
+import java.util.List;
+import java.util.logging.Logger;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonException;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-
+import com.ibm.fhir.config.FHIRConfigHelper;
+import com.ibm.fhir.config.FHIRConfiguration;
 import com.ibm.fhir.exception.FHIRException;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.parser.FHIRJsonParser;
+import com.ibm.fhir.model.parser.FHIRParser;
+import com.ibm.fhir.model.util.FHIRUtil;
 import com.ibm.fhir.model.util.JsonSupport;
 import com.ibm.fhir.notification.FHIRNotificationEvent;
+import com.ibm.fhir.search.SearchConstants;
+
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonException;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
 
+/**
+ * FHIRNotificationUtil supports serializing and deserializing the FHIRNotificationEvent based on conditions.
+ */
 public class FHIRNotificationUtil {
+    private static final Logger LOG = Logger.getLogger(FHIRNotificationUtil.class.getSimpleName());
     private static final JsonReaderFactory JSON_READER_FACTORY = Json.createReaderFactory(null);
     private static final JsonBuilderFactory JSON_BUILDER_FACTORY = Json.createBuilderFactory(null);
+
+    private static final int DEFAULT_MAX_SIZE = 1000000;
+
+    private FHIRNotificationUtil() {
+        // No Operation
+    }
+
+    /**
+     * serialize the FHIRNotificationEvent
+     *
+     * @param jsonString the input string
+     * @return FHIRNotificationEvent without the Resource
+     */
     public static FHIRNotificationEvent toNotificationEvent(String jsonString) {
         try (JsonReader reader = JSON_READER_FACTORY.createReader(new StringReader(jsonString))) {
             JsonObject jsonObject = reader.readObject();
             FHIRNotificationEvent event = new FHIRNotificationEvent();
-            event.setOperationType(jsonObject.getString("operationType"));
-            event.setLocation(jsonObject.getString("location"));
             event.setLastUpdated(jsonObject.getString("lastUpdated"));
+            event.setLocation(jsonObject.getString("location"));
+            event.setOperationType(jsonObject.getString("operationType"));
             event.setResourceId(jsonObject.getString("resourceId"));
             event.setDatasourceId(jsonObject.getString("datasourceId"));
             event.setTenantId(jsonObject.getString("tenantId"));
             return event;
         } catch (JsonException e) {
-            System.out.println("Failed to parse json string: " + e.getLocalizedMessage());
+            LOG.warning("Failed to parse json string: " + e.getLocalizedMessage());
             return null;
         }
     }
@@ -58,11 +85,47 @@ public static String toJsonString(FHIRNotificationEvent event, boolean includeRe
         builder.add("tenantId", event.getTenantId());
 
         // If it's a delete operation, don't add as there is no actual resource in the event.
+        String jsonString;
         if (!"delete".equals(event.getOperationType()) && includeResource && event.getResource() != null) {
             builder.add("resource", JsonSupport.toJsonObject(event.getResource()));
+            JsonObject jsonObject = builder.build();
+
+            jsonString = jsonObject.toString();
+            long length = jsonString.getBytes().length;
+
+            int maxSize = FHIRConfigHelper.getIntProperty(FHIRConfiguration.PROPERTY_NOTIFICATION_MAX_SIZE, DEFAULT_MAX_SIZE);
+            if (length > maxSize) {
+                LOG.fine(() -> event.getResource().getClass().getSimpleName() + "/" + event.getResourceId() + " is over the size limit - '" + length + "' > '" + maxSize + "'");
+
+                // If we are including a subset, we'll add here.
+                String subset = FHIRConfigHelper.getStringProperty(FHIRConfiguration.PROPERTY_NOTIFICATION_NOTIFICATION_SIZE_BEHAVIOR, "subset");
+                if ("subset".equals(subset)) {
+                    List<String> elements = Arrays.asList("id", "meta", "resourceType");
+                    com.ibm.fhir.model.resource.Resource resource = FHIRParser.parser(Format.JSON)
+                                                                        .as(FHIRJsonParser.class)
+                                                                        .parseAndFilter(JsonSupport.toJsonObject(event.getResource()), elements);
+                    // add a SUBSETTED tag to this resource to indicate that its elements have been filtered
+                    if (!FHIRUtil.hasTag(resource, SearchConstants.SUBSETTED_TAG)) {
+                        resource = FHIRUtil.addTag(resource, SearchConstants.SUBSETTED_TAG);
+                    }
+                    builder.add("resource", JsonSupport.toJsonObject(resource));
+                } else {
+                    LOG.fine(() -> "Omitting the resource in FHIRNotificationEvent");
+                }
+                // the build method wipes out any preexisting values, we have to add them back.
+                builder.add("lastUpdated", event.getLastUpdated());
+                builder.add("location", event.getLocation());
+                builder.add("operationType", event.getOperationType());
+                builder.add("resourceId", event.getResourceId());
+                builder.add("datasourceId", event.getDatasourceId());
+                builder.add("tenantId", event.getTenantId());
+                jsonObject = builder.build();
+                jsonString = jsonObject.toString();
+            }
+        } else {
+            JsonObject jsonObject = builder.build();
+            jsonString = jsonObject.toString();
         }
-        JsonObject jsonObject = builder.build();
-        String jsonString = jsonObject.toString();
         return jsonString;
     }
 }
\ No newline at end of file
diff --git a/fhir-notification/src/test/java/com/ibm/fhir/notification/util/FHIRNotificationUtilTest.java b/fhir-notification/src/test/java/com/ibm/fhir/notification/util/FHIRNotificationUtilTest.java
new file mode 100644
index 00000000000..27ac0046ec5
--- /dev/null
+++ b/fhir-notification/src/test/java/com/ibm/fhir/notification/util/FHIRNotificationUtilTest.java
@@ -0,0 +1,229 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.notification.util;
+
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.assertNotNull;
+import static org.testng.Assert.assertNull;
+
+import java.lang.reflect.Method;
+
+import org.testng.annotations.AfterMethod;
+import org.testng.annotations.BeforeClass;
+import org.testng.annotations.BeforeMethod;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.config.FHIRConfiguration;
+import com.ibm.fhir.config.FHIRRequestContext;
+import com.ibm.fhir.exception.FHIRException;
+import com.ibm.fhir.model.resource.Parameters;
+import com.ibm.fhir.notification.FHIRNotificationEvent;
+
+/**
+ * FHIRNotificationUtil Tests
+ */
+public class FHIRNotificationUtilTest {
+
+    @BeforeClass
+    public void setup() {
+        FHIRConfiguration.setConfigHome("src/test/resources");
+    }
+
+    @BeforeMethod
+    public void startMethod(Method method) throws FHIRException {
+        // Configure the request context for our search tests
+        FHIRRequestContext context = FHIRRequestContext.get();
+        if (context == null) {
+            context = new FHIRRequestContext();
+        }
+        FHIRRequestContext.set(context);
+
+        //Facilitate the switching of tenant configurations based on method name
+        String tenant = "default";
+        String methodName = method.getName();
+        if (methodName.contains("_tenant_")) {
+            int idx = methodName.indexOf("_tenant_") + "_tenant_".length();
+            tenant = methodName.substring(idx);
+        }
+        context.setTenantId(tenant);
+
+        context.setOriginalRequestUri("https://localhost:9443/fhir-server/api/v4");
+    }
+
+    @AfterMethod
+    public void clearThreadLocal() {
+        FHIRRequestContext.remove();
+    }
+
+    @Test
+    public void testUtil_NotDeleteDontInclude_tenant_default() throws FHIRException {
+        Parameters.Builder builder = Parameters.builder();
+        builder.id("144f2a21-856d-40d8-8411-2cb482ba0c6f");
+        Parameters parms = builder.build();
+
+        FHIRNotificationEvent evt = new FHIRNotificationEvent();
+        evt.setLastUpdated("2021-10-10");
+        evt.setLocation("Patient/1-2-3-4");
+        evt.setOperationType("$operation");
+        evt.setResourceId("1-2-3-4");
+        evt.setDatasourceId("default");
+        evt.setTenantId("default");
+        evt.setResource(parms);
+
+        assertEquals(FHIRNotificationUtil.toJsonString(evt, false),
+            "{\"lastUpdated\":\"2021-10-10\",\"location\":\"Patient/1-2-3-4\",\"operationType\":\"$operation\",\"resourceId\":\"1-2-3-4\",\"datasourceId\":\"default\",\"tenantId\":\"default\"}");
+    }
+
+    @Test
+    public void testUtil_NotDeleteAndInclude_tenant_default() throws FHIRException {
+        Parameters.Builder builder = Parameters.builder();
+        builder.id("144f2a21-856d-40d8-8411-2cb482ba0c6f");
+        Parameters parms = builder.build();
+
+        FHIRNotificationEvent evt = new FHIRNotificationEvent();
+        evt.setLastUpdated("2021-10-10");
+        evt.setLocation("Patient/1-2-3-4");
+        evt.setOperationType("$operation");
+        evt.setResourceId("1-2-3-4");
+        evt.setDatasourceId("default");
+        evt.setTenantId("default");
+        evt.setResource(parms);
+
+        assertEquals(FHIRNotificationUtil.toJsonString(evt, true),
+            "{\"lastUpdated\":\"2021-10-10\",\"location\":\"Patient/1-2-3-4\",\"operationType\":\"$operation\",\"resourceId\":\"1-2-3-4\",\"datasourceId\":\"default\",\"tenantId\":\"default\",\"resource\":{\"resourceType\":\"Parameters\",\"id\":\"144f2a21-856d-40d8-8411-2cb482ba0c6f\"}}");
+    }
+
+    @Test
+    public void testUtil_NotDeleteAndInclude_tenant_omit() throws FHIRException {
+        Parameters.Builder builder = Parameters.builder();
+        builder.id("144f2a21-856d-40d8-8411-2cb482ba0c6f");
+        Parameters parms = builder.build();
+
+        FHIRNotificationEvent evt = new FHIRNotificationEvent();
+        evt.setLastUpdated("2021-10-10");
+        evt.setLocation("Patient/1-2-3-4");
+        evt.setOperationType("$operation");
+        evt.setResourceId("1-2-3-4");
+        evt.setDatasourceId("default");
+        evt.setTenantId("default");
+        evt.setResource(parms);
+
+        assertEquals(FHIRNotificationUtil.toJsonString(evt, true),
+            "{\"lastUpdated\":\"2021-10-10\",\"location\":\"Patient/1-2-3-4\",\"operationType\":\"$operation\",\"resourceId\":\"1-2-3-4\",\"datasourceId\":\"default\",\"tenantId\":\"default\"}");
+    }
+
+    @Test
+    public void testUtil_NotDeleteAndInclude_tenant_subset() throws FHIRException {
+        Parameters.Builder builder = Parameters.builder();
+        builder.id("144f2a21-856d-40d8-8411-2cb482ba0c6f");
+        Parameters parms = builder.build();
+
+        FHIRNotificationEvent evt = new FHIRNotificationEvent();
+        evt.setLastUpdated("2021-10-10");
+        evt.setLocation("Patient/1-2-3-4");
+        evt.setOperationType("$operation");
+        evt.setResourceId("1-2-3-4");
+        evt.setDatasourceId("default");
+        evt.setTenantId("default");
+        evt.setResource(parms);
+
+        assertEquals(FHIRNotificationUtil.toJsonString(evt, true),
+            "{\"resource\":{\"resourceType\":\"Parameters\",\"id\":\"144f2a21-856d-40d8-8411-2cb482ba0c6f\",\"meta\":{\"tag\":[{\"system\":\"http://terminology.hl7.org/CodeSystem/v3-ObservationValue\",\"code\":\"SUBSETTED\",\"display\":\"subsetted\"}]}},\"lastUpdated\":\"2021-10-10\",\"location\":\"Patient/1-2-3-4\",\"operationType\":\"$operation\",\"resourceId\":\"1-2-3-4\",\"datasourceId\":\"default\",\"tenantId\":\"default\"}");
+    }
+
+    @Test
+    public void testUtil_NotDeleteAndInclude_tenant_empty() throws FHIRException {
+        Parameters.Builder builder = Parameters.builder();
+        builder.id("144f2a21-856d-40d8-8411-2cb482ba0c6f");
+        Parameters parms = builder.build();
+
+        FHIRNotificationEvent evt = new FHIRNotificationEvent();
+        evt.setLastUpdated("2021-10-10");
+        evt.setLocation("Patient/1-2-3-4");
+        evt.setOperationType("$operation");
+        evt.setResourceId("1-2-3-4");
+        evt.setDatasourceId("default");
+        evt.setTenantId("default");
+        evt.setResource(parms);
+
+        assertEquals(FHIRNotificationUtil.toJsonString(evt, true),
+            "{\"resource\":{\"resourceType\":\"Parameters\",\"id\":\"144f2a21-856d-40d8-8411-2cb482ba0c6f\",\"meta\":{\"tag\":[{\"system\":\"http://terminology.hl7.org/CodeSystem/v3-ObservationValue\",\"code\":\"SUBSETTED\",\"display\":\"subsetted\"}]}},\"lastUpdated\":\"2021-10-10\",\"location\":\"Patient/1-2-3-4\",\"operationType\":\"$operation\",\"resourceId\":\"1-2-3-4\",\"datasourceId\":\"default\",\"tenantId\":\"default\"}");
+    }
+
+    @Test
+    public void testUtil_NotDeleteNotInclude_tenant_default() throws FHIRException {
+        Parameters.Builder builder = Parameters.builder();
+        builder.id("144f2a21-856d-40d8-8411-2cb482ba0c6f");
+        Parameters parms = builder.build();
+
+        FHIRNotificationEvent evt = new FHIRNotificationEvent();
+        evt.setLastUpdated("2021-10-10");
+        evt.setLocation("Patient/1-2-3-4");
+        evt.setOperationType("$operation");
+        evt.setResourceId("1-2-3-4");
+        evt.setDatasourceId("default");
+        evt.setTenantId("default");
+        evt.setResource(parms);
+
+        assertEquals(FHIRNotificationUtil.toJsonString(evt, false),
+            "{\"lastUpdated\":\"2021-10-10\",\"location\":\"Patient/1-2-3-4\",\"operationType\":\"$operation\",\"resourceId\":\"1-2-3-4\",\"datasourceId\":\"default\",\"tenantId\":\"default\"}");
+    }
+
+    @Test
+    public void testUtil_NotDeleteIncludeWithoutResource_tenant_default() throws FHIRException {
+        FHIRNotificationEvent evt = new FHIRNotificationEvent();
+        evt.setLastUpdated("2021-10-10");
+        evt.setLocation("Patient/1-2-3-4");
+        evt.setOperationType("$operation");
+        evt.setResourceId("1-2-3-4");
+        evt.setDatasourceId("default");
+        evt.setTenantId("default");
+
+        assertEquals(FHIRNotificationUtil.toJsonString(evt, true),
+            "{\"lastUpdated\":\"2021-10-10\",\"location\":\"Patient/1-2-3-4\",\"operationType\":\"$operation\",\"resourceId\":\"1-2-3-4\",\"datasourceId\":\"default\",\"tenantId\":\"default\"}");
+    }
+
+    @Test
+    public void testUtil_Delete_tenant_default() throws FHIRException {
+        Parameters.Builder builder = Parameters.builder();
+        builder.id("144f2a21-856d-40d8-8411-2cb482ba0c6f");
+        Parameters parms = builder.build();
+
+        FHIRNotificationEvent evt = new FHIRNotificationEvent();
+        evt.setLastUpdated("2021-10-10");
+        evt.setLocation("Patient/1-2-3-4");
+        evt.setOperationType("delete");
+        evt.setResourceId("1-2-3-4");
+        evt.setDatasourceId("default");
+        evt.setTenantId("default");
+        evt.setResource(parms);
+
+        assertEquals(FHIRNotificationUtil.toJsonString(evt, true),
+            "{\"lastUpdated\":\"2021-10-10\",\"location\":\"Patient/1-2-3-4\",\"operationType\":\"delete\",\"resourceId\":\"1-2-3-4\",\"datasourceId\":\"default\",\"tenantId\":\"default\"}");
+    }
+
+    @Test
+    public void testUtil_RoundTrip_tenant_default() throws FHIRException {
+        String jsonString = "{\"lastUpdated\":\"2021-10-10\",\"location\":\"Patient/1-2-3-4\",\"operationType\":\"$operation\",\"resourceId\":\"1-2-3-4\",\"datasourceId\":\"default\",\"tenantId\":\"default\"}";
+        FHIRNotificationEvent evt = FHIRNotificationUtil.toNotificationEvent(jsonString);
+        assertNotNull(evt);
+        assertEquals(evt.getLastUpdated(),"2021-10-10");
+        assertEquals(evt.getLocation(),"Patient/1-2-3-4");
+        assertEquals(evt.getOperationType(),"$operation");
+        assertEquals(evt.getResourceId(),"1-2-3-4");
+        assertEquals(evt.getDatasourceId(),"default");
+        assertEquals(evt.getTenantId(),"default");
+        assertNull(evt.getResource());
+    }
+
+    @Test
+    public void testUtil_BadJson_tenant_default() throws FHIRException {
+        String jsonString = "{\"";
+        FHIRNotificationEvent evt = FHIRNotificationUtil.toNotificationEvent(jsonString);
+        assertNull(evt);
+    }
+}
\ No newline at end of file
diff --git a/fhir-notification/src/test/resources/config/empty/fhir-server-config.json b/fhir-notification/src/test/resources/config/empty/fhir-server-config.json
new file mode 100644
index 00000000000..58cf143f65f
--- /dev/null
+++ b/fhir-notification/src/test/resources/config/empty/fhir-server-config.json
@@ -0,0 +1,11 @@
+{
+    "__comment": "FHIR Server - Notification - Test Configuration",
+    "fhirServer": {
+        "notifications": {
+            "common": {
+                "maxNotificationSizeBytes": 1,
+                "maxNotificationSizeBehavior": "subset"
+            }
+        }
+    }
+}
diff --git a/fhir-notification/src/test/resources/config/omit/fhir-server-config.json b/fhir-notification/src/test/resources/config/omit/fhir-server-config.json
new file mode 100644
index 00000000000..07b7aba5d3b
--- /dev/null
+++ b/fhir-notification/src/test/resources/config/omit/fhir-server-config.json
@@ -0,0 +1,11 @@
+{
+    "__comment": "FHIR Server - Notification - Test Configuration",
+    "fhirServer": {
+        "notifications": {
+            "common": {
+                "maxNotificationSizeBytes": 1,
+                "maxNotificationSizeBehavior": "omit"
+            }
+        }
+    }
+}
diff --git a/fhir-notification/src/test/resources/config/subset/fhir-server-config.json b/fhir-notification/src/test/resources/config/subset/fhir-server-config.json
new file mode 100644
index 00000000000..c839def29fa
--- /dev/null
+++ b/fhir-notification/src/test/resources/config/subset/fhir-server-config.json
@@ -0,0 +1,10 @@
+{
+    "__comment": "FHIR Server - Notification - Test Configuration",
+    "fhirServer": {
+        "notifications": {
+            "common": {
+                "maxNotificationSizeBytes": 1
+            }
+        }
+    }
+}
diff --git a/fhir-openapi/pom.xml b/fhir-openapi/pom.xml
index fa34f6d5bda..7e9f015f635 100644
--- a/fhir-openapi/pom.xml
+++ b/fhir-openapi/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-parent/pom.xml b/fhir-parent/pom.xml
index dd374ea1d45..0ac257b3d14 100644
--- a/fhir-parent/pom.xml
+++ b/fhir-parent/pom.xml
@@ -5,7 +5,7 @@
 
     <groupId>com.ibm.fhir</groupId>
     <artifactId>fhir-parent</artifactId>
-    <version>4.8.0-SNAPSHOT</version>
+    <version>4.9.0-SNAPSHOT</version>
     <packaging>pom</packaging>
     <name>IBM FHIR Server</name>
 
@@ -38,7 +38,7 @@
     </developers>
 
     <properties>
-        <liberty.version>21.0.0.3</liberty.version>
+        <liberty.version>21.0.0.5</liberty.version>
         <!-- There are breaking changes in 10.15+ don't upgrade beyond this -->
         <derby.version>10.14.2.0</derby.version>
         <db2.version>11.5.5.0</db2.version>
@@ -63,8 +63,8 @@
         <fhir-persistence-jdbc.index>MINIMAL_JSON</fhir-persistence-jdbc.index>
         <fhir-server-test.index>MINIMAL_JSON</fhir-server-test.index>
         <java.version>1.8</java.version>
-        <fhir-examples.version>4.8.0-SNAPSHOT</fhir-examples.version>
-        <fhir-tools.version>4.8.0-SNAPSHOT</fhir-tools.version>
+        <fhir-examples.version>4.9.0-SNAPSHOT</fhir-examples.version>
+        <fhir-tools.version>4.9.0-SNAPSHOT</fhir-tools.version>
         <maven.build.timestamp.format>yyyyMMdd-HHmm</maven.build.timestamp.format>
     </properties>
 
@@ -101,6 +101,7 @@
         <module>../operation/fhir-operation-apply</module>
         <module>../operation/fhir-operation-convert</module>
         <module>../operation/fhir-operation-term</module>
+        <module>../operation/fhir-operation-term-cache</module>
         <module>../operation/fhir-operation-reindex</module>
         <module>../operation/fhir-operation-bulkdata</module>
         <module>../operation/fhir-operation-everything</module>
@@ -108,7 +109,6 @@
         <module>../fhir-bulkdata-webapp</module>
         <module>../fhir-search</module>
         <module>../fhir-client</module>
-        <module>../fhir-cli</module>
         <module>../fhir-notification</module>
         <module>../notification/fhir-notification-kafka</module>
         <module>../notification/fhir-notification-nats</module>
@@ -330,7 +330,7 @@
             <dependency>
                 <groupId>org.glassfish</groupId>
                 <artifactId>jakarta.json</artifactId>
-                <version>1.1.5</version>
+                <version>2.0.1</version>
             </dependency>
             <dependency>
                 <groupId>org.glassfish.tyrus.bundles</groupId>
@@ -555,6 +555,21 @@
                 <artifactId>snakeyaml</artifactId>
                 <version>1.28</version>
             </dependency>
+            <dependency>
+                <groupId>com.azure</groupId>
+                <artifactId>azure-storage-blob</artifactId>
+                <version>12.6.0</version>
+            </dependency>
+            <dependency>
+                <groupId>com.azure</groupId>
+                <artifactId>azure-core-http-okhttp</artifactId>
+                <version>1.6.2</version>
+            </dependency>
+            <dependency>
+                <groupId>com.azure</groupId>
+                <artifactId>azure-core</artifactId>
+                <version>1.15.0</version>
+            </dependency>
         </dependencies>
     </dependencyManagement>
 
diff --git a/fhir-path/pom.xml b/fhir-path/pom.xml
index 0ef25327441..fece2052bc3 100644
--- a/fhir-path/pom.xml
+++ b/fhir-path/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
     
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/evaluator/FHIRPathEvaluator.java b/fhir-path/src/main/java/com/ibm/fhir/path/evaluator/FHIRPathEvaluator.java
index d54e5204385..36a449a1032 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/evaluator/FHIRPathEvaluator.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/evaluator/FHIRPathEvaluator.java
@@ -6,6 +6,7 @@
 
 package com.ibm.fhir.path.evaluator;
 
+import static com.ibm.fhir.cache.CacheKey.key;
 import static com.ibm.fhir.cache.util.CacheSupport.createCacheAsMap;
 import static com.ibm.fhir.path.FHIRPathDateTimeValue.dateTimeValue;
 import static com.ibm.fhir.path.FHIRPathDateValue.dateValue;
@@ -60,6 +61,7 @@
 
 import org.antlr.v4.runtime.tree.ParseTree;
 
+import com.ibm.fhir.cache.CacheKey;
 import com.ibm.fhir.model.annotation.Constraint;
 import com.ibm.fhir.model.resource.OperationOutcome.Issue;
 import com.ibm.fhir.model.resource.Resource;
@@ -83,9 +85,14 @@
 import com.ibm.fhir.path.function.FHIRPathFunction;
 import com.ibm.fhir.path.util.FHIRPathUtil;
 
+import net.jcip.annotations.NotThreadSafe;
+
 /**
  * A FHIRPath evaluation engine that implements the FHIRPath 2.0.0 <a href="http://hl7.org/fhirpath/N1/">specification</a>
+ *
+ * The static factory method {@link #evaluator()} is threadsafe, but the created instances are not.
  */
+@NotThreadSafe
 public class FHIRPathEvaluator {
     private static final Logger log = Logger.getLogger(FHIRPathEvaluator.class.getName());
 
@@ -1009,7 +1016,11 @@ public Collection<FHIRPathNode> visitTypeExpression(FHIRPathParser.TypeExpressio
                 break;
             case "as":
                 for (FHIRPathNode node : nodes) {
-                    if (type.isAssignableFrom(node.type())) {
+                    FHIRPathType nodeType = node.type();
+                    if (SYSTEM_NAMESPACE.equals(type.namespace()) && node.hasValue()) {
+                        nodeType = node.getValue().type();
+                    }
+                    if (type.isAssignableFrom(nodeType)) {
                         result.add(node);
                     }
                 }
@@ -1139,10 +1150,14 @@ public Collection<FHIRPathNode> visitMemberInvocation(FHIRPathParser.MemberInvoc
                 }
             }
 
-            Collection<FHIRPathNode> result = currentContext.stream()
-                    .flatMap(node -> node.children().stream())
-                    .filter(node -> identifier.equals(node.name()))
-                    .collect(Collectors.toList());
+            List<FHIRPathNode> result = new ArrayList<>();
+            for (FHIRPathNode node : currentContext) {
+                for (FHIRPathNode child : node.children()) {
+                    if (identifier.equals(child.name())) {
+                        result.add(child);
+                    }
+                }
+            }
 
             indentLevel--;
 
@@ -1336,22 +1351,24 @@ private void debug(ParseTree ctx) {
      * A context object used to pass information to/from the FHIRPath evaluation engine
      */
     public static class EvaluationContext {
-        private static final String UCUM_SYSTEM = "http://unitsofmeasure.org";
-        private static final Collection<FHIRPathNode> UCUM_SYSTEM_SINGLETON = singleton(stringValue(UCUM_SYSTEM));
+        public static final boolean DEFAULT_RESOLVE_RELATIVE_REFERENCES = false;
 
+        private static final String UCUM_SYSTEM = "http://unitsofmeasure.org";
         private static final String LOINC_SYSTEM = "http://loinc.org";
-        private static final Collection<FHIRPathNode> LOINC_SYSTEM_SINGLETON = singleton(stringValue(LOINC_SYSTEM));
-
         private static final String SCT_SYSTEM = "http://snomed.info/sct";
-        private static final Collection<FHIRPathNode> SCT_SYSTEM_SINGLETON = singleton(stringValue(SCT_SYSTEM));
 
+        private static final Collection<FHIRPathNode> UCUM_SYSTEM_SINGLETON = singleton(stringValue(UCUM_SYSTEM));
+        private static final Collection<FHIRPathNode> LOINC_SYSTEM_SINGLETON = singleton(stringValue(LOINC_SYSTEM));
+        private static final Collection<FHIRPathNode> SCT_SYSTEM_SINGLETON = singleton(stringValue(SCT_SYSTEM));
         private static final Collection<FHIRPathNode> TERM_SERVICE_SINGLETON = singleton(FHIRPathTermServiceNode.termServiceNode());
 
         private final FHIRPathTree tree;
         private final Map<String, Collection<FHIRPathNode>> externalConstantMap = new HashMap<>();
+        private final List<Issue> issues = new ArrayList<>();
+        private final Map<CacheKey, Collection<FHIRPathNode>> functionResultCache = new HashMap<>();
 
         private Constraint constraint;
-        private final List<Issue> issues = new ArrayList<>();
+        private boolean resolveRelativeReferences = DEFAULT_RESOLVE_RELATIVE_REFERENCES;
 
         /**
          * Create an empty evaluation context, evaluating stand-alone expressions
@@ -1472,6 +1489,35 @@ public boolean hasExternalConstant(String name) {
             return externalConstantMap.containsKey(name);
         }
 
+        /**
+         * Get the list of supplemental issues that were generated during evaluation
+         *
+         * <p>Supplemental issues are used to convey additional information about the evaluation to the client
+         *
+         * @return
+         *     the list of supplemental issues that were generated during evaluation
+         */
+        public List<Issue> getIssues() {
+            return issues;
+        }
+
+        /**
+         * Clear the list of supplemental issues that were generated during evaluation
+         */
+        public void clearIssues() {
+            issues.clear();
+        }
+
+        /**
+         * Indicates whether this evaluation context has supplemental issues that were generated during evaluation
+         *
+         * @return
+         *     true if this evaluation context has supplemental issues that were generated during evaluation, otherwise false
+         */
+        public boolean hasIssues() {
+            return !issues.isEmpty();
+        }
+
         /**
          * Set the constraint currently under evaluation
          *
@@ -1514,32 +1560,74 @@ public boolean hasConstraint() {
         }
 
         /**
-         * Get the list of supplemental issues that were generated during evaluation
+         * Set the resolve relative references indicator
          *
-         * <p>Supplemental issues are used to convey additional information about the evaluation to the client
+         * @param resolveRelativeReferences
+         *     the resolve relative references indicator
+         */
+        public void setResolveRelativeReferences(boolean resolveRelativeReferences) {
+            this.resolveRelativeReferences = resolveRelativeReferences;
+        }
+
+        /**
+         * Indicates whether the evaluator using this evaluation context should resolve relative references (if possible)
          *
          * @return
-         *     the list of supplemental issues that were generated during evaluation
+         *     true if the evaluator using this evaluation context should resolve relative references (if possible), otherwise false
          */
-        public List<Issue> getIssues() {
-            return issues;
+        public boolean resolveRelativeReferences() {
+            return resolveRelativeReferences;
         }
 
         /**
-         * Clear the list of supplemental issues that were generated during evaluation
+         * Get the cached function result for the given function name, context, and arguments.
+         *
+         * @param functionName
+         *     the function name
+         * @param context
+         *     the context
+         * @param arguments
+         *     the arguments
+         * @return
+         *     the cached function result as a collection of FHIRPath nodes or an empty collection
          */
-        public void clearIssues() {
-            issues.clear();
+        public Collection<FHIRPathNode> getCachedFunctionResult(String functionName, Collection<FHIRPathNode> context, List<Collection<FHIRPathNode>> arguments) {
+            CacheKey key = key(functionName, context, arguments);
+            return functionResultCache.getOrDefault(key, empty());
         }
 
         /**
-         * Indicates whether this evaluation context has supplemental issues that were generated during evaluation
+         * Cache the function result for the given function name, context, and arguments
          *
+         * @param functionName
+         *     the function name
+         * @param context
+         *     the context
+         * @param arguments
+         *     the arguments
+         * @param result
+         *     the function result
+         */
+        public void cacheFunctionResult(String functionName, Collection<FHIRPathNode> context, List<Collection<FHIRPathNode>> arguments, Collection<FHIRPathNode> result) {
+            CacheKey key = key(functionName, context, arguments);
+            functionResultCache.put(key, result);
+        }
+
+        /**
+         * Indicates whether a function result has been cached for the given function name, context, and arguments.
+         *
+         * @param functionName
+         *     the function name
+         * @param context
+         *     the context
+         * @param arguments
+         *     the arguments
          * @return
-         *     true if this evaluation context has supplemental issues that were generated during evaluation, otherwise false
+         *     true if the function result has been cached, otherwise false
          */
-        public boolean hasIssues() {
-            return !issues.isEmpty();
+        public boolean hasCachedFunctionResult(String functionName, Collection<FHIRPathNode> context, List<Collection<FHIRPathNode>> arguments) {
+            CacheKey key = key(functionName, context, arguments);
+            return functionResultCache.containsKey(key);
         }
     }
 }
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/function/ConformsToFunction.java b/fhir-path/src/main/java/com/ibm/fhir/path/function/ConformsToFunction.java
index 3d7f9e31e11..20ad8684903 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/function/ConformsToFunction.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/function/ConformsToFunction.java
@@ -10,10 +10,8 @@
 import static com.ibm.fhir.path.evaluator.FHIRPathEvaluator.SINGLETON_TRUE;
 import static com.ibm.fhir.path.util.FHIRPathUtil.empty;
 import static com.ibm.fhir.path.util.FHIRPathUtil.evaluatesToBoolean;
-import static com.ibm.fhir.path.util.FHIRPathUtil.getBoolean;
 import static com.ibm.fhir.path.util.FHIRPathUtil.getSingleton;
 import static com.ibm.fhir.path.util.FHIRPathUtil.getStringValue;
-import static com.ibm.fhir.path.util.FHIRPathUtil.isBooleanValue;
 import static com.ibm.fhir.path.util.FHIRPathUtil.isElementNode;
 import static com.ibm.fhir.path.util.FHIRPathUtil.isFalse;
 import static com.ibm.fhir.path.util.FHIRPathUtil.isResourceNode;
@@ -26,10 +24,7 @@
 import java.util.logging.Logger;
 
 import com.ibm.fhir.model.annotation.Constraint;
-import com.ibm.fhir.model.resource.Resource;
 import com.ibm.fhir.model.resource.StructureDefinition;
-import com.ibm.fhir.model.type.Canonical;
-import com.ibm.fhir.model.type.Meta;
 import com.ibm.fhir.model.type.code.IssueSeverity;
 import com.ibm.fhir.model.type.code.IssueType;
 import com.ibm.fhir.model.type.code.StructureDefinitionKind;
@@ -57,7 +52,7 @@ public int getMinArity() {
 
     @Override
     public int getMaxArity() {
-        return 2;
+        return 1;
     }
 
     @Override
@@ -74,15 +69,10 @@ public Collection<FHIRPathNode> apply(EvaluationContext evaluationContext, Colle
             throw new IllegalArgumentException("The argument to the 'conformsTo' function must be a string value");
         }
 
-        if (arguments.size() == 2 && !isBooleanValue(arguments.get(1))) {
-            throw new IllegalArgumentException("The optional second argument to the 'conformsTo' function must be a boolean value");
-        }
-
         FHIRPathNode node = getSingleton(context);
         FHIRPathType type = node.type();
         Class<?> modelClass = type.modelClass();
         String url = getStringValue(arguments.get(0)).string();
-        boolean skipEvaluation = (arguments.size() == 2) ? getBoolean(arguments.get(1)) : false;
 
         if (FHIRRegistry.getInstance().hasResource(url, StructureDefinition.class)) {
             StructureDefinition structureDefinition = FHIRRegistry.getInstance().getResource(url,  StructureDefinition.class);
@@ -98,7 +88,6 @@ public Collection<FHIRPathNode> apply(EvaluationContext evaluationContext, Colle
                 return SINGLETON_TRUE;
             }
 
-
             if (!ProfileSupport.isApplicable(structureDefinition, modelClass)) {
                 // the profile (or base definition) is not applicable to type: modelClass
                 generateIssue(evaluationContext, IssueSeverity.INFORMATION, IssueType.INVALID, "Conformance check failed: profile (or base definition) '" + url + "' is not applicable to type: " + ModelSupport.getTypeName(modelClass), node.path());
@@ -110,36 +99,35 @@ public Collection<FHIRPathNode> apply(EvaluationContext evaluationContext, Colle
                 return SINGLETON_TRUE;
             }
 
-            if (node.isResourceNode() && skipEvaluation) {
+            if (hasCachedFunctionResult(evaluationContext, context, arguments)) {
+                Collection<FHIRPathNode> result = getCachedFunctionResult(evaluationContext, context, arguments);
+
+                if (result.isEmpty()) {
+                    log.finest("Non-empty (boolean) function result computation is in progress");
+
+                    // non-empty (boolean) function result computation is in progress
+                    return SINGLETON_TRUE;
+                }
+
+                if (log.isLoggable(Level.FINEST)) {
+                    log.finest("Cached non-empty (boolean) function result: " + result);
+                }
+
+                // return cached non-empty (boolean) function result
+                return result;
+            }
+
+            // cache empty function result to indicate that non-empty (boolean) function result computation is in progress
+            cacheFunctionResult(evaluationContext, context, arguments, empty());
+
+            if (node.isResourceNode() && evaluationContext.hasConstraint() && ProfileSupport.hasResourceAssertedProfile(node.asResourceNode().resource(), structureDefinition)) {
                 // optimization
-                Resource resource = node.asResourceNode().resource();
-                Meta meta = resource.getMeta();
-                if (meta != null) {
-                    for (Canonical profile : meta.getProfile()) {
-                        String value = profile.getValue();
-
-                        if (value == null) {
-                            continue;
-                        }
-
-                        String uri = value;
-                        String version = null;
-
-                        int index = value.indexOf("|");
-                        if (index != -1) {
-                            uri = value.substring(0, index);
-                            version = value.substring(index + 1);
-                        }
-
-                        if (uri.equals(structureDefinition.getUrl().getValue()) &&
-                                (version == null || structureDefinition.getVersion() == null || version.equals(structureDefinition.getVersion().getValue()))) {
-                            if (log.isLoggable(Level.FINEST)) {
-                                log.finest("Skipping constraint evaluation for profile '" + url + "'");
-                            }
-                            return SINGLETON_TRUE;
-                        }
-                    }
+                if (log.isLoggable(Level.FINEST)) {
+                    log.finest("Skipping constraint evaluation for profile '" + url + "'");
                 }
+
+                // cache and return non-empty (boolean) function result
+                return cacheFunctionResult(evaluationContext, context, arguments, SINGLETON_TRUE);
             }
 
             // save parent constraint reference
@@ -163,7 +151,8 @@ public Collection<FHIRPathNode> apply(EvaluationContext evaluationContext, Colle
                         // restore parent constraint reference
                         evaluationContext.setConstraint(parentConstraint);
 
-                        return SINGLETON_FALSE;
+                        // cache and return non-empty (boolean) function result
+                        return cacheFunctionResult(evaluationContext, context, arguments, SINGLETON_FALSE);
                     }
                 } catch (FHIRPathException e) {
                     log.log(Level.WARNING, "An unexpected error occurred while evaluating the following expression: " + constraint.expression(), e);
@@ -177,6 +166,7 @@ public Collection<FHIRPathNode> apply(EvaluationContext evaluationContext, Colle
             generateIssue(evaluationContext, IssueSeverity.WARNING, IssueType.NOT_SUPPORTED, "Conformance check was not performed: profile (or base definition) '" + url + "' is not supported", node.path());
         }
 
-        return SINGLETON_TRUE;
+        // cache and return non-empty (boolean) function result
+        return cacheFunctionResult(evaluationContext, context, arguments, SINGLETON_TRUE);
     }
 }
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/function/FHIRPathAbstractFunction.java b/fhir-path/src/main/java/com/ibm/fhir/path/function/FHIRPathAbstractFunction.java
index 1560704c4d3..dc8f0345f8b 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/function/FHIRPathAbstractFunction.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/function/FHIRPathAbstractFunction.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -68,4 +68,17 @@ public boolean equals(Object obj) {
     public int hashCode() {
         return Objects.hash(getName(), getMinArity(), getMaxArity());
     }
+
+    protected Collection<FHIRPathNode> getCachedFunctionResult(EvaluationContext evaluationContext, Collection<FHIRPathNode> context, List<Collection<FHIRPathNode>> arguments) {
+        return evaluationContext.getCachedFunctionResult(getName(), context, arguments);
+    }
+
+    protected Collection<FHIRPathNode> cacheFunctionResult(EvaluationContext evaluationContext, Collection<FHIRPathNode> context, List<Collection<FHIRPathNode>> arguments, Collection<FHIRPathNode> result) {
+        evaluationContext.cacheFunctionResult(getName(), context, arguments, result);
+        return result;
+    }
+
+    protected boolean hasCachedFunctionResult(EvaluationContext evaluationContext, Collection<FHIRPathNode> context, List<Collection<FHIRPathNode>> arguments) {
+        return evaluationContext.hasCachedFunctionResult(getName(), context, arguments);
+    }
 }
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/function/ResolveFunction.java b/fhir-path/src/main/java/com/ibm/fhir/path/function/ResolveFunction.java
index ccc476c3399..eadf51ec104 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/function/ResolveFunction.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/function/ResolveFunction.java
@@ -8,16 +8,13 @@
 
 import static com.ibm.fhir.model.util.FHIRUtil.REFERENCE_PATTERN;
 import static com.ibm.fhir.model.util.ModelSupport.isResourceType;
-import static com.ibm.fhir.path.util.FHIRPathUtil.convertsToBoolean;
 import static com.ibm.fhir.path.util.FHIRPathUtil.getRootResourceNode;
-import static com.ibm.fhir.path.util.FHIRPathUtil.isTrue;
 
 import java.util.ArrayList;
 import java.util.Collection;
 import java.util.List;
 import java.util.regex.Matcher;
 
-import com.ibm.fhir.model.resource.DomainResource;
 import com.ibm.fhir.model.resource.Resource;
 import com.ibm.fhir.model.type.Reference;
 import com.ibm.fhir.model.type.code.IssueSeverity;
@@ -29,9 +26,6 @@
 import com.ibm.fhir.path.evaluator.FHIRPathEvaluator.EvaluationContext;
 
 public class ResolveFunction extends FHIRPathAbstractFunction {
-    public static final String RESOLVE_RELATIVE_REFERENCES = "resolveRelativeReferences";
-    public static final boolean DEFAULT_RESOLVE_RELATIVE_REFERENCES = false;
-
     private static final int BASE_URL_GROUP = 1;
     private static final int RESOURCE_TYPE_GROUP = 4;
     private static final int LOGICAL_ID_GROUP = 5;
@@ -87,13 +81,17 @@ public Collection<FHIRPathNode> apply(EvaluationContext evaluationContext, Colle
 
                 String resourceType = null;
                 Resource resource = null;
+                FHIRPathResourceNode resourceNode = null;
 
                 if (referenceReference != null) {
                     if (referenceReference.startsWith("#")) {
                         // internal fragment reference
-                        resource = resolveInternalFragmentReference(evaluationContext, node, referenceReference);
-                        if (resource != null) {
-                            resourceType = resource.getClass().getSimpleName();
+                        resourceNode = resolveInternalFragmentReference(evaluationContext, node, referenceReference);
+                        if (resourceNode != null) {
+                            resource = resourceNode.resource();
+                            if (resource != null) {
+                                resourceType = resource.getClass().getSimpleName();
+                            }
                         }
                     } else {
                         Matcher matcher = REFERENCE_PATTERN.matcher(referenceReference);
@@ -103,7 +101,7 @@ public Collection<FHIRPathNode> apply(EvaluationContext evaluationContext, Colle
                                 throw new IllegalArgumentException("Resource type found in reference URL does not match reference type");
                             }
                             String baseUrl = matcher.group(BASE_URL_GROUP);
-                            if ((baseUrl == null ||  matchesServiceBaseUrl(baseUrl)) && resolveRelativeReferences(evaluationContext)) {
+                            if ((baseUrl == null ||  matchesServiceBaseUrl(baseUrl)) && evaluationContext.resolveRelativeReferences()) {
                                 // relative reference
                                 resource = resolveRelativeReference(evaluationContext, node, resourceType, matcher.group(LOGICAL_ID_GROUP), matcher.group(VERSION_ID_GROUP));
                             }
@@ -121,7 +119,11 @@ public Collection<FHIRPathNode> apply(EvaluationContext evaluationContext, Colle
                     generateIssue(evaluationContext, IssueSeverity.INFORMATION, IssueType.INFORMATIONAL, "Resource type could not be inferred from reference: " + referenceReference, node.path());
                 }
 
-                result.add((resource != null) ? FHIRPathTree.tree(resource).getRoot() : FHIRPathResourceNode.resourceNode(type));
+                if (resourceNode == null) {
+                    resourceNode = (resource != null) ? FHIRPathTree.tree(resource).getRoot().asResourceNode() : FHIRPathResourceNode.resourceNode(type);
+                }
+
+                result.add(resourceNode);
             }
         }
         return result;
@@ -135,20 +137,21 @@ protected boolean matchesServiceBaseUrl(String baseUrl) {
         return false;
     }
 
-    private Resource resolveInternalFragmentReference(EvaluationContext evaluationContext, FHIRPathNode node, String referenceReference) {
+    private FHIRPathResourceNode resolveInternalFragmentReference(EvaluationContext evaluationContext, FHIRPathNode node, String referenceReference) {
         if (evaluationContext.getTree() != null) {
             FHIRPathResourceNode rootResource = getRootResourceNode(evaluationContext.getTree(), node);
             if (rootResource != null) {
-                Resource resource = rootResource.resource();
                 if ("#".equals(referenceReference)) {
-                    return resource;
+                    return rootResource;
                 }
                 String id = referenceReference.substring(1);
-                if (resource instanceof DomainResource) {
-                    DomainResource domainResource = (DomainResource) resource;
-                    for (Resource contained : domainResource.getContained()) {
-                        if (contained.getId() != null && contained.getId().equals(id)) {
-                            return contained;
+                if (FHIRPathType.FHIR_DOMAIN_RESOURCE.isAssignableFrom(rootResource.type())) {
+                    for (FHIRPathNode child : rootResource.children()) {
+                        if ("contained".equals(child.name())) {
+                            Resource contained = child.asResourceNode().resource();
+                            if (contained.getId() != null && contained.getId().equals(id)) {
+                                return child.asResourceNode();
+                            }
                         }
                     }
                 }
@@ -170,12 +173,4 @@ private String getReferenceType(Reference reference) {
         }
         return null;
     }
-
-    private boolean resolveRelativeReferences(EvaluationContext evaluationContext) {
-        Collection<FHIRPathNode> resolveRelativeReferences = evaluationContext.getExternalConstant(RESOLVE_RELATIVE_REFERENCES);
-        if (convertsToBoolean(resolveRelativeReferences)) {
-            return isTrue(resolveRelativeReferences);
-        }
-        return DEFAULT_RESOLVE_RELATIVE_REFERENCES;
-    }
 }
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/util/AddingVisitor.java b/fhir-path/src/main/java/com/ibm/fhir/path/util/AddingVisitor.java
index 1ff11aac37a..5c0285cf3da 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/util/AddingVisitor.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/util/AddingVisitor.java
@@ -29,10 +29,10 @@ class AddingVisitor<T extends Visitable> extends CopyingVisitor<T> {
      * @throws IllegalArgumentException
      */
     public AddingVisitor(Visitable parent, String parentPath, String elementName, Visitable value) {
-        this.path = Objects.requireNonNull(parentPath);
-        this.elementNameToAdd = Objects.requireNonNull(elementName);
+        this.path = Objects.requireNonNull(parentPath, "parentPath");
+        this.elementNameToAdd = Objects.requireNonNull(elementName, "elementName");
         this.isRepeatingElement = ModelSupport.isRepeatingElement(parent.getClass(), elementName);
-        this.value = Objects.requireNonNull(value) instanceof Code ?
+        this.value = Objects.requireNonNull(value, "value") instanceof Code ?
                 convertToCodeSubtype(parent, elementName, (Code)value) : value;
     }
 
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/util/DeletingVisitor.java b/fhir-path/src/main/java/com/ibm/fhir/path/util/DeletingVisitor.java
index 50399854b06..425711efd9b 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/util/DeletingVisitor.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/util/DeletingVisitor.java
@@ -14,7 +14,7 @@ class DeletingVisitor<T extends Visitable> extends CopyingVisitor<T> {
     private String pathToDelete;
 
     public DeletingVisitor(String pathToDelete) {
-        this.pathToDelete = Objects.requireNonNull(pathToDelete);
+        this.pathToDelete = Objects.requireNonNull(pathToDelete, "pathToDelete");
     }
 
     @Override
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/util/FHIRPathUtil.java b/fhir-path/src/main/java/com/ibm/fhir/path/util/FHIRPathUtil.java
index ab63eab88b0..ae87a2f346c 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/util/FHIRPathUtil.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/util/FHIRPathUtil.java
@@ -88,8 +88,6 @@
 import com.ibm.fhir.path.exception.FHIRPathException;
 
 public final class FHIRPathUtil {
-    private static FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
-
     public static final Set<String> STRING_TRUE_VALUES = new HashSet<>(Arrays.asList("true", "t", "yes", "y", "1", "1.0"));
     public static final Set<String> STRING_FALSE_VALUES = new HashSet<>(Arrays.asList("false", "f", "no", "n", "0", "0.0"));
     public static final Integer INTEGER_TRUE = 1;
@@ -129,6 +127,26 @@ public void syntaxError(Recognizer<?, ?> recognizer, Object offendingSymbol, int
     private FHIRPathUtil() { }
 
     public static ExpressionContext compile(String expr) {
+        int startIndex = -1;
+        for (int i = 0; i < expr.length(); i++) {
+            if (!Character.isWhitespace(expr.charAt(i))) {
+                startIndex = i;
+                break;
+            }
+        }
+
+        int stopIndex = -1;
+        for (int i = expr.length() - 1; i >= 0; i--) {
+            if (!Character.isWhitespace(expr.charAt(i))) {
+                stopIndex = i;
+                break;
+            }
+        }
+
+        if (startIndex == -1 || stopIndex == -1) {
+            throw new IllegalArgumentException("Invalid FHIRPath expression: '" + expr + "'");
+        }
+
         FHIRPathLexer lexer = new FHIRPathLexer(CharStreams.fromString(expr));
         lexer.removeErrorListeners();
         lexer.addErrorListener(SYNTAX_ERROR_LISTENER);
@@ -139,7 +157,17 @@ public static ExpressionContext compile(String expr) {
         parser.removeErrorListeners();
         parser.addErrorListener(SYNTAX_ERROR_LISTENER);
 
-        return parser.expression();
+        ExpressionContext expressionContext = parser.expression();
+
+        if (expressionContext.getStart() == null || expressionContext.getStop() == null) {
+            throw new IllegalArgumentException("FHIRPath expression was parsed but start and/or stop token was null");
+        }
+
+        if (expressionContext.getStart().getStartIndex() != startIndex || expressionContext.getStop().getStopIndex() != stopIndex) {
+            throw new IllegalArgumentException("FHIRPath expression parsing error at: '" + expr.charAt(expressionContext.getStop().getStopIndex() + 1) + "'");
+        }
+
+        return expressionContext;
     }
 
     public static boolean isTypeCompatible(FHIRPathSystemValue leftValue, FHIRPathSystemValue rightValue) {
@@ -862,8 +890,10 @@ public static String unescape(String s) {
      * @throws FHIRPatchException
      * @throws NullPointerException if any of the passed arguments are null
      */
-    public static <T extends Visitable> T add(T elementOrResource, String fhirPath, String elementName, Visitable value) throws FHIRPathException, FHIRPatchException {
-        FHIRPathNode node = evaluateToSingle(elementOrResource, fhirPath);
+    public static <T extends Visitable> T add(T elementOrResource, String fhirPath, String elementName, Visitable value)
+            throws FHIRPathException, FHIRPatchException {
+        FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
+        FHIRPathNode node = evaluateToSingle(evaluator, elementOrResource, fhirPath);
         Visitable parent = node.isResourceNode() ?
                 node.asResourceNode().resource() : node.asElementNode().element();
 
@@ -883,7 +913,8 @@ public static <T extends Visitable> T add(T elementOrResource, String fhirPath,
      * @throws NullPointerException if any of the passed arguments are null
      */
     public static <T extends Visitable> T delete(T elementOrResource, String fhirPath) throws FHIRPathException, FHIRPatchException {
-        FHIRPathNode node = evaluateToSingle(elementOrResource, fhirPath);
+        FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
+        FHIRPathNode node = evaluateToSingle(evaluator, elementOrResource, fhirPath);
 
         try {
             DeletingVisitor<T> deletingVisitor = new DeletingVisitor<T>(node.path());
@@ -902,7 +933,8 @@ public static <T extends Visitable> T delete(T elementOrResource, String fhirPat
      * @throws NullPointerException if any of the passed arguments are null
      */
     public static <T extends Visitable> T replace(T elementOrResource, String fhirPath, Visitable value) throws FHIRPathException, FHIRPatchException {
-        FHIRPathNode node = evaluateToSingle(elementOrResource, fhirPath);
+        FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
+        FHIRPathNode node = evaluateToSingle(evaluator, elementOrResource, fhirPath);
         String elementName = node.name();
 
         FHIRPathTree tree = evaluator.getEvaluationContext().getTree();
@@ -925,13 +957,15 @@ public static <T extends Visitable> T replace(T elementOrResource, String fhirPa
     }
 
     /**
+     * @param evaluator
      * @param elementOrResource
      * @param fhirPath
      * @return
      * @throws FHIRPathException
      * @throws FHIRPatchException if the fhirPath does not evaluate to a single node
      */
-    private static FHIRPathNode evaluateToSingle(Visitable elementOrResource, String fhirPath) throws FHIRPathException, FHIRPatchException {
+    private static FHIRPathNode evaluateToSingle(FHIRPathEvaluator evaluator, Visitable elementOrResource, String fhirPath)
+            throws FHIRPathException, FHIRPatchException {
         /*
          * 1. The FHIRPath statement must return a single element.
          * 2. The FHIRPath statement SHALL NOT cross resources using the resolve() function
@@ -961,6 +995,7 @@ private static FHIRPathNode evaluateToSingle(Visitable elementOrResource, String
      */
     public static <T extends Visitable> T insert(T elementOrResource, String fhirPath, int index, Visitable value)
             throws FHIRPathException, FHIRPatchException {
+        FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
         Collection<FHIRPathNode> nodes = evaluator.evaluate(elementOrResource, fhirPath);
         if (index > nodes.size()) {
             throw new FHIRPatchException("Index must be equal or less than the number of elements in the list", fhirPath);
@@ -991,6 +1026,7 @@ public static <T extends Visitable> T insert(T elementOrResource, String fhirPat
      */
     public static <T extends Visitable> T move(T elementOrResource, String fhirPath, int source, int target)
             throws FHIRPathException, FHIRPatchException {
+        FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
         Collection<FHIRPathNode> nodes = evaluator.evaluate(elementOrResource, fhirPath);
         if (source > nodes.size() || target > nodes.size()) {
             throw new FHIRPatchException("Source and target indices must be less than or equal to"
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/util/InsertingVisitor.java b/fhir-path/src/main/java/com/ibm/fhir/path/util/InsertingVisitor.java
index 00cc51f289b..9a4f873f6c3 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/util/InsertingVisitor.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/util/InsertingVisitor.java
@@ -26,10 +26,10 @@ class InsertingVisitor<T extends Visitable> extends CopyingVisitor<T> {
      * @throws IllegalArgumentException
      */
     public InsertingVisitor(Visitable parent, String parentPath, String elementName, int index, Visitable value) {
-        this.parentPath = Objects.requireNonNull(parentPath);
-        this.elementNameToInsert = Objects.requireNonNull(elementName);
+        this.parentPath = Objects.requireNonNull(parentPath, "parentPath");
+        this.elementNameToInsert = Objects.requireNonNull(elementName, "elementName");
         this.index = index;
-        this.value = Objects.requireNonNull(value) instanceof Code ?
+        this.value = Objects.requireNonNull(value, "value") instanceof Code ?
                 convertToCodeSubtype(parent, elementName, (Code)value) : value;
     }
 
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/util/MovingVisitor.java b/fhir-path/src/main/java/com/ibm/fhir/path/util/MovingVisitor.java
index 1300dedfeb4..fef47f8661e 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/util/MovingVisitor.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/util/MovingVisitor.java
@@ -24,8 +24,8 @@ class MovingVisitor<T extends Visitable> extends CopyingVisitor<T> {
      * @param value
      */
     public MovingVisitor(String parentPath, String elementName, int sourceIndex, int targetIndex) {
-        this.parentPath = Objects.requireNonNull(parentPath);
-        this.elementName = Objects.requireNonNull(elementName);
+        this.parentPath = Objects.requireNonNull(parentPath, "parentPath");
+        this.elementName = Objects.requireNonNull(elementName, "elementName");
         this.sourceIndex = sourceIndex;
         this.targetIndex = targetIndex;
     }
diff --git a/fhir-path/src/main/java/com/ibm/fhir/path/util/ReplacingVisitor.java b/fhir-path/src/main/java/com/ibm/fhir/path/util/ReplacingVisitor.java
index ee818794bc5..ed52f5dc3b0 100644
--- a/fhir-path/src/main/java/com/ibm/fhir/path/util/ReplacingVisitor.java
+++ b/fhir-path/src/main/java/com/ibm/fhir/path/util/ReplacingVisitor.java
@@ -25,8 +25,8 @@ class ReplacingVisitor<T extends Visitable> extends CopyingVisitor<T> {
      * @throws IllegalArgumentException
      */
     public ReplacingVisitor(Visitable parent, String elementName, String pathToReplace, Visitable newValue) {
-        this.pathToReplace = Objects.requireNonNull(pathToReplace);
-        this.newValue = Objects.requireNonNull(newValue) instanceof Code ?
+        this.pathToReplace = Objects.requireNonNull(pathToReplace, "pathToReplace");
+        this.newValue = Objects.requireNonNull(newValue, "newValue") instanceof Code ?
                 convertToCodeSubtype(parent, elementName, (Code)newValue) : newValue;
     }
 
diff --git a/fhir-path/src/test/java/com/ibm/fhir/path/patch/test/FHIRPathUtilTest.java b/fhir-path/src/test/java/com/ibm/fhir/path/patch/test/FHIRPathUtilTest.java
index c620ae41f96..a8e24bd9fe9 100644
--- a/fhir-path/src/test/java/com/ibm/fhir/path/patch/test/FHIRPathUtilTest.java
+++ b/fhir-path/src/test/java/com/ibm/fhir/path/patch/test/FHIRPathUtilTest.java
@@ -7,6 +7,14 @@
 
 import static org.testng.Assert.assertEquals;
 
+import java.util.ArrayList;
+import java.util.List;
+import java.util.concurrent.Callable;
+import java.util.concurrent.ExecutionException;
+import java.util.concurrent.ExecutorService;
+import java.util.concurrent.Executors;
+import java.util.concurrent.Future;
+
 import org.testng.annotations.Test;
 
 import com.ibm.fhir.model.patch.exception.FHIRPatchException;
@@ -45,4 +53,143 @@ private void testAddSingleResource() throws FHIRPathException, FHIRPatchExceptio
         assertEquals(modifiedBundle.getEntry().get(0).getResource(), patient);
         assertEquals(modifiedBundle.getEntry().get(1).getResource(), practitioner);
     }
+
+    @Test
+    private void testConcurrentPatches() throws FHIRPathException, FHIRPatchException, InterruptedException, ExecutionException {
+        List<Callable<Bundle>> concurrentUpdates = new ArrayList<>();
+        int maxThreads = 12;
+        ExecutorService executor = Executors.newFixedThreadPool(maxThreads);
+
+        // 1. Execute a set of adds in parallel.
+        Entry addEntry = Entry.builder().fullUrl(Uri.of("add")).build();
+        for (int i = 0; i < maxThreads; i++) {
+            concurrentUpdates.add(new Add(bundle, addEntry));
+        }
+        List<Future<Bundle>> futureResults = executor.invokeAll(concurrentUpdates);
+        for (Future<Bundle> future : futureResults) {
+            assertEquals(future.get().getEntry().size(), 1, "Each bundle should have 1 entry.");
+        }
+
+
+        // 2. Execute a set of inserts in parallel.
+        concurrentUpdates = new ArrayList<>();
+        Entry insertEntry = Entry.builder().fullUrl(Uri.of("insert")).build();
+
+        for (Future<Bundle> future : futureResults) {
+            concurrentUpdates.add(new Insert(future.get(), insertEntry));
+        }
+        futureResults = executor.invokeAll(concurrentUpdates);
+        for (Future<Bundle> future : futureResults) {
+            assertEquals(future.get().getEntry().size(), 2, "Each bundle should have 2 entries.");
+        }
+
+
+        // 3. Execute a set of replacements in parallel.
+        concurrentUpdates = new ArrayList<>();
+        Entry replaceEntry = Entry.builder().fullUrl(Uri.of("replace")).build();
+
+        for (Future<Bundle> future : futureResults) {
+            concurrentUpdates.add(new Replace(future.get(), replaceEntry));
+        }
+        futureResults = executor.invokeAll(concurrentUpdates);
+        for (Future<Bundle> future : futureResults) {
+            assertEquals(future.get().getEntry().size(), 2, "Each bundle should have 2 entries.");
+        }
+
+
+        // 4. Execute a set of moves in parallel.
+        concurrentUpdates = new ArrayList<>();
+
+        for (Future<Bundle> future : futureResults) {
+            concurrentUpdates.add(new Move(future.get()));
+        }
+        futureResults = executor.invokeAll(concurrentUpdates);
+        for (Future<Bundle> future : futureResults) {
+            assertEquals(future.get().getEntry().size(), 2, "Each bundle should have 2 entries.");
+        }
+
+
+        // 5. Execute a set of deletes in parallel.
+        concurrentUpdates = new ArrayList<>();
+
+        for (Future<Bundle> future : futureResults) {
+            concurrentUpdates.add(new Delete(future.get()));
+        }
+        futureResults = executor.invokeAll(concurrentUpdates);
+        assertEquals(futureResults.size(), maxThreads);
+        for (Future<Bundle> future : futureResults) {
+            assertEquals(future.get().getEntry().size(), 1, "Each bundle should have 1 entry.");
+        }
+    }
+
+    private class Add implements Callable<Bundle> {
+        private Bundle bundle;
+        private Entry entry;
+
+        Add(Bundle bundle, Entry entry) {
+            this.bundle = bundle;
+            this.entry = entry;
+        }
+
+        @Override
+        public Bundle call() throws Exception {
+            return FHIRPathUtil.add(bundle, "Bundle", "entry", entry);
+        }
+    }
+
+    private class Insert implements Callable<Bundle> {
+        private Bundle bundle;
+        private Entry entry;
+
+        Insert(Bundle bundle, Entry entry) {
+            this.bundle = bundle;
+            this.entry = entry;
+        }
+
+        @Override
+        public Bundle call() throws Exception {
+            return FHIRPathUtil.insert(bundle, "Bundle.entry", 0, entry);
+        }
+    }
+
+    private class Replace implements Callable<Bundle> {
+        private Bundle bundle;
+        private Entry entry;
+
+        Replace(Bundle bundle, Entry entry) {
+            this.bundle = bundle;
+            this.entry = entry;
+        }
+
+        @Override
+        public Bundle call() throws Exception {
+            return FHIRPathUtil.replace(bundle, "Bundle.entry[0]", entry);
+        }
+    }
+
+    private class Move implements Callable<Bundle> {
+        private Bundle bundle;
+
+        Move(Bundle bundle) {
+            this.bundle = bundle;
+        }
+
+        @Override
+        public Bundle call() throws Exception {
+            return FHIRPathUtil.move(bundle, "Bundle.entry", 0, 1);
+        }
+    }
+
+    private class Delete implements Callable<Bundle> {
+        private Bundle bundle;
+
+        Delete(Bundle bundle) {
+            this.bundle = bundle;
+        }
+
+        @Override
+        public Bundle call() throws Exception {
+            return FHIRPathUtil.delete(bundle, "Bundle.entry[0]");
+        }
+    }
 }
diff --git a/fhir-path/src/test/java/com/ibm/fhir/path/test/ConstraintAnnotationProcessor.java b/fhir-path/src/test/java/com/ibm/fhir/path/test/ConstraintAnnotationProcessor.java
index 9760d73bfc9..8d2f3ae9244 100644
--- a/fhir-path/src/test/java/com/ibm/fhir/path/test/ConstraintAnnotationProcessor.java
+++ b/fhir-path/src/test/java/com/ibm/fhir/path/test/ConstraintAnnotationProcessor.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -15,7 +15,7 @@
 import java.util.Set;
 import java.util.stream.Collectors;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 
 import com.ibm.fhir.model.annotation.Constraint;
 import com.ibm.fhir.model.resource.Resource;
diff --git a/fhir-path/src/test/java/com/ibm/fhir/path/test/FHIRPathAsTest.java b/fhir-path/src/test/java/com/ibm/fhir/path/test/FHIRPathAsTest.java
index 7ca989be03f..584f6896dd1 100644
--- a/fhir-path/src/test/java/com/ibm/fhir/path/test/FHIRPathAsTest.java
+++ b/fhir-path/src/test/java/com/ibm/fhir/path/test/FHIRPathAsTest.java
@@ -8,6 +8,7 @@
 import static com.ibm.fhir.model.type.String.string;
 import static org.testng.Assert.assertEquals;
 
+import java.time.ZoneOffset;
 import java.util.Collection;
 
 import org.testng.annotations.Test;
@@ -38,6 +39,19 @@ void testAsOperation() throws Exception {
         assertEquals(result.size(), 0, "Number of selected nodes");
     }
 
+    @Test
+    void testAsOperationSystemValue() throws Exception {
+        // Testing 'as'
+        Patient patient = Patient.builder()
+                .deceased(DateTime.now(ZoneOffset.UTC))
+                .build();
+
+        FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
+        Collection<FHIRPathNode> result = evaluator.evaluate(patient, "Patient.deceased as System.DateTime");
+
+        assertEquals(result.size(), 1, "Number of selected nodes");
+    }
+
     @Test
     void testAsFunction() throws Exception {
         Condition condition = Condition.builder()
diff --git a/fhir-path/src/test/java/com/ibm/fhir/path/test/ResolveInternalFragmentReferenceTest.java b/fhir-path/src/test/java/com/ibm/fhir/path/test/ResolveInternalFragmentReferenceTest.java
new file mode 100644
index 00000000000..160e96bccd5
--- /dev/null
+++ b/fhir-path/src/test/java/com/ibm/fhir/path/test/ResolveInternalFragmentReferenceTest.java
@@ -0,0 +1,67 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.path.test;
+
+import static com.ibm.fhir.model.type.String.string;
+import static com.ibm.fhir.path.evaluator.FHIRPathEvaluator.SINGLETON_TRUE;
+import static org.testng.Assert.assertEquals;
+
+import java.util.Collection;
+
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.model.resource.Bundle;
+import com.ibm.fhir.model.resource.Bundle.Entry;
+import com.ibm.fhir.model.resource.Bundle.Entry.Request;
+import com.ibm.fhir.model.resource.HealthcareService;
+import com.ibm.fhir.model.resource.Organization;
+import com.ibm.fhir.model.type.Reference;
+import com.ibm.fhir.model.type.Uri;
+import com.ibm.fhir.model.type.code.BundleType;
+import com.ibm.fhir.model.type.code.HTTPVerb;
+import com.ibm.fhir.path.FHIRPathNode;
+import com.ibm.fhir.path.FHIRPathResourceNode;
+import com.ibm.fhir.path.evaluator.FHIRPathEvaluator;
+import com.ibm.fhir.path.evaluator.FHIRPathEvaluator.EvaluationContext;
+
+public class ResolveInternalFragmentReferenceTest {
+    @Test
+    public void testResolveInternalFragmentReference() throws Exception {
+        Bundle bundle = Bundle.builder()
+                .type(BundleType.TRANSACTION)
+                .entry(Entry.builder()
+                    .resource(Organization.builder()
+                        .id("1")
+                        .name(string("Test Organization"))
+                        .contained(HealthcareService.builder()
+                            .providedBy(Reference.builder()
+                                .reference(string("#"))
+                                .build())
+                            .build(),
+                            Organization.builder()
+                                .id("parentOrg")
+                                .name(string("Parent Organization"))
+                            .build())
+                        .partOf(Reference.builder()
+                            .reference(string("#parentOrg"))
+                            .build())
+                        .build())
+                    .request(Request.builder()
+                        .method(HTTPVerb.PUT)
+                        .url(Uri.of("Organization/1"))
+                        .build())
+                    .build())
+                .build();
+
+        EvaluationContext evaluationContext = new EvaluationContext(bundle);
+        FHIRPathResourceNode resourceNode = evaluationContext.getTree().getNode("Bundle.entry[0].resource.contained[0]").asResourceNode();
+
+        Collection<FHIRPathNode> result = FHIRPathEvaluator.evaluator().evaluate(evaluationContext, "providedBy.exists() and providedBy.resolve().partOf.resolve().is(Organization)", resourceNode);
+
+        assertEquals(result, SINGLETON_TRUE);
+    }
+}
\ No newline at end of file
diff --git a/fhir-path/src/test/resources/FHIRPath/tests-fhir-r4.xml b/fhir-path/src/test/resources/FHIRPath/tests-fhir-r4.xml
index 644d29fd07c..f0aedca6a4a 100644
--- a/fhir-path/src/test/resources/FHIRPath/tests-fhir-r4.xml
+++ b/fhir-path/src/test/resources/FHIRPath/tests-fhir-r4.xml
@@ -222,9 +222,7 @@
 		<test name="testLiteralTimeMinute" inputfile="patient-example.xml"><expression>@T14:34.is(Time)</expression><output type="boolean">true</output></test>
 		<test name="testLiteralTimeSecond" inputfile="patient-example.xml"><expression>@T14:34:28.is(Time)</expression><output type="boolean">true</output></test>
 		<test name="testLiteralTimeMillisecond" inputfile="patient-example.xml"><expression>@T14:34:28.123.is(Time)</expression><output type="boolean">true</output></test>
-        <!--
 		<test name="testLiteralTimeUTC" inputfile="patient-example.xml"><expression invalid="true">@T14:34:28Z.is(Time)</expression></test>
-		-->
 		<test name="testLiteralTimeTimezoneOffset" inputfile="patient-example.xml"><expression invalid="true">@T14:34:28+10:00.is(Time)</expression></test>
 
 		<test name="testLiteralQuantityDecimal" inputfile="patient-example.xml"><expression>10.1 'mg'.convertsToQuantity()</expression><output type="boolean">true</output></test>
diff --git a/fhir-persistence-jdbc/pom.xml b/fhir-persistence-jdbc/pom.xml
index 92b926925cf..40bb94e1fae 100644
--- a/fhir-persistence-jdbc/pom.xml
+++ b/fhir-persistence-jdbc/pom.xml
@@ -8,7 +8,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/db2/Db2ResourceReferenceDAO.java b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/db2/Db2ResourceReferenceDAO.java
index ec325e5a756..bf3054fc930 100644
--- a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/db2/Db2ResourceReferenceDAO.java
+++ b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/db2/Db2ResourceReferenceDAO.java
@@ -403,6 +403,65 @@ protected void insertSystemResourceTags(String resourceType, Collection<Resource
                 }
             }
 
+            if (count > 0) {
+                ps.executeBatch();
+            }
+        } catch (SQLException x) {
+            logger.log(Level.SEVERE, insert, x);
+            throw getTranslator().translate(x);
+        }
+    }
+    @Override
+    protected void insertResourceSecurity(String resourceType, Collection<ResourceTokenValueRec> xrefs) {
+        // Now all the values should have ids assigned so we can go ahead and insert them
+        // as a batch
+        final String tableName = resourceType + "_SECURITY";
+        DataDefinitionUtil.assertValidName(tableName);
+        final String insert = "INSERT INTO " + tableName + "("
+                + "mt_id, logical_resource_id, common_token_value_id) "
+                + "VALUES (" + this.adminSchemaName + ".SV_TENANT_ID, ?, ?)";
+        try (PreparedStatement ps = getConnection().prepareStatement(insert)) {
+            int count = 0;
+            for (ResourceTokenValueRec xr: xrefs) {
+                ps.setLong(1, xr.getLogicalResourceId());
+                ps.setLong(2, xr.getCommonTokenValueId());
+                ps.addBatch();
+                if (++count == BATCH_SIZE) {
+                    ps.executeBatch();
+                    count = 0;
+                }
+            }
+
+            if (count > 0) {
+                ps.executeBatch();
+            }
+        } catch (SQLException x) {
+            logger.log(Level.SEVERE, insert, x);
+            throw getTranslator().translate(x);
+        }
+    }
+
+    @Override
+    protected void insertSystemResourceSecurity(String resourceType, Collection<ResourceTokenValueRec> xrefs) {
+        // Now all the values should have ids assigned so we can go ahead and insert them
+        // as a batch
+        final String tableName =  "LOGICAL_RESOURCE_SECURITY";
+        DataDefinitionUtil.assertValidName(tableName);
+        final String insert = "INSERT INTO " + tableName + "("
+                + "mt_id, logical_resource_id, common_token_value_id) "
+                + "VALUES (" + this.adminSchemaName + ".SV_TENANT_ID, ?, ?)";
+        try (PreparedStatement ps = getConnection().prepareStatement(insert)) {
+            int count = 0;
+            for (ResourceTokenValueRec xr: xrefs) {
+                ps.setLong(1, xr.getLogicalResourceId());
+                ps.setLong(2, xr.getCommonTokenValueId());
+                ps.addBatch();
+                if (++count == BATCH_SIZE) {
+                    ps.executeBatch();
+                    count = 0;
+                }
+            }
+
             if (count > 0) {
                 ps.executeBatch();
             }
diff --git a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/impl/FHIRPersistenceJDBCImpl.java b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/impl/FHIRPersistenceJDBCImpl.java
index 36710bb1646..ccb261fdf2b 100644
--- a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/impl/FHIRPersistenceJDBCImpl.java
+++ b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/impl/FHIRPersistenceJDBCImpl.java
@@ -59,11 +59,13 @@
 import com.ibm.fhir.exception.FHIRException;
 import com.ibm.fhir.model.format.Format;
 import com.ibm.fhir.model.generator.FHIRGenerator;
+import com.ibm.fhir.model.generator.exception.FHIRGeneratorException;
 import com.ibm.fhir.model.parser.FHIRJsonParser;
 import com.ibm.fhir.model.parser.FHIRParser;
 import com.ibm.fhir.model.resource.OperationOutcome;
 import com.ibm.fhir.model.resource.OperationOutcome.Issue;
 import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.resource.Resource.Builder;
 import com.ibm.fhir.model.resource.SearchParameter;
 import com.ibm.fhir.model.resource.SearchParameter.Component;
 import com.ibm.fhir.model.type.Code;
@@ -357,13 +359,8 @@ public <T extends Resource> SingleResourceResult<T> create(FHIRPersistenceContex
         final String METHODNAME = "create";
         log.entering(CLASSNAME, METHODNAME);
 
-        // Most resources are well under 10K after being serialized and compressed
-        InputOutputByteStream ioStream = new InputOutputByteStream(DATA_BUFFER_INITIAL_SIZE);
         String logicalId;
 
-        // We need to update the meta in the resource, so we need a modifiable version
-        Resource.Builder resultResourceBuilder = resource.toBuilder();
-
         try (Connection connection = openConnection()) {
 
             // This create() operation is only called by a REST create. If the given resource
@@ -378,31 +375,11 @@ public <T extends Resource> SingleResourceResult<T> create(FHIRPersistenceContex
 
             // Set the resource id and meta fields.
             Instant lastUpdated = Instant.now(ZoneOffset.UTC);
-            resultResourceBuilder.id(logicalId);
-            Meta meta = resource.getMeta();
-            Meta.Builder metaBuilder = meta == null ? Meta.builder() : meta.toBuilder();
-            metaBuilder.versionId(Id.of(Integer.toString(newVersionNumber)));
-            metaBuilder.lastUpdated(lastUpdated);
-            resultResourceBuilder.meta(metaBuilder.build());
-
-            // rebuild the resource with updated meta
-            @SuppressWarnings("unchecked")
-            T updatedResource = (T) resultResourceBuilder.build();
+            T updatedResource = copyAndSetResourceMetaFields(resource, logicalId, newVersionNumber, lastUpdated);
 
             // Create the new Resource DTO instance.
-            com.ibm.fhir.persistence.jdbc.dto.Resource resourceDTO = new com.ibm.fhir.persistence.jdbc.dto.Resource();
-            resourceDTO.setLogicalId(logicalId);
-            resourceDTO.setVersionId(newVersionNumber);
-            Timestamp timestamp = FHIRUtilities.convertToTimestamp(lastUpdated.getValue());
-            resourceDTO.setLastUpdated(timestamp);
-            resourceDTO.setResourceType(updatedResource.getClass().getSimpleName());
-
-            // Serialize and compress the Resource
-            GZIPOutputStream zipStream = new GZIPOutputStream(ioStream.outputStream());
-            FHIRGenerator.generator( Format.JSON, false).generate(updatedResource, zipStream);
-            zipStream.finish();
-            resourceDTO.setDataStream(ioStream);
-            zipStream.close();
+            com.ibm.fhir.persistence.jdbc.dto.Resource resourceDTO =
+                    createResourceDTO(logicalId, newVersionNumber, lastUpdated, updatedResource);
 
             // The DAO objects are now created on-the-fly (not expensive to construct) and
             // given the connection to use while processing this request
@@ -449,6 +426,66 @@ public <T extends Resource> SingleResourceResult<T> create(FHIRPersistenceContex
         }
     }
 
+    /**
+     * Creates and returns a data transfer object (DTO) with the contents of the passed arguments.
+     *
+     * @param logicalId
+     * @param newVersionNumber
+     * @param lastUpdated
+     * @param updatedResource
+     * @return
+     * @throws IOException
+     * @throws FHIRGeneratorException
+     */
+    private com.ibm.fhir.persistence.jdbc.dto.Resource createResourceDTO(String logicalId, int newVersionNumber,
+            Instant lastUpdated, Resource updatedResource) throws IOException, FHIRGeneratorException {
+
+        Timestamp timestamp = FHIRUtilities.convertToTimestamp(lastUpdated.getValue());
+
+        com.ibm.fhir.persistence.jdbc.dto.Resource resourceDTO = new com.ibm.fhir.persistence.jdbc.dto.Resource();
+        resourceDTO.setLogicalId(logicalId);
+        resourceDTO.setVersionId(newVersionNumber);
+        resourceDTO.setLastUpdated(timestamp);
+        resourceDTO.setResourceType(updatedResource.getClass().getSimpleName());
+
+        // Most resources are well under 10K after being serialized and compressed
+        InputOutputByteStream ioStream = new InputOutputByteStream(DATA_BUFFER_INITIAL_SIZE);
+
+        // Serialize and compress the Resource
+        try (GZIPOutputStream zipStream = new GZIPOutputStream(ioStream.outputStream())) {
+            FHIRGenerator.generator(Format.JSON, false).generate(updatedResource, zipStream);
+            zipStream.finish();
+            resourceDTO.setDataStream(ioStream);
+        }
+
+        return resourceDTO;
+    }
+
+    /**
+     * Creates and returns a copy of the passed resource with the {@code Resource.id}
+     * {@code Resource.meta.versionId}, and {@code Resource.meta.lastUpdated} elements replaced.
+     *
+     * @param resource
+     * @param logicalId
+     * @param newVersionNumber
+     * @param lastUpdated
+     * @return the updated resource
+     */
+    @SuppressWarnings("unchecked")
+    private <T extends Resource> T copyAndSetResourceMetaFields(T resource, String logicalId, int newVersionNumber, Instant lastUpdated) {
+        Meta meta = resource.getMeta();
+        Meta.Builder metaBuilder = meta == null ? Meta.builder() : meta.toBuilder();
+        metaBuilder.versionId(Id.of(Integer.toString(newVersionNumber)));
+        metaBuilder.lastUpdated(lastUpdated);
+
+        Builder resourceBuilder = resource.toBuilder();
+        resourceBuilder.setValidating(false);
+        return (T) resourceBuilder
+                .id(logicalId)
+                .meta(metaBuilder.build())
+                .build();
+    }
+
     /**
      * Convenience method to construct a new instance of the {@link ResourceDAO}
      * @param connection the connection to the database for the DAO to use
@@ -457,7 +494,8 @@ public <T extends Resource> SingleResourceResult<T> create(FHIRPersistenceContex
      * @throws FHIRPersistenceException
      * @throws FHIRPersistenceDataAccessException
      */
-    private ResourceDAO makeResourceDAO(Connection connection) throws FHIRPersistenceDataAccessException, FHIRPersistenceException, IllegalArgumentException {
+    private ResourceDAO makeResourceDAO(Connection connection)
+            throws FHIRPersistenceDataAccessException, FHIRPersistenceException, IllegalArgumentException {
 
         // The resourceDAO is made before any database interaction, so this is a great spot
         // to prefill the caches if needed
@@ -515,10 +553,6 @@ public <T extends Resource> SingleResourceResult<T> update(FHIRPersistenceContex
 
         Class<? extends Resource> resourceType = resource.getClass();
         com.ibm.fhir.persistence.jdbc.dto.Resource existingResourceDTO;
-        InputOutputByteStream ioStream = new InputOutputByteStream(DATA_BUFFER_INITIAL_SIZE);
-
-        // Resources are immutable, so we need a new builder to update it (since R4)
-        Resource.Builder resultResourceBuilder = resource.toBuilder();
 
         try (Connection connection = openConnection()) {
             ResourceDAO resourceDao = makeResourceDAO(connection);
@@ -568,33 +602,13 @@ public <T extends Resource> SingleResourceResult<T> update(FHIRPersistenceContex
                 log.fine("Storing new FHIR Resource '" + resource.getClass().getSimpleName() + "/" + logicalId + "', version=" + newVersionNumber);
             }
 
-            Instant lastUpdated = Instant.now(ZoneOffset.UTC);
-
             // Set the resource id and meta fields.
-//            resultBuilder.id(logicalId);
-            Meta meta = resource.getMeta();
-            Meta.Builder metaBuilder = meta == null ? Meta.builder() : meta.toBuilder();
-            metaBuilder.versionId(Id.of(Integer.toString(newVersionNumber)));
-            metaBuilder.lastUpdated(lastUpdated);
-            resultResourceBuilder.meta(metaBuilder.build());
-
-            @SuppressWarnings("unchecked")
-            T updatedResource = (T) resultResourceBuilder.build();
+            Instant lastUpdated = Instant.now(ZoneOffset.UTC);
+            T updatedResource = copyAndSetResourceMetaFields(resource, resource.getId(), newVersionNumber, lastUpdated);
 
             // Create the new Resource DTO instance.
-            com.ibm.fhir.persistence.jdbc.dto.Resource resourceDTO = new com.ibm.fhir.persistence.jdbc.dto.Resource();
-            resourceDTO.setLogicalId(logicalId);
-            resourceDTO.setVersionId(newVersionNumber);
-            Timestamp timestamp = FHIRUtilities.convertToTimestamp(lastUpdated.getValue());
-            resourceDTO.setLastUpdated(timestamp);
-            resourceDTO.setResourceType(updatedResource.getClass().getSimpleName());
-
-            // Serialize and compress the Resource
-            GZIPOutputStream zipStream = new GZIPOutputStream(ioStream.outputStream());
-            FHIRGenerator.generator(Format.JSON, false).generate(updatedResource, zipStream);
-            zipStream.finish();
-            resourceDTO.setDataStream(ioStream);
-            zipStream.close();
+            com.ibm.fhir.persistence.jdbc.dto.Resource resourceDTO =
+                    createResourceDTO(logicalId, newVersionNumber, lastUpdated, updatedResource);
 
             // Persist the Resource DTO.
             final String parameterHashB64 = "";
@@ -1338,7 +1352,7 @@ private FHIRPersistenceNotSupportedException buildNotSupportedException(String m
                 .severity(IssueSeverity.FATAL)
                 .code(IssueType.NOT_SUPPORTED.toBuilder()
                         .extension(Extension.builder()
-                            .url("http://ibm.com/fhir/extension/not-supported-detail")
+                            .url(FHIRConstants.EXT_BASE + "not-supported-detail")
                             .value(Code.of("interaction"))
                             .build())
                         .build())
@@ -1354,9 +1368,6 @@ public <T extends Resource> SingleResourceResult<T> delete(FHIRPersistenceContex
 
         com.ibm.fhir.persistence.jdbc.dto.Resource existingResourceDTO = null;
         T existingResource = null;
-        InputOutputByteStream ioStream = new InputOutputByteStream(DATA_BUFFER_INITIAL_SIZE);
-
-        Resource.Builder resourceBuilder;
 
         try (Connection connection = openConnection()) {
             ResourceDAO resourceDao = makeResourceDAO(connection);
@@ -1370,7 +1381,6 @@ public <T extends Resource> SingleResourceResult<T> delete(FHIRPersistenceContex
 
             if (existingResourceDTO.isDeleted()) {
                 existingResource = this.convertResourceDTO(existingResourceDTO, resourceType, null);
-                resourceBuilder = existingResource.toBuilder();
 
                 addWarning(IssueType.DELETED, "Resource of type'" + resourceType.getSimpleName() +
                         "' with id '" + logicalId + "' is already deleted.");
@@ -1385,38 +1395,15 @@ public <T extends Resource> SingleResourceResult<T> delete(FHIRPersistenceContex
 
             existingResource = this.convertResourceDTO(existingResourceDTO, resourceType, null);
 
-            // Resources are immutable, so we need a new builder to update it (since R4)
-            resourceBuilder = existingResource.toBuilder();
-
             int newVersionNumber = existingResourceDTO.getVersionId() + 1;
             Instant lastUpdated = Instant.now(ZoneOffset.UTC);
 
             // Update the soft-delete resource to reflect the new version and lastUpdated values.
-            Meta meta = existingResource.getMeta();
-            Meta.Builder metaBuilder = meta == null ? Meta.builder() : meta.toBuilder();
-            metaBuilder.versionId(Id.of(Integer.toString(newVersionNumber)));
-            metaBuilder.lastUpdated(lastUpdated);
-            resourceBuilder.meta(metaBuilder.build());
-
-
-            @SuppressWarnings("unchecked")
-            T updatedResource = (T) resourceBuilder.build();
+            T updatedResource = copyAndSetResourceMetaFields(existingResource, existingResource.getId(), newVersionNumber, lastUpdated);
 
             // Create a new Resource DTO instance to represent the deleted version.
-            com.ibm.fhir.persistence.jdbc.dto.Resource resourceDTO = new com.ibm.fhir.persistence.jdbc.dto.Resource();
-            resourceDTO.setLogicalId(logicalId);
-            resourceDTO.setVersionId(newVersionNumber);
-
-            // Serialize and compress the Resource
-            GZIPOutputStream zipStream = new GZIPOutputStream(ioStream.outputStream());
-            FHIRGenerator.generator(Format.JSON, false).generate(updatedResource, zipStream);
-            zipStream.finish();
-            resourceDTO.setDataStream(ioStream);
-            zipStream.close();
-
-            Timestamp timestamp = FHIRUtilities.convertToTimestamp(lastUpdated.getValue());
-            resourceDTO.setLastUpdated(timestamp);
-            resourceDTO.setResourceType(resourceType.getSimpleName());
+            com.ibm.fhir.persistence.jdbc.dto.Resource resourceDTO =
+                    createResourceDTO(logicalId, newVersionNumber, lastUpdated, updatedResource);
             resourceDTO.setDeleted(true);
 
             // Persist the logically deleted Resource DTO.
@@ -2332,16 +2319,18 @@ private <T extends Resource> T convertResourceDTO(com.ibm.fhir.persistence.jdbc.
         InputStream in = null;
         try {
             if (resourceDTO != null && resourceDTO.getDataStream() != null) {
+                FHIRParser parser = FHIRParser.parser(Format.JSON);
+                parser.setValidating(false);
                 in = new GZIPInputStream(resourceDTO.getDataStream().inputStream());
                 if (elements != null) {
                     // parse/filter the resource using elements
-                    resource = FHIRParser.parser(Format.JSON).as(FHIRJsonParser.class).parseAndFilter(in, elements);
+                    resource = parser.as(FHIRJsonParser.class).parseAndFilter(in, elements);
                     if (resourceType.equals(resource.getClass()) && !FHIRUtil.hasTag(resource, SearchConstants.SUBSETTED_TAG)) {
                         // add a SUBSETTED tag to this resource to indicate that its elements have been filtered
                         resource = FHIRUtil.addTag(resource, SearchConstants.SUBSETTED_TAG);
                     }
                 } else {
-                    resource = FHIRParser.parser(Format.JSON).parse(in);
+                    resource = parser.parse(in);
                 }
             }
         } finally {
diff --git a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/JDBCParameterBuildingVisitor.java b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/JDBCParameterBuildingVisitor.java
index 9e4f1658f32..3fdb199680c 100644
--- a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/JDBCParameterBuildingVisitor.java
+++ b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/JDBCParameterBuildingVisitor.java
@@ -43,6 +43,7 @@
 import com.ibm.fhir.model.type.Reference;
 import com.ibm.fhir.model.type.Timing;
 import com.ibm.fhir.model.type.Uri;
+import com.ibm.fhir.model.type.code.QuantityComparator;
 import com.ibm.fhir.model.type.code.SearchParamType;
 import com.ibm.fhir.model.util.ModelSupport;
 import com.ibm.fhir.model.visitor.DefaultVisitor;
@@ -56,7 +57,7 @@
 import com.ibm.fhir.persistence.jdbc.dto.ReferenceParmVal;
 import com.ibm.fhir.persistence.jdbc.dto.StringParmVal;
 import com.ibm.fhir.persistence.jdbc.dto.TokenParmVal;
-import com.ibm.fhir.persistence.jdbc.util.type.NumberParmBehaviorUtil;
+import com.ibm.fhir.persistence.jdbc.util.type.NewNumberParmBehaviorUtil;
 import com.ibm.fhir.search.SearchConstants;
 import com.ibm.fhir.search.date.DateTimeHandler;
 import com.ibm.fhir.search.exception.FHIRSearchException;
@@ -229,8 +230,8 @@ public boolean visit(java.lang.String elementName, int elementIndex, com.ibm.fhi
             p.setName(searchParamCode);
             BigDecimal value = decimal.getValue();
             p.setValueNumber(value);
-            p.setValueNumberLow(NumberParmBehaviorUtil.generateLowerBound(value));
-            p.setValueNumberHigh(NumberParmBehaviorUtil.generateUpperBound(value));
+            p.setValueNumberLow(NewNumberParmBehaviorUtil.generateLowerBound(value));
+            p.setValueNumberHigh(NewNumberParmBehaviorUtil.generateUpperBound(value));
             result.add(p);
         }
         return false;
@@ -510,6 +511,8 @@ public boolean visit(java.lang.String elementName, int elementIndex, Money money
             p.setResourceType(resourceType);
             p.setName(searchParamCode);
             p.setValueNumber(money.getValue().getValue());
+            p.setValueNumberLow(NewNumberParmBehaviorUtil.generateLowerBound(money.getValue().getValue()));
+            p.setValueNumberHigh(NewNumberParmBehaviorUtil.generateUpperBound(money.getValue().getValue()));
             if (money.getCurrency() != null) {
                 p.setValueCode(money.getCurrency().getValue());
             }
@@ -555,8 +558,29 @@ public boolean visit(java.lang.String elementName, int elementIndex, Quantity qu
         }
         if (quantity.getValue() != null && quantity.getValue().hasValue()) {
             BigDecimal value = quantity.getValue().getValue();
-            BigDecimal valueLow = NumberParmBehaviorUtil.generateLowerBound(value);
-            BigDecimal valueHigh = NumberParmBehaviorUtil.generateUpperBound(value);
+            BigDecimal valueLow = null;
+            BigDecimal valueHigh = null;
+            if (quantity.getComparator() != null) {
+                // Calculate range based on comparator
+                if (QuantityComparator.GREATER_OR_EQUALS.equals(quantity.getComparator())) {
+                    // Range low value is quantity value
+                    valueLow = value;
+                } else if (QuantityComparator.GREATER_THAN.equals(quantity.getComparator())) {
+                    // Range low value is quantity value plus 1e-<scale+9>
+                    int scale = value.scale() < 0 ? 9 : value.scale()+9;
+                    valueLow = value.add(new BigDecimal("1e-" + scale));
+                } else if (QuantityComparator.LESS_OR_EQUALS.equals(quantity.getComparator())) {
+                    // Range high value is quantity value
+                    valueHigh = value;
+                } else { // QuantityComparator.LESS_THAN
+                    // Range high value is quantity value minus 1e-<scale+9>
+                    int scale = value.scale() < 0 ? 9 : value.scale()+9;
+                    valueHigh = value.subtract(new BigDecimal("1e-" + scale));
+                }
+            } else {
+                valueLow = NewNumberParmBehaviorUtil.generateLowerBound(value);
+                valueHigh = NewNumberParmBehaviorUtil.generateUpperBound(value);
+            }
             boolean addedCodeOrUnit = false;
 
             // see https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=19597
diff --git a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/type/NewNumberParmBehaviorUtil.java b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/type/NewNumberParmBehaviorUtil.java
index 961e1716f45..487a08e23d3 100644
--- a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/type/NewNumberParmBehaviorUtil.java
+++ b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/type/NewNumberParmBehaviorUtil.java
@@ -103,41 +103,41 @@ public static void addValue(WhereFragment whereClauseSegment, String tableAlias,
             // EB - Ends Before
             // the range of the search value does not overlap with the range of the target value,
             // and the range above the search value contains the range of the target value
-            buildEbOrSaClause(whereClauseSegment, tableAlias, columnBase, columnBase + _HIGH,
-                    LT, value, value);
+            buildEbOrSaClause(whereClauseSegment, tableAlias, columnBase + _HIGH,
+                    LT, lowerBound);
             break;
         case SA:
             // SA - Starts After
             // the range of the search value does not overlap with the range of the target value,
             // and the range below the search value contains the range of the target value
-            buildEbOrSaClause(whereClauseSegment, tableAlias, columnBase, columnBase + _LOW,
-                    GT, value, value);
+            buildEbOrSaClause(whereClauseSegment, tableAlias, columnBase + _LOW,
+                    GT, upperBound);
             break;
         case GE:
             // GE - Greater Than Equal
             // the range above the search value intersects (i.e. overlaps) with the range of the target value,
             // or the range of the search value fully contains the range of the target value
-            buildCommonClause(whereClauseSegment, tableAlias, columnBase, columnBase + _HIGH,
-                    GTE, value, value);
+            buildCommonClause(whereClauseSegment, tableAlias, columnBase, columnBase + _LOW,
+                    columnBase + _HIGH, GTE, value, lowerBound);
             break;
         case GT:
             // GT - Greater Than
             // the range above the search value intersects (i.e. overlaps) with the range of the target value
-            buildCommonClause(whereClauseSegment, tableAlias, columnBase, columnBase + _HIGH,
-                    GT, value, value);
+            buildCommonClause(whereClauseSegment, tableAlias, columnBase, columnBase + _LOW,
+                    columnBase + _HIGH, GT, value, lowerBound);
             break;
         case LE:
             // LE - Less Than Equal
             // the range below the search value intersects (i.e. overlaps) with the range of the target value
             // or the range of the search value fully contains the range of the target value
             buildCommonClause(whereClauseSegment, tableAlias, columnBase, columnBase + _LOW,
-                    LTE, value, value);
+                    columnBase + _HIGH, LTE, value, upperBound);
             break;
         case LT:
             // LT - Less Than
             // the range below the search value intersects (i.e. overlaps) with the range of the target value
             buildCommonClause(whereClauseSegment, tableAlias, columnBase, columnBase + _LOW,
-                    LT, value, value);
+                    columnBase + _HIGH, LT, value, upperBound);
             break;
         case AP:
             // AP - Approximate - Relative
@@ -169,19 +169,41 @@ public static void addValue(WhereFragment whereClauseSegment, String tableAlias,
      * @param whereClauseSegment
      * @param tableAlias
      * @param columnName
-     * @param columnNameLowOrHigh
+     * @param columnNameLow
+     * @param columnNameHigh
      * @param operator
      * @param value
      * @param bound
      */
     public static void buildCommonClause(WhereFragment whereClauseSegment, String tableAlias,
-            String columnName, String columnNameLowOrHigh, String operator, BigDecimal value, BigDecimal bound) {
+            String columnName, String columnNameLow, String columnNameHigh, String operator,
+            BigDecimal value, BigDecimal bound) {
+
+        Operator op = null;
+        Operator orEqualsOp = null;
+        if (GTE.equals(operator)) {
+            op = OperatorUtil.convert(GT);
+            orEqualsOp = OperatorUtil.convert(GTE);
+        } else if (LTE.equals(operator)) {
+            op = OperatorUtil.convert(LT);
+            orEqualsOp = OperatorUtil.convert(LTE);
+        } else {
+            op = OperatorUtil.convert(operator);
+        }
+        boolean gtOp = Operator.GT.equals(op);
 
-        Operator op = OperatorUtil.convert(operator);
         whereClauseSegment.leftParen();
-        whereClauseSegment.col(tableAlias, columnName).operator(op).bind(value);
+        whereClauseSegment.col(tableAlias, gtOp ? columnNameHigh : columnNameLow).operator(op).bind(value);
         whereClauseSegment.or();
-        whereClauseSegment.col(tableAlias, columnNameLowOrHigh).operator(op).bind(bound);
+        if (orEqualsOp != null) {
+            whereClauseSegment.col(tableAlias, gtOp ? columnNameLow : columnNameHigh).operator(orEqualsOp).bind(bound);
+        } else {
+            whereClauseSegment.col(tableAlias, gtOp ? columnNameLow : columnNameHigh).operator(op).bind(value);
+        }
+        whereClauseSegment.or();
+        whereClauseSegment.col(tableAlias, columnName).isNotNull();
+        whereClauseSegment.and();
+        whereClauseSegment.col(tableAlias, gtOp ? columnNameHigh : columnNameLow).isNull();
         whereClauseSegment.rightParen();
     }
 
@@ -189,17 +211,15 @@ public static void buildCommonClause(WhereFragment whereClauseSegment, String ta
      * the build eb or sa clause considers only _VALUE_LOW and _VALUE_HIGH
      * @param whereClauseSegment
      * @param tableAlias
-     * @param columnName
      * @param columnNameLowOrHigh
      * @param operator
-     * @param value
      * @param bound
      */
     public static void buildEbOrSaClause(WhereFragment whereClauseSegment, String tableAlias,
-            String columnName, String columnNameLowOrHigh, String operator, BigDecimal value, BigDecimal bound) {
+            String columnNameLowOrHigh, String operator, BigDecimal bound) {
 
         Operator op = OperatorUtil.convert(operator);
-        whereClauseSegment.col(tableAlias, columnNameLowOrHigh).operator(op).bind(value);
+        whereClauseSegment.col(tableAlias, columnNameLowOrHigh).operator(op).bind(bound);
     }
 
     /**
@@ -214,10 +234,6 @@ public static void buildEqualsRangeClause(WhereFragment whereClauseSegment, Stri
            String columnBase, BigDecimal lowerBound, BigDecimal upperBound) {
 
         whereClauseSegment.leftParen();
-        whereClauseSegment.col(tableAlias, columnBase).gte().bind(lowerBound);
-        whereClauseSegment.and();
-        whereClauseSegment.col(tableAlias, columnBase).lt().bind(upperBound);
-        whereClauseSegment.or();
         whereClauseSegment.col(tableAlias, columnBase + _LOW).gte().bind(lowerBound);
         whereClauseSegment.and();
         whereClauseSegment.col(tableAlias, columnBase + _HIGH).lte().bind(upperBound);
@@ -236,15 +252,61 @@ public static void buildEqualsRangeClause(WhereFragment whereClauseSegment, Stri
     public static void buildApproxRangeClause(WhereFragment whereClauseSegment, String tableAlias,
             String columnBase, BigDecimal lowerBound, BigDecimal upperBound, BigDecimal value) {
         BigDecimal factor = value.multiply(FACTOR);
+        BigDecimal approximateLowerBound = lowerBound.subtract(factor);
+        BigDecimal approximateUpperBound = upperBound.add(factor);
+
+        whereClauseSegment.leftParen();
+        
+        // The following clauses test for overlap when both xx_VALUE_HIGH and xx_VALUE_LOW are non-null.
+        // Example:
+        //      P2.QUANTITY_VALUE_HIGH >= 8.5
+        //  AND P2.QUANTITY_VALUE_LOW <= 11.5
+        whereClauseSegment.col(tableAlias, columnBase + _HIGH).gte().bind(approximateLowerBound);
+        whereClauseSegment.and();
+        whereClauseSegment.col(tableAlias, columnBase + _LOW).lte().bind(approximateUpperBound);
+        
+        // The following clauses test for overlap when the target is a Range data type and either
+        // xx_VALUE_HIGH or xx_VALUE_LOW is NULL (unknown bound).
+        // Example:
+        //   OR P2.QUANTITY_VALUE IS NULL
+        //  AND (P2.QUANTITY_VALUE_HIGH >= 8.5
+        //  AND P2.QUANTITY_VALUE_HIGH <= 11.5
+        //   OR P2.QUANTITY_VALUE_LOW >= 8.5
+        //  AND P2.QUANTITY_VALUE_LOW <= 11.5)
+        whereClauseSegment.or();
+        whereClauseSegment.col(tableAlias, columnBase).isNull();
+        whereClauseSegment.and();
+        whereClauseSegment.leftParen();
+        whereClauseSegment.col(tableAlias, columnBase + _HIGH).gte().bind(approximateLowerBound);
+        whereClauseSegment.and();
+        whereClauseSegment.col(tableAlias, columnBase + _HIGH).lte().bind(approximateUpperBound);
+        whereClauseSegment.or();
+        whereClauseSegment.col(tableAlias, columnBase + _LOW).gte().bind(approximateLowerBound);
+        whereClauseSegment.and();
+        whereClauseSegment.col(tableAlias, columnBase + _LOW).lte().bind(approximateUpperBound);
+        whereClauseSegment.rightParen();
 
+        // The following clauses test for overlap when the target is a Quantity data type and either
+        // xx_VALUE_HIGH or xx_VALUE_LOW is NULL (negative or positive infinity bound).
+        // Example:
+        //   OR P2.QUANTITY_VALUE IS NOT NULL
+        //  AND (P2.QUANTITY_VALUE_HIGH >= 8.5
+        //  AND P2.QUANTITY_VALUE_LOW IS NULL
+        //   OR P2.QUANTITY_VALUE_LOW <= 11.5
+        //  AND P2.QUANTITY_VALUE_HIGH IS NULL)
+        whereClauseSegment.or();
+        whereClauseSegment.col(tableAlias, columnBase).isNotNull();
+        whereClauseSegment.and();
         whereClauseSegment.leftParen();
-        whereClauseSegment.col(tableAlias, columnBase).gte().bind(lowerBound.subtract(factor)); // -10% of the Lower Bound
+        whereClauseSegment.col(tableAlias, columnBase + _HIGH).gte().bind(approximateLowerBound);
         whereClauseSegment.and();
-        whereClauseSegment.col(tableAlias, columnBase).lt().bind(upperBound.add(factor)); // +10% of the Upper Bound
+        whereClauseSegment.col(tableAlias, columnBase + _LOW).isNull();
         whereClauseSegment.or();
-        whereClauseSegment.col(tableAlias, columnBase + _LOW).lte().bind(upperBound);
+        whereClauseSegment.col(tableAlias, columnBase + _LOW).lte().bind(approximateUpperBound);
         whereClauseSegment.and();
-        whereClauseSegment.col(tableAlias, columnBase + _HIGH).gte().bind(lowerBound);
+        whereClauseSegment.col(tableAlias, columnBase + _HIGH).isNull();
+        whereClauseSegment.rightParen();
+        
         whereClauseSegment.rightParen();
     }
 
@@ -260,13 +322,13 @@ public static void buildNotEqualsRangeClause(WhereFragment whereClauseSegment, S
             String columnBase, BigDecimal lowerBound, BigDecimal upperBound) {
 
         whereClauseSegment.leftParen();
-        whereClauseSegment.col(tableAlias, columnBase).lt().bind(lowerBound);
-        whereClauseSegment.or();
-        whereClauseSegment.col(tableAlias, columnBase).gte().bind(upperBound);
-        whereClauseSegment.or();
         whereClauseSegment.col(tableAlias, columnBase + _LOW).lt().bind(lowerBound);
         whereClauseSegment.or();
+        whereClauseSegment.col(tableAlias, columnBase + _LOW).isNull();
+        whereClauseSegment.or();
         whereClauseSegment.col(tableAlias, columnBase + _HIGH).gt().bind(upperBound);
+        whereClauseSegment.or();
+        whereClauseSegment.col(tableAlias, columnBase + _HIGH).isNull();
         whereClauseSegment.rightParen();
     }
 
diff --git a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/type/NumberParmBehaviorUtil.java b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/type/NumberParmBehaviorUtil.java
index 9f8ff33d349..3ffec8671eb 100644
--- a/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/type/NumberParmBehaviorUtil.java
+++ b/fhir-persistence-jdbc/src/main/java/com/ibm/fhir/persistence/jdbc/util/type/NumberParmBehaviorUtil.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -43,6 +43,16 @@ private NumberParmBehaviorUtil() {
         // No operation
     }
 
+    /**
+     * Add the filter predicate logic to the given whereClauseSegment
+     * @param whereClauseSegment
+     * @param queryParm
+     * @param bindVariables
+     * @param resourceType
+     * @param tableAlias
+     * @param queryBuilder
+     * @throws FHIRPersistenceException
+     */
     public static void executeBehavior(StringBuilder whereClauseSegment, QueryParameter queryParm,
             List<Object> bindVariables, Class<?> resourceType, String tableAlias, JDBCQueryBuilder queryBuilder)
             throws FHIRPersistenceException {
@@ -95,6 +105,7 @@ public static void executeBehavior(StringBuilder whereClauseSegment, QueryParame
      * @param whereClauseSegment
      * @param bindVariables
      * @param tableAlias
+     * @param columnBase
      * @param prefix
      * @param value
      */
@@ -109,41 +120,37 @@ public static void addValue(StringBuilder whereClauseSegment, List<Object> bindV
             // EB - Ends Before
             // the range of the search value does not overlap with the range of the target value,
             // and the range above the search value contains the range of the target value
-            buildEbOrSaClause(whereClauseSegment, bindVariables, tableAlias, columnBase, columnBase + _HIGH,
-                    LT, value, value);
+            buildEbOrSaClause(whereClauseSegment, bindVariables, tableAlias, columnBase + _HIGH,
+                    LT, lowerBound);
             break;
         case SA:
             // SA - Starts After
             // the range of the search value does not overlap with the range of the target value,
             // and the range below the search value contains the range of the target value
-            buildEbOrSaClause(whereClauseSegment, bindVariables, tableAlias, columnBase, columnBase + _LOW,
-                    GT, value, value);
+            buildEbOrSaClause(whereClauseSegment, bindVariables, tableAlias, columnBase + _LOW,
+                    GT, upperBound);
             break;
         case GE:
             // GE - Greater Than Equal
             // the range above the search value intersects (i.e. overlaps) with the range of the target value,
             // or the range of the search value fully contains the range of the target value
-            buildCommonClause(whereClauseSegment, bindVariables, tableAlias, columnBase, columnBase + _HIGH,
-                    GTE, value, value);
+            buildCommonClause(whereClauseSegment, bindVariables, tableAlias, columnBase, GTE, value, lowerBound);
             break;
         case GT:
             // GT - Greater Than
             // the range above the search value intersects (i.e. overlaps) with the range of the target value
-            buildCommonClause(whereClauseSegment, bindVariables, tableAlias, columnBase, columnBase + _HIGH,
-                    GT, value, value);
+            buildCommonClause(whereClauseSegment, bindVariables, tableAlias, columnBase, GT, value, lowerBound);
             break;
         case LE:
             // LE - Less Than Equal
             // the range below the search value intersects (i.e. overlaps) with the range of the target value
             // or the range of the search value fully contains the range of the target value
-            buildCommonClause(whereClauseSegment, bindVariables, tableAlias, columnBase, columnBase + _LOW,
-                    LTE, value, value);
+            buildCommonClause(whereClauseSegment, bindVariables, tableAlias, columnBase, LTE, value, upperBound);
             break;
         case LT:
             // LT - Less Than
             // the range below the search value intersects (i.e. overlaps) with the range of the target value
-            buildCommonClause(whereClauseSegment, bindVariables, tableAlias, columnBase, columnBase + _LOW,
-                    LT, value, value);
+            buildCommonClause(whereClauseSegment, bindVariables, tableAlias, columnBase, LT, value, upperBound);
             break;
         case AP:
             // AP - Approximate - Relative
@@ -176,22 +183,38 @@ public static void addValue(StringBuilder whereClauseSegment, List<Object> bindV
      * @param whereClauseSegment
      * @param bindVariables
      * @param tableAlias
-     * @param columnName
-     * @param columnNameLowOrHigh
+     * @param columnBase
      * @param operator
      * @param value
+     * @param bound
      */
     public static void buildCommonClause(StringBuilder whereClauseSegment, List<Object> bindVariables, String tableAlias,
-            String columnName, String columnNameLowOrHigh, String operator, BigDecimal value, BigDecimal bound) {
+            String columnBase, String operator, BigDecimal value, BigDecimal bound) {
+        
+        String orEqualsOperator = null;
+        if (GTE.equals(operator)) {
+            operator = GT;
+            orEqualsOperator = GTE;
+        } else if (LTE.equals(operator)) {
+            operator = LT;
+            orEqualsOperator = LTE;
+        }
+        boolean gtOp = GT.equals(operator);
+        
         whereClauseSegment
-                .append(LEFT_PAREN)
-                .append(tableAlias).append(DOT).append(columnName).append(operator).append(BIND_VAR)
+            .append(LEFT_PAREN)
+                .append(tableAlias).append(DOT).append(gtOp ? columnBase + _HIGH : columnBase + _LOW).append(operator).append(BIND_VAR)
                 .append(OR)
-                .append(tableAlias).append(DOT).append(columnNameLowOrHigh).append(operator).append(BIND_VAR)
-                .append(RIGHT_PAREN);
+                .append(tableAlias).append(DOT).append(gtOp ? columnBase + _LOW : columnBase + _HIGH)
+                .append(orEqualsOperator != null ? orEqualsOperator : operator).append(BIND_VAR)
+                .append(OR)
+                .append(tableAlias).append(DOT).append(columnBase).append(" IS NOT NULL")
+                .append(AND)
+                .append(tableAlias).append(DOT).append(gtOp ? columnBase + _HIGH : columnBase + _LOW).append(" IS NULL")
+            .append(RIGHT_PAREN);
 
         bindVariables.add(value);
-        bindVariables.add(bound);
+        bindVariables.add(orEqualsOperator != null ? bound : value);
     }
     
     /**
@@ -200,94 +223,136 @@ public static void buildCommonClause(StringBuilder whereClauseSegment, List<Obje
      * @param whereClauseSegment
      * @param bindVariables
      * @param tableAlias
-     * @param columnName
      * @param columnNameLowOrHigh
      * @param operator
-     * @param value
+     * @param bound
      */
     public static void buildEbOrSaClause(StringBuilder whereClauseSegment, List<Object> bindVariables, String tableAlias,
-            String columnName, String columnNameLowOrHigh, String operator, BigDecimal value, BigDecimal bound) {
+            String columnNameLowOrHigh, String operator, BigDecimal bound) {
         whereClauseSegment.append(tableAlias).append(DOT).append(columnNameLowOrHigh).append(operator).append(BIND_VAR);
-        bindVariables.add(value);
+        bindVariables.add(bound);
     }
     
+    /**
+     * Add the equals range clause to the given whereClauseSegment
+     * @param whereClauseSegment
+     * @param bindVariables
+     * @param tableAlias
+     * @param columnBase
+     * @param lowerBound
+     * @param upperBound
+     */
     public static void buildEqualsRangeClause(StringBuilder whereClauseSegment, List<Object> bindVariables, String tableAlias,
            String columnBase, BigDecimal lowerBound, BigDecimal upperBound) {
         whereClauseSegment
             .append(LEFT_PAREN)
-                .append(LEFT_PAREN)
-                    .append(tableAlias).append(DOT).append(columnBase).append(GTE).append(BIND_VAR)
-                    .append(AND)
-                    .append(tableAlias).append(DOT).append(columnBase).append(LT).append(BIND_VAR)
-                .append(RIGHT_PAREN)
-                .append(OR)
-                .append(LEFT_PAREN)
-                    .append(tableAlias).append(DOT).append(columnBase + _LOW).append(GTE).append(BIND_VAR)
-                    .append(AND)
-                    .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(LTE).append(BIND_VAR)
-                .append(RIGHT_PAREN)
+                .append(tableAlias).append(DOT).append(columnBase + _LOW).append(GTE).append(BIND_VAR)
+                .append(AND)
+                .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(LTE).append(BIND_VAR)
             .append(RIGHT_PAREN);
 
         bindVariables.add(lowerBound);
         bindVariables.add(upperBound);
-        bindVariables.add(lowerBound);
-        bindVariables.add(upperBound);
     }
     
+    /**
+     * Add the approx range clause to the given whereClauseSegment
+     * @param whereClauseSegment
+     * @param bindVariables
+     * @param tableAlias
+     * @param columnBase
+     * @param lowerBound
+     * @param upperBound
+     * @param value
+     */
     public static void buildApproxRangeClause(StringBuilder whereClauseSegment, List<Object> bindVariables, String tableAlias,
             String columnBase, BigDecimal lowerBound, BigDecimal upperBound, BigDecimal value) {
         BigDecimal factor = value.multiply(FACTOR);
+        BigDecimal approximateLowerBound = lowerBound.subtract(factor);
+        BigDecimal approximateUpperBound = upperBound.add(factor);
+
         whereClauseSegment
-             .append(LEFT_PAREN)
-                 .append(LEFT_PAREN)
-                     .append(tableAlias).append(DOT).append(columnBase).append(GTE).append(BIND_VAR)
-                     .append(AND)
-                     .append(tableAlias).append(DOT).append(columnBase).append(LT).append(BIND_VAR)
-                 .append(RIGHT_PAREN)
-                 .append(OR)
-                 .append(LEFT_PAREN)
-                     .append(tableAlias).append(DOT).append(columnBase + _LOW).append(LTE).append(BIND_VAR)
-                     .append(AND)
-                     .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(GTE).append(BIND_VAR)
-                 .append(RIGHT_PAREN)
-             .append(RIGHT_PAREN);
+            .append(LEFT_PAREN)
+                .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(GTE).append(BIND_VAR)
+                .append(AND)
+                .append(tableAlias).append(DOT).append(columnBase + _LOW).append(LTE).append(BIND_VAR)
+                .append(OR)
+                .append(tableAlias).append(DOT).append(columnBase).append(" IS NULL")
+                .append(AND)
+                .append(LEFT_PAREN)
+                    .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(GTE).append(BIND_VAR)
+                    .append(AND)
+                    .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(LTE).append(BIND_VAR)
+                    .append(OR)
+                    .append(tableAlias).append(DOT).append(columnBase + _LOW).append(GTE).append(BIND_VAR)
+                    .append(AND)
+                    .append(tableAlias).append(DOT).append(columnBase + _LOW).append(LTE).append(BIND_VAR)
+                .append(RIGHT_PAREN)
+                .append(OR)
+                .append(tableAlias).append(DOT).append(columnBase).append(" IS NOT NULL")
+                .append(AND)
+                .append(LEFT_PAREN)
+                    .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(GTE).append(BIND_VAR)
+                    .append(AND)
+                    .append(tableAlias).append(DOT).append(columnBase + _LOW).append(" IS NULL")
+                    .append(OR)
+                    .append(tableAlias).append(DOT).append(columnBase + _LOW).append(LTE).append(BIND_VAR)
+                    .append(AND)
+                    .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(" IS NULL")
+                .append(RIGHT_PAREN)
+            .append(RIGHT_PAREN);
 
-        // -10% of the Lower Bound
-        bindVariables.add(lowerBound.subtract(factor));
-        // +10% of the Upper Bound
-        bindVariables.add(upperBound.add(factor));
-        bindVariables.add(upperBound);
-        bindVariables.add(lowerBound);
+        bindVariables.add(approximateLowerBound);
+        bindVariables.add(approximateUpperBound);
+        bindVariables.add(approximateLowerBound);
+        bindVariables.add(approximateUpperBound);
+        bindVariables.add(approximateLowerBound);
+        bindVariables.add(approximateUpperBound);
+        bindVariables.add(approximateLowerBound);
+        bindVariables.add(approximateUpperBound);
     }
     
+    /**
+     * Add the not-equals range clause to the given whereClauseSegment
+     * @param whereClauseSegment
+     * @param bindVariables
+     * @param tableAlias
+     * @param columnBase
+     * @param lowerBound
+     * @param upperBound
+     */
     public static void buildNotEqualsRangeClause(StringBuilder whereClauseSegment, List<Object> bindVariables, String tableAlias,
             String columnBase, BigDecimal lowerBound, BigDecimal upperBound) {
         whereClauseSegment
-             .append(LEFT_PAREN)
-                 .append(LEFT_PAREN)
-                     .append(tableAlias).append(DOT).append(columnBase).append(LT).append(BIND_VAR)
-                     .append(OR)
-                     .append(tableAlias).append(DOT).append(columnBase).append(GTE).append(BIND_VAR)
-                 .append(RIGHT_PAREN)
-                 .append(OR)
-                 .append(LEFT_PAREN)
-                     .append(tableAlias).append(DOT).append(columnBase + _LOW).append(LT).append(BIND_VAR)
-                     .append(OR)
-                     .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(GT).append(BIND_VAR)
-                 .append(RIGHT_PAREN)
-             .append(RIGHT_PAREN);
+            .append(LEFT_PAREN)
+                .append(tableAlias).append(DOT).append(columnBase + _LOW).append(LT).append(BIND_VAR)
+                .append(OR)
+                .append(tableAlias).append(DOT).append(columnBase + _LOW).append(" IS NULL")
+                .append(OR)
+                .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(GT).append(BIND_VAR)
+                .append(OR)
+                .append(tableAlias).append(DOT).append(columnBase + _HIGH).append(" IS NULL")
+            .append(RIGHT_PAREN);
 
         bindVariables.add(lowerBound);
         bindVariables.add(upperBound);
-        bindVariables.add(lowerBound);
-        bindVariables.add(upperBound);
     }
 
+    /**
+     * Generate the lower bound for the given value
+     * @param original
+     * @return
+     */
     public static BigDecimal generateLowerBound(BigDecimal original) {
         BigDecimal scaleFactor = new BigDecimal("5e" + -1 * (original.scale() + 1));
         return original.subtract(scaleFactor);
     }
 
+    /**
+     * Generate the upper bound for the given value
+     * @param original
+     * @return
+     */
     public static BigDecimal generateUpperBound(BigDecimal original) {
         BigDecimal scaleFactor = new BigDecimal("5e" + -1 * (original.scale() + 1));
         return original.add(scaleFactor);
diff --git a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/spec/Main.java b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/spec/Main.java
index d9ed24ede77..390bfa78ab3 100644
--- a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/spec/Main.java
+++ b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/spec/Main.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -19,10 +19,10 @@
 import java.util.logging.Level;
 import java.util.logging.Logger;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
 
 import com.ibm.fhir.config.DefaultFHIRConfigProvider;
 import com.ibm.fhir.config.FHIRConfigProvider;
diff --git a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/NewNumberParmBehaviorUtilTest.java b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/NewNumberParmBehaviorUtilTest.java
index c72674793f1..e0de8f0c4ac 100644
--- a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/NewNumberParmBehaviorUtilTest.java
+++ b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/NewNumberParmBehaviorUtilTest.java
@@ -133,7 +133,8 @@ public void testPrecisionWithExact() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        String expectedSql = "(Basic.NUMBER_VALUE > ? OR Basic.NUMBER_VALUE_HIGH > ?)";
+        String expectedSql = "(Basic.NUMBER_VALUE_HIGH > ? OR Basic.NUMBER_VALUE_LOW > ? "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND Basic.NUMBER_VALUE_HIGH IS NULL)";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // lt - Less Than
@@ -141,36 +142,39 @@ public void testPrecisionWithExact() throws FHIRPersistenceException {
         expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedSql = "(Basic.NUMBER_VALUE < ? OR Basic.NUMBER_VALUE_LOW < ?)";
+        expectedSql = "(Basic.NUMBER_VALUE_LOW < ? OR Basic.NUMBER_VALUE_HIGH < ? "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND Basic.NUMBER_VALUE_LOW IS NULL)";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // ge - Greater than Equal
         queryParm             = generateParameter(SearchConstants.Prefix.GE, null, "1e3");
         expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedSql = "(Basic.NUMBER_VALUE >= ? OR Basic.NUMBER_VALUE_HIGH >= ?)";
+        expectedBindVariables.add(new BigDecimal("5E+2"));
+        expectedSql = "(Basic.NUMBER_VALUE_HIGH > ? OR Basic.NUMBER_VALUE_LOW >= ? "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND Basic.NUMBER_VALUE_HIGH IS NULL)";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // le - Less than Equal
         queryParm             = generateParameter(SearchConstants.Prefix.LE, null, "1e3");
         expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedSql = "(Basic.NUMBER_VALUE <= ? OR Basic.NUMBER_VALUE_LOW <= ?)";
+        expectedBindVariables.add(new BigDecimal("1.5E+3"));
+        expectedSql = "(Basic.NUMBER_VALUE_LOW < ? OR Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND Basic.NUMBER_VALUE_LOW IS NULL)";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // sa - starts after
         queryParm             = generateParameter(SearchConstants.Prefix.SA, null, "1e3");
         expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1E+3"));
+        expectedBindVariables.add(new BigDecimal("1.5E+3"));
         expectedSql = "Basic.NUMBER_VALUE_LOW > ?";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // eb - Ends before
         queryParm             = generateParameter(SearchConstants.Prefix.EB, null, "1e3");
         expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1E+3"));
+        expectedBindVariables.add(new BigDecimal("5E+2"));
         expectedSql = "Basic.NUMBER_VALUE_HIGH < ?";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
@@ -181,7 +185,7 @@ public void testPrecisionIntegerWithStartsAfter() throws FHIRPersistenceExceptio
         QueryParameter queryParm =
                 generateParameter(SearchConstants.Prefix.SA, null, "window-end", new String[] { "1" });
         List<Object> expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1"));
+        expectedBindVariables.add(new BigDecimal("1.5"));
         String expectedSql = "MolecularSequence.NUMBER_VALUE_LOW > ?";
         runTest(queryParm, expectedBindVariables, expectedSql, "MolecularSequence", MolecularSequence.class);
     }
@@ -192,7 +196,7 @@ public void testPrecisionIntegerWithEndsBefore() throws FHIRPersistenceException
         QueryParameter queryParm =
                 generateParameter(SearchConstants.Prefix.EB, null, "window-end", new String[] { "1" });
         List<Object> expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1"));
+        expectedBindVariables.add(new BigDecimal("0.5"));
         String expectedSql = "MolecularSequence.NUMBER_VALUE_HIGH < ?";
         runTest(queryParm, expectedBindVariables, expectedSql, "MolecularSequence", MolecularSequence.class);
     }
@@ -214,10 +218,7 @@ public void testPrecisionWithEqual() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal(99.5));
         expectedBindVariables.add(new BigDecimal(100.5));
-        expectedBindVariables.add(new BigDecimal(99.5));
-        expectedBindVariables.add(new BigDecimal(100.5));
-        String expectedSql = "(Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ? "
-                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?)";
+        String expectedSql = "(Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?)";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -238,14 +239,10 @@ public void testPrecisionWithMultipleValuesForEqual() throws FHIRPersistenceExce
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("99.5"));
         expectedBindVariables.add(new BigDecimal("100.5"));
-        expectedBindVariables.add(new BigDecimal("99.5"));
-        expectedBindVariables.add(new BigDecimal("100.5"));
         expectedBindVariables.add(new BigDecimal("0.995"));
         expectedBindVariables.add(new BigDecimal("1.005"));
-        expectedBindVariables.add(new BigDecimal("0.995"));
-        expectedBindVariables.add(new BigDecimal("1.005"));
-        String expectedSql = "(Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ? OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?)"
-                + " OR (Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ? OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?)";
+        String expectedSql = "(Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?) "
+                + "OR (Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?)";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -263,9 +260,8 @@ public void testPrecisionWithNotEqual() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal(99.5));
         expectedBindVariables.add(new BigDecimal(100.5));
-        expectedBindVariables.add(new BigDecimal(99.5));
-        expectedBindVariables.add(new BigDecimal(100.5));
-        String expectedSql = "(Basic.NUMBER_VALUE < ? OR Basic.NUMBER_VALUE >= ? OR Basic.NUMBER_VALUE_LOW < ? OR Basic.NUMBER_VALUE_HIGH > ?)";
+        String expectedSql = "(Basic.NUMBER_VALUE_LOW < ? OR Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_HIGH > ? OR Basic.NUMBER_VALUE_HIGH IS NULL)";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -281,11 +277,18 @@ public void testPrecisionWithApprox() throws FHIRPersistenceException {
         QueryParameter queryParm = generateParameter(SearchConstants.Prefix.AP, null, "100");
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("89.5"));  // V >= lowerBound - factor
-        expectedBindVariables.add(new BigDecimal("110.5")); // V <  upperBound + factor
-        expectedBindVariables.add(new BigDecimal("100.5")); // L <= upperBound
-        expectedBindVariables.add(new BigDecimal("99.5"));  // H >= lowerBound
-        String expectedSql = "(Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ? "
-                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?)";
+        expectedBindVariables.add(new BigDecimal("110.5")); // V <= upperBound + factor
+        expectedBindVariables.add(new BigDecimal("89.5"));  // V >= lowerBound - factor
+        expectedBindVariables.add(new BigDecimal("110.5")); // V <= upperBound + factor
+        expectedBindVariables.add(new BigDecimal("89.5"));  // V >= lowerBound - factor
+        expectedBindVariables.add(new BigDecimal("110.5")); // V <= upperBound + factor
+        expectedBindVariables.add(new BigDecimal("89.5"));  // V >= lowerBound - factor
+        expectedBindVariables.add(new BigDecimal("110.5")); // V <= upperBound + factor
+        String expectedSql = "(Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -302,10 +305,17 @@ public void testPrecisionWithApproxNumberOne() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("0.4"));
         expectedBindVariables.add(new BigDecimal("1.6"));
-        expectedBindVariables.add(new BigDecimal("1.5"));
-        expectedBindVariables.add(new BigDecimal("0.5"));
-        String expectedSql = "(Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ? "
-                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?)";
+        expectedBindVariables.add(new BigDecimal("0.4"));
+        expectedBindVariables.add(new BigDecimal("1.6"));
+        expectedBindVariables.add(new BigDecimal("0.4"));
+        expectedBindVariables.add(new BigDecimal("1.6"));
+        expectedBindVariables.add(new BigDecimal("0.4"));
+        expectedBindVariables.add(new BigDecimal("1.6"));
+        String expectedSql = "(Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -324,9 +334,17 @@ public void testPrecisionWithMultipleSameApprox() throws FHIRPersistenceExceptio
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("89.5"));
         expectedBindVariables.add(new BigDecimal("110.5"));
-        expectedBindVariables.add(new BigDecimal("100.5"));
-        expectedBindVariables.add(new BigDecimal("99.5"));
-        String expectedSql = "(Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ? OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?)";
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        String expectedSql = "(Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -342,15 +360,31 @@ public void testPrecisionWithMultipleDifferentApprox() throws FHIRPersistenceExc
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("89.5"));
         expectedBindVariables.add(new BigDecimal("110.5"));
-        expectedBindVariables.add(new BigDecimal("100.5"));
-        expectedBindVariables.add(new BigDecimal("99.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.995"));
+        expectedBindVariables.add(new BigDecimal("110.005"));
+        expectedBindVariables.add(new BigDecimal("89.995"));
+        expectedBindVariables.add(new BigDecimal("110.005"));
+        expectedBindVariables.add(new BigDecimal("89.995"));
+        expectedBindVariables.add(new BigDecimal("110.005"));
         expectedBindVariables.add(new BigDecimal("89.995"));
         expectedBindVariables.add(new BigDecimal("110.005"));
-        expectedBindVariables.add(new BigDecimal("100.005"));
-        expectedBindVariables.add(new BigDecimal("99.995"));
         String expectedSql =
-                "(Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ? OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?) "
-                + "OR (Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ? OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?)";
+                "(Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL)) "
+                + "OR (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -442,10 +476,7 @@ public void testPrecisionIntegerWithEQ() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("0.5"));
         expectedBindVariables.add(new BigDecimal("1.5"));
-        expectedBindVariables.add(new BigDecimal("0.5"));
-        expectedBindVariables.add(new BigDecimal("1.5"));
-        String expectedSql = "(MolecularSequence.NUMBER_VALUE >= ? AND MolecularSequence.NUMBER_VALUE < ? "
-                + "OR MolecularSequence.NUMBER_VALUE_LOW >= ? AND MolecularSequence.NUMBER_VALUE_HIGH <= ?)";
+        String expectedSql = "(MolecularSequence.NUMBER_VALUE_LOW >= ? AND MolecularSequence.NUMBER_VALUE_HIGH <= ?)";
         runTest(queryParm, expectedBindVariables, expectedSql, "MolecularSequence", MolecularSequence.class);
     }
 
@@ -457,10 +488,8 @@ public void testPrecisionIntegerWithNE() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("0.5"));
         expectedBindVariables.add(new BigDecimal("1.5"));
-        expectedBindVariables.add(new BigDecimal("0.5"));
-        expectedBindVariables.add(new BigDecimal("1.5"));
-        String expectedSql = "(MolecularSequence.NUMBER_VALUE < ? OR MolecularSequence.NUMBER_VALUE >= ? "
-                + "OR MolecularSequence.NUMBER_VALUE_LOW < ? OR MolecularSequence.NUMBER_VALUE_HIGH > ?)";
+        String expectedSql = "(MolecularSequence.NUMBER_VALUE_LOW < ? OR MolecularSequence.NUMBER_VALUE_LOW IS NULL "
+                + "OR MolecularSequence.NUMBER_VALUE_HIGH > ? OR MolecularSequence.NUMBER_VALUE_HIGH IS NULL)";
         runTest(queryParm, expectedBindVariables, expectedSql, "MolecularSequence", MolecularSequence.class);
     }
 }
\ No newline at end of file
diff --git a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/NumberParmBehaviorUtilTest.java b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/NumberParmBehaviorUtilTest.java
index 8a6cd70183a..0a7dd488d46 100644
--- a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/NumberParmBehaviorUtilTest.java
+++ b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/NumberParmBehaviorUtilTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -123,7 +123,8 @@ public void testPrecisionWithExact() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        String expectedSql = " AND ((Basic.NUMBER_VALUE > ? OR Basic.NUMBER_VALUE_HIGH > ?)))";
+        String expectedSql = " AND ((Basic.NUMBER_VALUE_HIGH > ? OR Basic.NUMBER_VALUE_LOW > ? "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND Basic.NUMBER_VALUE_HIGH IS NULL)))";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // lt - Less Than
@@ -131,38 +132,39 @@ public void testPrecisionWithExact() throws FHIRPersistenceException {
         expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedSql = " AND ((Basic.NUMBER_VALUE < ? OR Basic.NUMBER_VALUE_LOW < ?)))";
+        expectedSql = " AND ((Basic.NUMBER_VALUE_LOW < ? OR Basic.NUMBER_VALUE_HIGH < ? "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND Basic.NUMBER_VALUE_LOW IS NULL)))";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // ge - Greater than Equal
         queryParm             = generateParameter(SearchConstants.Prefix.GE, null, "1e3");
         expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedSql = " AND ((Basic.NUMBER_VALUE >= ? OR Basic.NUMBER_VALUE_HIGH >= ?)))";
+        expectedBindVariables.add(new BigDecimal("5E+2"));
+        expectedSql = " AND ((Basic.NUMBER_VALUE_HIGH > ? OR Basic.NUMBER_VALUE_LOW >= ? "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND Basic.NUMBER_VALUE_HIGH IS NULL)))";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // le - Less than Equal
         queryParm             = generateParameter(SearchConstants.Prefix.LE, null, "1e3");
         expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedSql = " AND ((Basic.NUMBER_VALUE <= ? OR Basic.NUMBER_VALUE_LOW <= ?)))";
+        expectedBindVariables.add(new BigDecimal("1.5E+3"));
+        expectedSql = " AND ((Basic.NUMBER_VALUE_LOW < ? OR Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND Basic.NUMBER_VALUE_LOW IS NULL)))";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // sa - starts after
         queryParm             = generateParameter(SearchConstants.Prefix.SA, null, "1e3");
         expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
+        expectedBindVariables.add(new BigDecimal("1.5E+3"));
         expectedSql = " AND (Basic.NUMBER_VALUE_LOW > ?))";
         runTest(queryParm, expectedBindVariables, expectedSql);
 
         // eb - Ends before
         queryParm             = generateParameter(SearchConstants.Prefix.EB, null, "1e3");
         expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
+        expectedBindVariables.add(new BigDecimal("5E+2"));
         expectedSql = " AND (Basic.NUMBER_VALUE_HIGH < ?))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
@@ -173,8 +175,7 @@ public void testPrecisionIntegerWithStartsAfter() throws FHIRPersistenceExceptio
         QueryParameter queryParm =
                 generateParameter(SearchConstants.Prefix.SA, null, "window-end", new String[] { "1" });
         List<Object> expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1"));
-        expectedBindVariables.add(new BigDecimal("1"));
+        expectedBindVariables.add(new BigDecimal("1.5"));
         String expectedSql = " AND (MolecularSequence.NUMBER_VALUE_LOW > ?))";
         runTest(queryParm, expectedBindVariables, expectedSql, "MolecularSequence", MolecularSequence.class);
     }
@@ -185,8 +186,7 @@ public void testPrecisionIntegerWithEndsBefore() throws FHIRPersistenceException
         QueryParameter queryParm =
                 generateParameter(SearchConstants.Prefix.EB, null, "window-end", new String[] { "1" });
         List<Object> expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1"));
-        expectedBindVariables.add(new BigDecimal("1"));
+        expectedBindVariables.add(new BigDecimal("0.5"));
         String expectedSql = " AND (MolecularSequence.NUMBER_VALUE_HIGH < ?))";
         runTest(queryParm, expectedBindVariables, expectedSql, "MolecularSequence", MolecularSequence.class);
     }
@@ -208,10 +208,7 @@ public void testPrecisionWithEqual() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal(99.5));
         expectedBindVariables.add(new BigDecimal(100.5));
-        expectedBindVariables.add(new BigDecimal(99.5));
-        expectedBindVariables.add(new BigDecimal(100.5));
-        String expectedSql = " AND (((Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ?) "
-                + "OR (Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?))))";
+        String expectedSql = " AND ((Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?)))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -232,14 +229,10 @@ public void testPrecisionWithMultipleValuesForEqual() throws FHIRPersistenceExce
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("99.5"));
         expectedBindVariables.add(new BigDecimal("100.5"));
-        expectedBindVariables.add(new BigDecimal("99.5"));
-        expectedBindVariables.add(new BigDecimal("100.5"));
         expectedBindVariables.add(new BigDecimal("0.995"));
         expectedBindVariables.add(new BigDecimal("1.005"));
-        expectedBindVariables.add(new BigDecimal("0.995"));
-        expectedBindVariables.add(new BigDecimal("1.005"));
-        String expectedSql = " AND (((Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ?) OR (Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?)))"
-                + " OR (((Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ?) OR (Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?))))";
+        String expectedSql = " AND ((Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?)) "
+                + "OR ((Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_HIGH <= ?)))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -257,9 +250,8 @@ public void testPrecisionWithNotEqual() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal(99.5));
         expectedBindVariables.add(new BigDecimal(100.5));
-        expectedBindVariables.add(new BigDecimal(99.5));
-        expectedBindVariables.add(new BigDecimal(100.5));
-        String expectedSql = " AND (((Basic.NUMBER_VALUE < ? OR Basic.NUMBER_VALUE >= ?) OR (Basic.NUMBER_VALUE_LOW < ? OR Basic.NUMBER_VALUE_HIGH > ?))))";
+        String expectedSql = " AND ((Basic.NUMBER_VALUE_LOW < ? OR Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_HIGH > ? OR Basic.NUMBER_VALUE_HIGH IS NULL)))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -276,10 +268,17 @@ public void testPrecisionWithApprox() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("89.5"));
         expectedBindVariables.add(new BigDecimal("110.5"));
-        expectedBindVariables.add(new BigDecimal("99.5"));
-        expectedBindVariables.add(new BigDecimal("100.5"));
-        String expectedSql = " AND (((Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ?) "
-                + "OR (Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?))))";
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        String expectedSql = " AND ((Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL))))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -296,10 +295,17 @@ public void testPrecisionWithApproxNumberOne() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("0.4"));
         expectedBindVariables.add(new BigDecimal("1.6"));
-        expectedBindVariables.add(new BigDecimal("1.5"));
-        expectedBindVariables.add(new BigDecimal("0.5"));
-        String expectedSql = " AND (((Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ?) "
-                + "OR (Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?))))";
+        expectedBindVariables.add(new BigDecimal("0.4"));
+        expectedBindVariables.add(new BigDecimal("1.6"));
+        expectedBindVariables.add(new BigDecimal("0.4"));
+        expectedBindVariables.add(new BigDecimal("1.6"));
+        expectedBindVariables.add(new BigDecimal("0.4"));
+        expectedBindVariables.add(new BigDecimal("1.6"));
+        String expectedSql = " AND ((Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL))))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -318,9 +324,17 @@ public void testPrecisionWithMultipleSameApprox() throws FHIRPersistenceExceptio
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("89.5"));
         expectedBindVariables.add(new BigDecimal("110.5"));
-        expectedBindVariables.add(new BigDecimal("99.5"));
-        expectedBindVariables.add(new BigDecimal("100.5"));
-        String expectedSql = " AND (((Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ?) OR (Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?))))";
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        String expectedSql = " AND ((Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL))))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -336,15 +350,31 @@ public void testPrecisionWithMultipleDifferentApprox() throws FHIRPersistenceExc
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("89.5"));
         expectedBindVariables.add(new BigDecimal("110.5"));
-        expectedBindVariables.add(new BigDecimal("99.5"));
-        expectedBindVariables.add(new BigDecimal("100.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.5"));
+        expectedBindVariables.add(new BigDecimal("110.5"));
+        expectedBindVariables.add(new BigDecimal("89.995"));
+        expectedBindVariables.add(new BigDecimal("110.005"));
+        expectedBindVariables.add(new BigDecimal("89.995"));
+        expectedBindVariables.add(new BigDecimal("110.005"));
+        expectedBindVariables.add(new BigDecimal("89.995"));
+        expectedBindVariables.add(new BigDecimal("110.005"));
         expectedBindVariables.add(new BigDecimal("89.995"));
         expectedBindVariables.add(new BigDecimal("110.005"));
-        expectedBindVariables.add(new BigDecimal("99.995"));
-        expectedBindVariables.add(new BigDecimal("100.005"));
         String expectedSql =
-                " AND (((Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ?) OR (Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?))) "
-                + "OR (((Basic.NUMBER_VALUE >= ? AND Basic.NUMBER_VALUE < ?) OR (Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH >= ?))))";
+                " AND ((Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL))) "
+                + "OR ((Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW <= ? "
+                + "OR Basic.NUMBER_VALUE IS NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_HIGH <= ? "
+                + "OR Basic.NUMBER_VALUE_LOW >= ? AND Basic.NUMBER_VALUE_LOW <= ?) "
+                + "OR Basic.NUMBER_VALUE IS NOT NULL AND (Basic.NUMBER_VALUE_HIGH >= ? AND Basic.NUMBER_VALUE_LOW IS NULL "
+                + "OR Basic.NUMBER_VALUE_LOW <= ? AND Basic.NUMBER_VALUE_HIGH IS NULL))))";
         runTest(queryParm, expectedBindVariables, expectedSql);
     }
 
@@ -436,10 +466,7 @@ public void testPrecisionIntegerWithEQ() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("0.5"));
         expectedBindVariables.add(new BigDecimal("1.5"));
-        expectedBindVariables.add(new BigDecimal("0.5"));
-        expectedBindVariables.add(new BigDecimal("1.5"));
-        String expectedSql = " AND (((MolecularSequence.NUMBER_VALUE >= ? AND MolecularSequence.NUMBER_VALUE < ?) "
-                + "OR (MolecularSequence.NUMBER_VALUE_LOW >= ? AND MolecularSequence.NUMBER_VALUE_HIGH <= ?))))";
+        String expectedSql = " AND ((MolecularSequence.NUMBER_VALUE_LOW >= ? AND MolecularSequence.NUMBER_VALUE_HIGH <= ?)))";
         runTest(queryParm, expectedBindVariables, expectedSql, "MolecularSequence", MolecularSequence.class);
     }
 
@@ -451,10 +478,8 @@ public void testPrecisionIntegerWithNE() throws FHIRPersistenceException {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("0.5"));
         expectedBindVariables.add(new BigDecimal("1.5"));
-        expectedBindVariables.add(new BigDecimal("0.5"));
-        expectedBindVariables.add(new BigDecimal("1.5"));
-        String expectedSql = " AND (((MolecularSequence.NUMBER_VALUE < ? OR MolecularSequence.NUMBER_VALUE >= ?) "
-                + "OR (MolecularSequence.NUMBER_VALUE_LOW < ? OR MolecularSequence.NUMBER_VALUE_HIGH > ?))))";
+        String expectedSql = " AND ((MolecularSequence.NUMBER_VALUE_LOW < ? OR MolecularSequence.NUMBER_VALUE_LOW IS NULL "
+                + "OR MolecularSequence.NUMBER_VALUE_HIGH > ? OR MolecularSequence.NUMBER_VALUE_HIGH IS NULL)))";
         runTest(queryParm, expectedBindVariables, expectedSql, "MolecularSequence", MolecularSequence.class);
     }
 }
\ No newline at end of file
diff --git a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/QuantityParmBehaviorUtilTest.java b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/QuantityParmBehaviorUtilTest.java
index 5e8c86fcaad..e2b14b26d5e 100644
--- a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/QuantityParmBehaviorUtilTest.java
+++ b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/QuantityParmBehaviorUtilTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -341,7 +341,9 @@ public void testHandleQuantityRangeComparisonWithExact() throws Exception {
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
         String expectedSql =
-                " AND (((Basic.QUANTITY_VALUE > ? OR Basic.QUANTITY_VALUE_HIGH > ?) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+                " AND (((Basic.QUANTITY_VALUE_HIGH > ? OR Basic.QUANTITY_VALUE_LOW > ? "
+                + "OR Basic.QUANTITY_VALUE IS NOT NULL AND Basic.QUANTITY_VALUE_HIGH IS NULL) "
+                + "AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -354,7 +356,9 @@ public void testHandleQuantityRangeComparisonWithExact() throws Exception {
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
         expectedSql =
-                " AND (((Basic.QUANTITY_VALUE < ? OR Basic.QUANTITY_VALUE_LOW < ?) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+                " AND (((Basic.QUANTITY_VALUE_LOW < ? OR Basic.QUANTITY_VALUE_HIGH < ? "
+                + "OR Basic.QUANTITY_VALUE IS NOT NULL AND Basic.QUANTITY_VALUE_LOW IS NULL) "
+                + "AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -363,11 +367,13 @@ public void testHandleQuantityRangeComparisonWithExact() throws Exception {
         queryParm             = generateParameter(SearchConstants.Prefix.GE, null, "1e3");
         expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
+        expectedBindVariables.add(new BigDecimal("5E+2"));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
         expectedSql =
-                " AND (((Basic.QUANTITY_VALUE >= ? OR Basic.QUANTITY_VALUE_HIGH >= ?) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+                " AND (((Basic.QUANTITY_VALUE_HIGH > ? OR Basic.QUANTITY_VALUE_LOW >= ? "
+                + "OR Basic.QUANTITY_VALUE IS NOT NULL AND Basic.QUANTITY_VALUE_HIGH IS NULL) "
+                + "AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -376,11 +382,13 @@ public void testHandleQuantityRangeComparisonWithExact() throws Exception {
         queryParm             = generateParameter(SearchConstants.Prefix.LE, null, "1e3");
         expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
+        expectedBindVariables.add(new BigDecimal("1.5E+3"));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
         expectedSql =
-                " AND (((Basic.QUANTITY_VALUE <= ? OR Basic.QUANTITY_VALUE_LOW <= ?) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+                " AND (((Basic.QUANTITY_VALUE_LOW < ? OR Basic.QUANTITY_VALUE_HIGH <= ? "
+                + "OR Basic.QUANTITY_VALUE IS NOT NULL AND Basic.QUANTITY_VALUE_LOW IS NULL) "
+                + "AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -388,8 +396,7 @@ public void testHandleQuantityRangeComparisonWithExact() throws Exception {
         // sa - starts after
         queryParm             = generateParameter(SearchConstants.Prefix.SA, null, "1e3");
         expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
+        expectedBindVariables.add(new BigDecimal("1.5E+3"));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
         expectedSql =
@@ -401,8 +408,7 @@ public void testHandleQuantityRangeComparisonWithExact() throws Exception {
         // eb - Ends before
         queryParm             = generateParameter(SearchConstants.Prefix.EB, null, "1e3");
         expectedBindVariables = new ArrayList<>();
-        expectedBindVariables.add(new BigDecimal("1E+3"));
-        expectedBindVariables.add(new BigDecimal("1E+3"));
+        expectedBindVariables.add(new BigDecimal("5E+2"));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
         expectedSql =
@@ -424,12 +430,10 @@ public void testPrecisionWithEqual() throws Exception {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal(99.5));
         expectedBindVariables.add(new BigDecimal(100.5));
-        expectedBindVariables.add(new BigDecimal(99.5));
-        expectedBindVariables.add(new BigDecimal(100.5));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
-        String expectedSql = " AND ((((Basic.QUANTITY_VALUE >= ? AND Basic.QUANTITY_VALUE < ?) "
-                + "OR (Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_HIGH <= ?)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+        String expectedSql = " AND (((Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_HIGH <= ?) "
+                + "AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -485,23 +489,16 @@ public void testPrecisionWithMultipleValuesForEqual() throws Exception {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("99.5"));
         expectedBindVariables.add(new BigDecimal("100.5"));
-        expectedBindVariables.add(new BigDecimal("99.5"));
-        expectedBindVariables.add(new BigDecimal("100.5"));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
 
-        expectedBindVariables.add(new BigDecimal("0.995"));
-        expectedBindVariables.add(new BigDecimal("1.005"));
         expectedBindVariables.add(new BigDecimal("0.995"));
         expectedBindVariables.add(new BigDecimal("1.005"));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
 
-        String expectedSql = " AND ((((Basic.QUANTITY_VALUE >= ? AND Basic.QUANTITY_VALUE < ?) OR "
-                + "(Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_HIGH <= ?)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?) "
-                + "OR "
-                + "(((Basic.QUANTITY_VALUE >= ? AND Basic.QUANTITY_VALUE < ?) OR "
-                + "(Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_HIGH <= ?)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+        String expectedSql = " AND (((Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_HIGH <= ?) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?) "
+                + "OR ((Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_HIGH <= ?) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -533,7 +530,7 @@ public void testEqualsClauseBuilder() {
                 lowerBound, upperBound);
 
         assertEquals(whereClauseSegment.toString(),
-                "((Basic.QUANTITY_VALUE >= ? AND Basic.QUANTITY_VALUE < ?) OR (Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_HIGH <= ?))");
+                "(Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_HIGH <= ?)");
     }
 
     @Test
@@ -545,13 +542,11 @@ public void testPrecisionWithNotEqual() throws Exception {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal(99.5));
         expectedBindVariables.add(new BigDecimal(100.5));
-        expectedBindVariables.add(new BigDecimal(99.5));
-        expectedBindVariables.add(new BigDecimal(100.5));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
 
-        String expectedSql = " AND ((((Basic.QUANTITY_VALUE < ? OR Basic.QUANTITY_VALUE >= ?) "
-                + "OR (Basic.QUANTITY_VALUE_LOW < ? OR Basic.QUANTITY_VALUE_HIGH > ?)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+        String expectedSql = " AND (((Basic.QUANTITY_VALUE_LOW < ? OR Basic.QUANTITY_VALUE_LOW IS NULL "
+                + "OR Basic.QUANTITY_VALUE_HIGH > ? OR Basic.QUANTITY_VALUE_HIGH IS NULL) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -566,13 +561,20 @@ public void testPrecisionWithApprox() throws Exception {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal(89.5));
         expectedBindVariables.add(new BigDecimal(110.5));
-        expectedBindVariables.add(new BigDecimal(100.5));
-        expectedBindVariables.add(new BigDecimal(99.5));
+        expectedBindVariables.add(new BigDecimal(89.5));
+        expectedBindVariables.add(new BigDecimal(110.5));
+        expectedBindVariables.add(new BigDecimal(89.5));
+        expectedBindVariables.add(new BigDecimal(110.5));
+        expectedBindVariables.add(new BigDecimal(89.5));
+        expectedBindVariables.add(new BigDecimal(110.5));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
 
-        String expectedSql = " AND ((((Basic.QUANTITY_VALUE >= ? AND Basic.QUANTITY_VALUE < ?) "
-                + "OR (Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH >= ?)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+        String expectedSql = " AND (((Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW <= ? "
+                + "OR Basic.QUANTITY_VALUE IS NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_HIGH <= ? "
+                + "OR Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_LOW <= ?) "
+                + "OR Basic.QUANTITY_VALUE IS NOT NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW IS NULL "
+                + "OR Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH IS NULL)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -587,13 +589,20 @@ public void testPrecisionWithApproxNumberOne() throws Exception {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal("0.4"));
         expectedBindVariables.add(new BigDecimal("1.6"));
-        expectedBindVariables.add(new BigDecimal("1.5"));
-        expectedBindVariables.add(new BigDecimal("0.5"));
+        expectedBindVariables.add(new BigDecimal("0.4"));
+        expectedBindVariables.add(new BigDecimal("1.6"));
+        expectedBindVariables.add(new BigDecimal("0.4"));
+        expectedBindVariables.add(new BigDecimal("1.6"));
+        expectedBindVariables.add(new BigDecimal("0.4"));
+        expectedBindVariables.add(new BigDecimal("1.6"));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
 
-        String expectedSql = " AND ((((Basic.QUANTITY_VALUE >= ? AND Basic.QUANTITY_VALUE < ?) "
-                + "OR (Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH >= ?)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+        String expectedSql = " AND (((Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW <= ? "
+                + "OR Basic.QUANTITY_VALUE IS NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_HIGH <= ? "
+                + "OR Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_LOW <= ?) "
+                + "OR Basic.QUANTITY_VALUE IS NOT NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW IS NULL "
+                + "OR Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH IS NULL)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -609,12 +618,19 @@ public void testPrecisionWithMultipleSameApprox() throws Exception {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal(89.5));
         expectedBindVariables.add(new BigDecimal(110.5));
-        expectedBindVariables.add(new BigDecimal(99.5));
-        expectedBindVariables.add(new BigDecimal(100.5));
+        expectedBindVariables.add(new BigDecimal(89.5));
+        expectedBindVariables.add(new BigDecimal(110.5));
+        expectedBindVariables.add(new BigDecimal(89.5));
+        expectedBindVariables.add(new BigDecimal(110.5));
+        expectedBindVariables.add(new BigDecimal(89.5));
+        expectedBindVariables.add(new BigDecimal(110.5));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
-        String expectedSql = " AND ((((Basic.QUANTITY_VALUE >= ? AND Basic.QUANTITY_VALUE < ?) "
-                + "OR (Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH >= ?)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+        String expectedSql = " AND (((Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW <= ? "
+                + "OR Basic.QUANTITY_VALUE IS NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_HIGH <= ? "
+                + "OR Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_LOW <= ?) "
+                + "OR Basic.QUANTITY_VALUE IS NOT NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW IS NULL "
+                + "OR Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH IS NULL)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
@@ -632,26 +648,35 @@ public void testPrecisionWithMultipleDifferentApprox() throws Exception {
         List<Object> expectedBindVariables = new ArrayList<>();
         expectedBindVariables.add(new BigDecimal(89.5));
         expectedBindVariables.add(new BigDecimal(110.5));
-        expectedBindVariables.add(new BigDecimal(100));
-        expectedBindVariables.add(new BigDecimal(100));
+        expectedBindVariables.add(new BigDecimal(89.5));
+        expectedBindVariables.add(new BigDecimal(110.5));
+        expectedBindVariables.add(new BigDecimal(89.5));
+        expectedBindVariables.add(new BigDecimal(110.5));
+        expectedBindVariables.add(new BigDecimal(89.5));
+        expectedBindVariables.add(new BigDecimal(110.5));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
 
-        expectedBindVariables.add(new BigDecimal("89.5"));
-        expectedBindVariables.add(new BigDecimal("110.5"));
-        expectedBindVariables.add(new BigDecimal("99.5"));
-        expectedBindVariables.add(new BigDecimal("100.5"));
         expectedBindVariables.add(new BigDecimal("89.995"));
         expectedBindVariables.add(new BigDecimal("110.005"));
-        expectedBindVariables.add(new BigDecimal("100.005"));
-        expectedBindVariables.add(new BigDecimal("99.995"));
+        expectedBindVariables.add(new BigDecimal("89.995"));
+        expectedBindVariables.add(new BigDecimal("110.005"));
+        expectedBindVariables.add(new BigDecimal("89.995"));
+        expectedBindVariables.add(new BigDecimal("110.005"));
+        expectedBindVariables.add(new BigDecimal("89.995"));
+        expectedBindVariables.add(new BigDecimal("110.005"));
         expectedBindVariables.add(1);
         expectedBindVariables.add("code");
-        String expectedSql = " AND ((((Basic.QUANTITY_VALUE >= ? AND Basic.QUANTITY_VALUE < ?) OR "
-                + "(Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH >= ?)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?) "
-                + "OR "
-                + "(((Basic.QUANTITY_VALUE >= ? AND Basic.QUANTITY_VALUE < ?) OR "
-                + "(Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH >= ?)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
+        String expectedSql = " AND (((Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW <= ? "
+                + "OR Basic.QUANTITY_VALUE IS NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_HIGH <= ? "
+                + "OR Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_LOW <= ?) "
+                + "OR Basic.QUANTITY_VALUE IS NOT NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW IS NULL "
+                + "OR Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH IS NULL)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?) "
+                + "OR ((Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW <= ? "
+                + "OR Basic.QUANTITY_VALUE IS NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_HIGH <= ? "
+                + "OR Basic.QUANTITY_VALUE_LOW >= ? AND Basic.QUANTITY_VALUE_LOW <= ?) "
+                + "OR Basic.QUANTITY_VALUE IS NOT NULL AND (Basic.QUANTITY_VALUE_HIGH >= ? AND Basic.QUANTITY_VALUE_LOW IS NULL "
+                + "OR Basic.QUANTITY_VALUE_LOW <= ? AND Basic.QUANTITY_VALUE_HIGH IS NULL)) AND Basic.CODE_SYSTEM_ID = ? AND Basic.CODE = ?)))";
         runTest(queryParm,
                 expectedBindVariables,
                 expectedSql, false);
diff --git a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/TimestampPrefixedUUIDTest.java b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/TimestampPrefixedUUIDTest.java
index 0f0c522e46d..1633edddd1b 100644
--- a/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/TimestampPrefixedUUIDTest.java
+++ b/fhir-persistence-jdbc/src/test/java/com/ibm/fhir/persistence/jdbc/test/util/TimestampPrefixedUUIDTest.java
@@ -10,6 +10,7 @@
 
 import org.testng.annotations.Test;
 
+import com.ibm.fhir.model.util.ValidationSupport;
 import com.ibm.fhir.persistence.jdbc.util.TimestampPrefixedUUID;
 
 /**
@@ -25,6 +26,10 @@ public void testCollation() {
         for (int i=0; i<10; i++) {
             // We need a time gap between the two strings
             String s1 = provider.createNewIdentityValue();
+
+            // Ensure the generated id is always valid
+            ValidationSupport.checkId(s1);
+
             try {
                 // It's only 10ms, which is sufficient. We don't want to make it any longer
                 // for the sake of slowing down the build.
@@ -32,7 +37,12 @@ public void testCollation() {
             } catch (InterruptedException x) {
                 // NOP. Not gonna happen
             }
+
             String s2 = provider.createNewIdentityValue();
+
+            // Ensure the generated id is always valid
+            ValidationSupport.checkId(s2);
+
             assertTrue(s1.compareTo(s2) < 0); // s1 < s2
         }
     }
diff --git a/fhir-persistence-proxy/pom.xml b/fhir-persistence-proxy/pom.xml
index 79f82458487..f9120e6297b 100644
--- a/fhir-persistence-proxy/pom.xml
+++ b/fhir-persistence-proxy/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-persistence-schema/README.md b/fhir-persistence-schema/README.md
index de5a5c84cad..74cab4a3496 100644
--- a/fhir-persistence-schema/README.md
+++ b/fhir-persistence-schema/README.md
@@ -142,6 +142,7 @@ Once the server has determined the tenant id for a given request, it uses this t
 used in conjunction to create or retrieve data for this tenant.
 For more information on multi-tenancy, see section [4.9 Multi-tenancy of the IBM FHIR Server Users Guide](https://ibm.github.io/FHIR/guides/FHIRServerUsersGuide#49-multi-tenancy).
 
+
 ### Refresh Tenant Following Schema Update (Db2 only)
 
 After a schema update you must run the refresh-tenants command to ensure that any new tables added by the update have the correct partitions. The refresh-tenants process will iterate over each tenant and allocate new partitions as needed. This step is idempotent, so you can run it more than once if required.
@@ -212,6 +213,46 @@ Note, you may want to add a tenant key when a key is lost or needs to be changed
 
 Use `--tenant-key-file tenant.key.file` to direct the action to read the tenant-key from file.  If the file exists the tenant key (up to 44 characters is read from the file.  If the file does not exist, the generated tenantKey is written out to the file.
 
+
+### Remove all tenant keys from an Existing Tenant (Db2 only)
+To remove all tenant keys for an existing tenant, replace FHIRDATA with your client schema, and change default to your tenant's name. 
+
+```
+--prop-file db2.properties
+--schema-name FHIRDATA
+--db-type db2
+--revoke-all-tenant-keys default
+```
+
+**Example Output**
+```
+2021-06-07 15:30:41.782 00000001    INFO .common.JdbcConnectionProvider Opening connection to database: jdbc:db2://demodb2:50000/fhirdb
+2021-06-07 15:30:42.405 00000001    INFO   com.ibm.fhir.schema.app.Main Tenant Key revoked for 'default' total removed=[1]
+2021-06-07 15:30:42.419 00000001    INFO   com.ibm.fhir.schema.app.Main Processing took:   0.699 s
+2021-06-07 15:30:42.420 00000001    INFO   com.ibm.fhir.schema.app.Main SCHEMA CHANGE: OK
+```
+
+### Remove a tenant key key from an Existing Tenant (Db2 only)
+To remove a tenant key for an existing tenant, replace FHIRDATA with your client schema, and change default to your tenant's name. 
+
+```
+--prop-file db2.properties
+--schema-name FHIRDATA
+--db-type db2
+--revoke-tenant-key default
+--tenant-key rZ59TLyEpjU+FAKEtgVk8J44J0=
+```
+
+**Example Output**
+```
+2021-06-07 15:30:41.782 00000001    INFO .common.JdbcConnectionProvider Opening connection to database: jdbc:db2://demodb2:50000/fhirdb
+2021-06-07 15:30:42.405 00000001    INFO   com.ibm.fhir.schema.app.Main Tenant Key revoked for 'default' total removed=[1]
+2021-06-07 15:30:42.419 00000001    INFO   com.ibm.fhir.schema.app.Main Processing took:   0.699 s
+2021-06-07 15:30:42.420 00000001    INFO   com.ibm.fhir.schema.app.Main SCHEMA CHANGE: OK
+```
+
+Use `--tenant-key-file tenant.key.file` to direct the action to read the tenant-key from file.
+
 ### Update the stored procedures and functions for FHIRDATA (and not FHIR_ADMIN) (Db2 and PostgreSQL)
 
 For Db2:
diff --git a/fhir-persistence-schema/pom.xml b/fhir-persistence-schema/pom.xml
index 67288f331d8..cec3e39abf4 100644
--- a/fhir-persistence-schema/pom.xml
+++ b/fhir-persistence-schema/pom.xml
@@ -8,7 +8,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/app/Main.java b/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/app/Main.java
index 982035fc9cc..a4581d98ac1 100644
--- a/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/app/Main.java
+++ b/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/app/Main.java
@@ -42,6 +42,7 @@
 import com.ibm.fhir.database.utils.api.IDatabaseTranslator;
 import com.ibm.fhir.database.utils.api.ITransaction;
 import com.ibm.fhir.database.utils.api.ITransactionProvider;
+import com.ibm.fhir.database.utils.api.TableSpaceRemovalException;
 import com.ibm.fhir.database.utils.api.TenantStatus;
 import com.ibm.fhir.database.utils.api.UndefinedNameException;
 import com.ibm.fhir.database.utils.common.DataDefinitionUtil;
@@ -61,6 +62,7 @@
 import com.ibm.fhir.database.utils.pool.PoolConnectionProvider;
 import com.ibm.fhir.database.utils.postgres.PostgresTranslator;
 import com.ibm.fhir.database.utils.tenant.AddTenantKeyDAO;
+import com.ibm.fhir.database.utils.tenant.DeleteTenantKeyDAO;
 import com.ibm.fhir.database.utils.tenant.GetTenantDAO;
 import com.ibm.fhir.database.utils.transaction.SimpleTransactionProvider;
 import com.ibm.fhir.database.utils.transaction.TransactionFactory;
@@ -108,6 +110,7 @@ public class Main {
     private static final int EXIT_RUNTIME_ERROR = 2; // programming error
     private static final int EXIT_VALIDATION_FAILED = 3; // validation test failed
     private static final int EXIT_NOT_READY = 4; // DATABASE NOT READY
+    private static final int EXIT_TABLESPACE_REMOVAL_NOT_COMPLETE = 5; // Tablespace Removal not complete
     private static final double NANOS = 1e9;
 
     // Indicates if the feature is enabled for the DbType
@@ -172,6 +175,8 @@ public class Main {
     private boolean listTenants;
     private boolean dropDetached;
     private boolean deleteTenantMeta;
+    private boolean revokeTenantKey;
+    private boolean revokeAllTenantKeys;
 
     // Tenant Key Output or Input File
     private String tenantKeyFileName;
@@ -390,10 +395,6 @@ protected void updateSchema() {
             populateResourceTypeAndParameterNameTableEntries(null);
         }
 
-        // Let's refresh the procedures and functions.
-        logger.info("Refreshing procedures and functions");
-        updateProcedures();
-
         if (MULTITENANT_FEATURE_ENABLED.contains(dbType)) {
             logger.info("Refreshing tenant partitions");
             refreshTenants();
@@ -407,6 +408,10 @@ protected void updateSchema() {
 
         // V0014 IS_DELETED and LAST_UPDATED added to whole-system LOGICAL_RESOURCES
         applyDataMigrationForV0014();
+
+        // Log warning messages that unused tables will be removed in a future release.
+        // TODO: This will no longer be needed after the tables are removed (https://github.com/IBM/FHIR/issues/713).
+        logWarningMessagesForDeprecatedTables();
     }
 
     /**
@@ -1113,7 +1118,6 @@ protected void dropTenant() {
         // this may not complete successfully because Db2 runs the detach as an async
         // process. Just need to run --drop-detached to clean up.
         dropDetachedPartitionTables(pdm, tenantInfo);
-
     }
 
     /**
@@ -1142,7 +1146,6 @@ protected void dropDetachedPartitionTables(PhysicalDataModel pdm, TenantInfo ten
         // the partition detach operation.
         Db2Adapter adapter = new Db2Adapter(connectionPool);
         try (ITransaction tx = TransactionFactory.openTransaction(connectionPool)) {
-
             try {
                 pdm.dropDetachedPartitions(adapter, tenantInfo.getTenantSchema(), tenantInfo.getTenantId());
             } catch (DataAccessException x) {
@@ -1155,18 +1158,35 @@ protected void dropDetachedPartitionTables(PhysicalDataModel pdm, TenantInfo ten
         // We can drop the tenant's tablespace only after all the table drops have been committed
         logger.info("Dropping tablespace for tenant " + tenantInfo.getTenantId() + "/" + tenantName);
         try (ITransaction tx = TransactionFactory.openTransaction(connectionPool)) {
-
-            try {
-                // With all the objects removed, it should be safe to remove the tablespace
-                pdm.dropTenantTablespace(adapter, tenantInfo.getTenantId());
-            } catch (DataAccessException x) {
-                // Something went wrong, so mark the transaction as failed
-                tx.setRollbackOnly();
-                throw x;
+            boolean retry = true;
+            int wait = 0;
+            while (retry) {
+                try {
+                    retry = false;
+                    // With all the objects removed, it should be safe to remove the tablespace
+                    pdm.dropTenantTablespace(adapter, tenantInfo.getTenantId());
+                } catch (DataAccessException x) {
+                    boolean error = x instanceof DataAccessException && x.getCause() instanceof SQLException
+                            && (((SQLException) x.getCause()).getErrorCode() == -282);
+                    if (error && wait++ <= 30){
+                        retry = true;
+                        logger.warning("Waiting on async dettach dependency to finish - count '"+ wait + "'");
+                        try {
+                            Thread.sleep(2000);
+                        } catch (InterruptedException e) {
+                            throw new DataAccessException(e);
+                        }
+                    } else if (error) {
+                        throw new TableSpaceRemovalException(x.getCause());
+                    } else {
+                        // Something went wrong, so mark the transaction as failed
+                        tx.setRollbackOnly();
+                        throw x;
+                    }
+                }
             }
         }
 
-
         // Now all the table partitions have been allocated, we can mark the tenant as dropped
         try (ITransaction tx = TransactionFactory.openTransaction(connectionPool)) {
             try {
@@ -1242,7 +1262,40 @@ protected void deleteTenantMeta() {
                 throw x;
             }
         }
+    }
+
+    /**
+     * revokes a tenant key or if no tenant key is specified remove all of them for the
+     * given tenant.
+     */
+    protected void revokeTenantKey() {
+        if (!MULTITENANT_FEATURE_ENABLED.contains(dbType)) {
+            return;
+        }
+
+        TenantInfo tenantInfo = getTenantInfo();
+        int tenantId = tenantInfo.getTenantId();
+
+        // Only if the Tenant Key file is provided as a parameter is it not null.
+        // in  this case we want special behavior.
+        if (tenantKeyFileUtil.keyFileExists(tenantKeyFileName)) {
+            tenantKey = this.tenantKeyFileUtil.readTenantFile(tenantKeyFileName);
+        }
+
+        try (ITransaction tx = TransactionFactory.openTransaction(connectionPool)) {
+            try {
+                DeleteTenantKeyDAO dtk = new DeleteTenantKeyDAO(schema.getAdminSchemaName(), tenantId, tenantKey);
 
+                Db2Adapter adapter = new Db2Adapter(connectionPool);
+                adapter.runStatement(dtk);
+                int count = dtk.getCount();
+                logger.info("Tenant Key revoked for '" + tenantInfo.getTenantName() + "' total removed=[" + count + "]");
+            } catch (DataAccessException x) {
+                // Something went wrong, so mark the transaction as failed
+                tx.setRollbackOnly();
+                throw x;
+            }
+        }
     }
 
     //-----------------------------------------------------------------------------------------------------------------
@@ -1332,6 +1385,20 @@ protected void parseArgs(String[] args) {
                     throw new IllegalArgumentException("Missing value for argument at posn: " + i);
                 }
                 break;
+            case "--revoke-tenant-key":
+                if (++i >= args.length) {
+                    throw new IllegalArgumentException("Missing value for argument at posn: " + i);
+                }
+                this.tenantName = args[i];
+                this.revokeTenantKey = true;
+                break;
+            case "--revoke-all-tenant-keys":
+                if (++i >= args.length) {
+                    throw new IllegalArgumentException("Missing value for argument at posn: " + i);
+                }
+                this.tenantName = args[i];
+                this.revokeAllTenantKeys = true;
+                break;
             case "--update-proc":
                 this.updateProc = true;
                 break;
@@ -1935,6 +2002,13 @@ protected void process() {
             deleteTenantMeta();
         } else if (this.dropTenant) {
             dropTenant();
+        } else if (this.revokeTenantKey) {
+            revokeTenantKey();
+        } else if (this.revokeAllTenantKeys) {
+            if (this.tenantKey != null) {
+                throw new IllegalArgumentException("[ERROR] --tenant-key <key-value> should not be specified together with --drop-all-tenant-keys");
+            }
+            revokeTenantKey();
         }
 
         if (this.grantTo != null) {
@@ -1978,6 +2052,20 @@ protected void logStatusMessage(int status) {
         }
     }
 
+    /**
+     * Log warning messages for deprecated tables.
+     */
+    private void logWarningMessagesForDeprecatedTables() {
+        List<String> deprecatedTables = Arrays.asList(
+            "DOMAINRESOURCE_DATE_VALUES", "DOMAINRESOURCE_LATLNG_VALUES", "DOMAINRESOURCE_LOGICAL_RESOURCES", "DOMAINRESOURCE_NUMBER_VALUES",
+            "DOMAINRESOURCE_QUANTITY_VALUES", "DOMAINRESOURCE_RESOURCE_TOKEN_REFS", "DOMAINRESOURCE_RESOURCES","DOMAINRESOURCE_STR_VALUES",
+            "RESOURCE_DATE_VALUES", "RESOURCE_LATLNG_VALUES", "RESOURCE_LOGICAL_RESOURCES", "RESOURCE_NUMBER_VALUES",
+            "RESOURCE_QUANTITY_VALUES", "RESOURCE_RESOURCE_TOKEN_REFS", "RESOURCE_RESOURCES", "RESOURCE_STR_VALUES");
+        for (String deprecatedTable : deprecatedTables) {
+            logger.warning("Table '" + deprecatedTable + "' will be dropped in a future release. No data should be written to this table. If any data exists in the table, that data should be deleted.");
+        }
+    }
+
     /**
      * Main entry point
      *
@@ -1993,7 +2081,10 @@ public static void main(String[] args) {
             m.parseArgs(args);
             m.process();
             exitStatus = m.getExitStatus();
-        } catch(DatabaseNotReadyException x) {
+        } catch (TableSpaceRemovalException x) {
+            logger.warning("Tablespace removal is not complete, as an async dependency has not finished dettaching. Please re-try.");
+            exitStatus = EXIT_TABLESPACE_REMOVAL_NOT_COMPLETE;
+        } catch (DatabaseNotReadyException x) {
             logger.log(Level.SEVERE, "The database is not yet available. Please re-try.", x);
             exitStatus = EXIT_NOT_READY;
         } catch (IllegalArgumentException x) {
diff --git a/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/app/util/CommonUtil.java b/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/app/util/CommonUtil.java
index af40ad02b50..23d002a2694 100644
--- a/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/app/util/CommonUtil.java
+++ b/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/app/util/CommonUtil.java
@@ -137,6 +137,12 @@ public static void printUsage() {
         ps.println("--list-tenants");
         ps.println(" * fetches list of tenants and current status");
 
+        ps.println("--revoke-all-tenant-keys");
+        ps.println(" * revokes the all of the keys for the specified tenant");
+
+        ps.println("--revoke-tenant-key");
+        ps.println(" * revokes the key for the specified tenant and tenant key");
+
         // Dry Run functionality
         ps.println("--dry-run ");
         ps.println(" * simulates the actions of the actions that change the datastore");
diff --git a/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/control/SchemaGeneratorUtil.java b/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/control/SchemaGeneratorUtil.java
index 6abf67ad705..74643e888e9 100644
--- a/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/control/SchemaGeneratorUtil.java
+++ b/fhir-persistence-schema/src/main/java/com/ibm/fhir/schema/control/SchemaGeneratorUtil.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -10,6 +10,7 @@
 import java.io.IOException;
 import java.io.InputStream;
 import java.io.InputStreamReader;
+import java.time.Instant;
 import java.util.ArrayList;
 import java.util.Collection;
 import java.util.List;
@@ -33,6 +34,7 @@ public static String readTemplate(String adminSchemaName, String schemaName, Str
         }
         replacers.add(new Replacer("SCHEMA_NAME", schemaName));
         replacers.add(new Replacer("ADMIN_SCHEMA_NAME", adminSchemaName));
+        replacers.add(new Replacer("DATE", Instant.now().toString()));
 
         ClassLoader classLoader = Thread.currentThread().getContextClassLoader();
 
diff --git a/fhir-persistence-schema/src/main/resources/db2/add_any_resource.sql b/fhir-persistence-schema/src/main/resources/db2/add_any_resource.sql
index 0c091aef3d0..2805083bb3f 100644
--- a/fhir-persistence-schema/src/main/resources/db2/add_any_resource.sql
+++ b/fhir-persistence-schema/src/main/resources/db2/add_any_resource.sql
@@ -4,6 +4,8 @@
 -- SPDX-License-Identifier: Apache-2.0
 -------------------------------------------------------------------------------
 
+-- LOADED ON: {{DATE}}
+
 -- ----------------------------------------------------------------------------
 -- Procedure to add a resource version and its associated parameters. These
 -- parameters only ever point to the latest version of a resource, never to
diff --git a/fhir-persistence-schema/src/main/resources/db2/add_code_system.sql b/fhir-persistence-schema/src/main/resources/db2/add_code_system.sql
index d5a14bddd45..eae7307779c 100644
--- a/fhir-persistence-schema/src/main/resources/db2/add_code_system.sql
+++ b/fhir-persistence-schema/src/main/resources/db2/add_code_system.sql
@@ -1,9 +1,11 @@
 -------------------------------------------------------------------------------
--- (C) Copyright IBM Corp. 2016, 2020
+-- (C) Copyright IBM Corp. 2016, 2021
 --
 -- SPDX-License-Identifier: Apache-2.0
 -------------------------------------------------------------------------------
 
+-- LOADED ON: {{DATE}}
+
 -- ----------------------------------------------------------------------------
 -- Procedure to add a new code system in a thread-safe way
 -- ----------------------------------------------------------------------------
diff --git a/fhir-persistence-schema/src/main/resources/db2/add_parameter_name.sql b/fhir-persistence-schema/src/main/resources/db2/add_parameter_name.sql
index 5e20a24462e..52e3bba3ebf 100644
--- a/fhir-persistence-schema/src/main/resources/db2/add_parameter_name.sql
+++ b/fhir-persistence-schema/src/main/resources/db2/add_parameter_name.sql
@@ -1,9 +1,11 @@
 -------------------------------------------------------------------------------
--- (C) Copyright IBM Corp. 2016, 2020
+-- (C) Copyright IBM Corp. 2016, 2021
 --
 -- SPDX-License-Identifier: Apache-2.0
 -------------------------------------------------------------------------------
 
+-- LOADED ON: {{DATE}}
+
 -- ----------------------------------------------------------------------------
 -- The stored procedure adds search parameters name (code) to logical id mappings
 -- ----------------------------------------------------------------------------
diff --git a/fhir-persistence-schema/src/main/resources/db2/add_resource_type.sql b/fhir-persistence-schema/src/main/resources/db2/add_resource_type.sql
index 95d0c5f5a1d..c4861ffe6df 100644
--- a/fhir-persistence-schema/src/main/resources/db2/add_resource_type.sql
+++ b/fhir-persistence-schema/src/main/resources/db2/add_resource_type.sql
@@ -1,9 +1,11 @@
 -------------------------------------------------------------------------------
--- (C) Copyright IBM Corp. 2016, 2020
+-- (C) Copyright IBM Corp. 2016, 2021
 --
 -- SPDX-License-Identifier: Apache-2.0
 -------------------------------------------------------------------------------
 
+-- LOADED ON: {{DATE}}
+
 -- ----------------------------------------------------------------------------
 -- Procedure to add a resource type to the resource_types table
 -- ----------------------------------------------------------------------------
diff --git a/fhir-persistence-schema/src/main/resources/db2/erase_resource.sql b/fhir-persistence-schema/src/main/resources/db2/erase_resource.sql
index 3e26bb52c38..eae1092a092 100644
--- a/fhir-persistence-schema/src/main/resources/db2/erase_resource.sql
+++ b/fhir-persistence-schema/src/main/resources/db2/erase_resource.sql
@@ -4,6 +4,8 @@
 -- SPDX-License-Identifier: Apache-2.0
 -------------------------------------------------------------------------------
 
+-- LOADED ON: {{DATE}}
+
 -- ----------------------------------------------------------------------------
 -- Procedure to remove a resource, history and parameters values
 -- 
diff --git a/fhir-persistence-schema/src/main/resources/db2/set_tenant.sql b/fhir-persistence-schema/src/main/resources/db2/set_tenant.sql
index f41682f69a7..7a2220b20ec 100644
--- a/fhir-persistence-schema/src/main/resources/db2/set_tenant.sql
+++ b/fhir-persistence-schema/src/main/resources/db2/set_tenant.sql
@@ -1,8 +1,11 @@
 -------------------------------------------------------------------------------
--- (C) Copyright IBM Corp. 2016, 2020
+-- (C) Copyright IBM Corp. 2016, 2021
 --
 -- SPDX-License-Identifier: Apache-2.0
 -------------------------------------------------------------------------------
+
+-- LOADED ON: {{DATE}}
+
 ( IN p_tenant_name VARCHAR(36),
   IN p_tenant_key  VARCHAR(44)
 )
diff --git a/fhir-persistence-schema/src/main/resources/postgres/add_any_resource.sql b/fhir-persistence-schema/src/main/resources/postgres/add_any_resource.sql
index 83e51cba270..22fc8bb7d0c 100644
--- a/fhir-persistence-schema/src/main/resources/postgres/add_any_resource.sql
+++ b/fhir-persistence-schema/src/main/resources/postgres/add_any_resource.sql
@@ -53,6 +53,7 @@
   lock_cur CURSOR (t_resource_type_id INT, t_logical_id VARCHAR(255)) FOR SELECT logical_resource_id, parameter_hash FROM {{SCHEMA_NAME}}.logical_resources WHERE resource_type_id = t_resource_type_id AND logical_id = t_logical_id FOR NO KEY UPDATE;
 
 BEGIN
+  -- LOADED ON: {{DATE}}
   v_schema_name := '{{SCHEMA_NAME}}';
   SELECT resource_type_id INTO v_resource_type_id 
     FROM {{SCHEMA_NAME}}.resource_types WHERE resource_type = p_resource_type;
diff --git a/fhir-persistence-schema/src/main/resources/postgres/add_code_system.sql b/fhir-persistence-schema/src/main/resources/postgres/add_code_system.sql
index 89ee91d9401..12f29dfb495 100644
--- a/fhir-persistence-schema/src/main/resources/postgres/add_code_system.sql
+++ b/fhir-persistence-schema/src/main/resources/postgres/add_code_system.sql
@@ -1,5 +1,5 @@
 -------------------------------------------------------------------------------
--- (C) Copyright IBM Corp. 2020
+-- (C) Copyright IBM Corp. 2020, 2021
 --
 -- SPDX-License-Identifier: Apache-2.0
 -------------------------------------------------------------------------------
@@ -12,7 +12,8 @@
     LANGUAGE plpgsql
       AS $$
 
-  BEGIN  
+BEGIN  
+    -- LOADED ON: {{DATE}}
     SELECT code_system_id INTO p_code_system_id
     FROM {{SCHEMA_NAME}}.code_systems
     WHERE code_system_name = p_code_system_name;
diff --git a/fhir-persistence-schema/src/main/resources/postgres/add_parameter_name.sql b/fhir-persistence-schema/src/main/resources/postgres/add_parameter_name.sql
index 264d5f6545e..16d4c6cd9a9 100644
--- a/fhir-persistence-schema/src/main/resources/postgres/add_parameter_name.sql
+++ b/fhir-persistence-schema/src/main/resources/postgres/add_parameter_name.sql
@@ -1,5 +1,5 @@
 -------------------------------------------------------------------------------
--- (C) Copyright IBM Corp. 2020
+-- (C) Copyright IBM Corp. 2020, 2021
 --
 -- SPDX-License-Identifier: Apache-2.0
 -------------------------------------------------------------------------------
@@ -13,6 +13,7 @@
      AS $$
 
 BEGIN
+    -- LOADED ON: {{DATE}}
     SELECT parameter_name_id INTO p_parameter_name_id
     FROM {{SCHEMA_NAME}}.parameter_names
     WHERE parameter_name = p_parameter_name;
diff --git a/fhir-persistence-schema/src/main/resources/postgres/add_resource_type.sql b/fhir-persistence-schema/src/main/resources/postgres/add_resource_type.sql
index 95d35906df0..3620081edcf 100644
--- a/fhir-persistence-schema/src/main/resources/postgres/add_resource_type.sql
+++ b/fhir-persistence-schema/src/main/resources/postgres/add_resource_type.sql
@@ -1,5 +1,5 @@
 -------------------------------------------------------------------------------
--- (C) Copyright IBM Corp. 2020
+-- (C) Copyright IBM Corp. 2020, 2021
 --
 -- SPDX-License-Identifier: Apache-2.0
 -------------------------------------------------------------------------------
@@ -13,6 +13,7 @@
        AS $$
 
 BEGIN
+    -- LOADED ON: {{DATE}}
     SELECT resource_type_id INTO p_resource_type_id
     FROM {{SCHEMA_NAME}}.resource_types
     WHERE resource_type = p_resource_type;
diff --git a/fhir-persistence-schema/src/main/resources/postgres/erase_resource.sql b/fhir-persistence-schema/src/main/resources/postgres/erase_resource.sql
index c8c5dc359fd..26bb1ea1584 100644
--- a/fhir-persistence-schema/src/main/resources/postgres/erase_resource.sql
+++ b/fhir-persistence-schema/src/main/resources/postgres/erase_resource.sql
@@ -25,6 +25,7 @@
   v_total               BIGINT := 0;
 
 BEGIN
+  -- LOADED ON: {{DATE}}
   v_schema_name := '{{SCHEMA_NAME}}';
 
   -- Prep 1: Get the v_resource_type_id
diff --git a/fhir-persistence-scout/pom.xml b/fhir-persistence-scout/pom.xml
index 3335683601b..226d0810b1b 100644
--- a/fhir-persistence-scout/pom.xml
+++ b/fhir-persistence-scout/pom.xml
@@ -7,7 +7,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-persistence/pom.xml b/fhir-persistence/pom.xml
index 35de8d2921b..95edb53c2fd 100644
--- a/fhir-persistence/pom.xml
+++ b/fhir-persistence/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-persistence/src/main/java/com/ibm/fhir/persistence/interceptor/impl/FHIRPersistenceInterceptorMgr.java b/fhir-persistence/src/main/java/com/ibm/fhir/persistence/interceptor/impl/FHIRPersistenceInterceptorMgr.java
index 1695d071ff8..32bb8007b22 100644
--- a/fhir-persistence/src/main/java/com/ibm/fhir/persistence/interceptor/impl/FHIRPersistenceInterceptorMgr.java
+++ b/fhir-persistence/src/main/java/com/ibm/fhir/persistence/interceptor/impl/FHIRPersistenceInterceptorMgr.java
@@ -6,10 +6,10 @@
 
 package com.ibm.fhir.persistence.interceptor.impl;
 
-import java.util.ArrayList;
 import java.util.Iterator;
 import java.util.List;
 import java.util.ServiceLoader;
+import java.util.concurrent.CopyOnWriteArrayList;
 import java.util.logging.Level;
 import java.util.logging.Logger;
 
@@ -35,7 +35,7 @@ public class FHIRPersistenceInterceptorMgr {
     private static FHIRPersistenceInterceptorMgr instance = new FHIRPersistenceInterceptorMgr();
 
     // Our list of discovered interceptors.
-    List<FHIRPersistenceInterceptor> interceptors = new ArrayList<>();
+    List<FHIRPersistenceInterceptor> interceptors = new CopyOnWriteArrayList<>();
 
     public static FHIRPersistenceInterceptorMgr getInstance() {
         return instance;
diff --git a/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchCompartmentTest.java b/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchCompartmentTest.java
index 378adceb3fd..0d58a886f5c 100644
--- a/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchCompartmentTest.java
+++ b/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchCompartmentTest.java
@@ -15,8 +15,10 @@
 import java.util.Arrays;
 import java.util.Collections;
 import java.util.HashMap;
+import java.util.HashSet;
 import java.util.List;
 import java.util.Map;
+import java.util.Set;
 
 import org.testng.annotations.Test;
 
@@ -213,25 +215,25 @@ public void testSearchPatientCompartment_relativeReference_multiCompartment_stri
         Map<String, List<String>> queryParms = new HashMap<>(1);
         queryParms.put("string", Collections.singletonList("testString"));
         assertTrue("Expected resource was not returned from the search",
-            multiCompartmentSearchReturnsResource(PATIENT, Arrays.asList(new String[]{PATIENT_ID, OTHER_ID}),
+            multiCompartmentSearchReturnsResource(PATIENT, new HashSet<>(Arrays.asList(new String[]{PATIENT_ID, OTHER_ID})),
                     queryParms, savedResource));
         assertTrue("Expected resource was not returned from the search",
-            multiCompartmentSearchReturnsResource(PATIENT, Arrays.asList(new String[]{OTHER_ID, PATIENT_ID}),
+            multiCompartmentSearchReturnsResource(PATIENT, new HashSet<>(Arrays.asList(new String[]{OTHER_ID, PATIENT_ID})),
                     queryParms, savedResource));
         assertFalse("Unexpected resource was returned from the search",
-            multiCompartmentSearchReturnsResource(PATIENT, Arrays.asList(new String[]{PRACTITIONER_ID, OTHER_ID}),
+            multiCompartmentSearchReturnsResource(PATIENT, new HashSet<>(Arrays.asList(new String[]{PRACTITIONER_ID, OTHER_ID})),
                     queryParms, savedResource));
 
         queryParms.clear();
         queryParms.put("subject:Basic.string", Collections.singletonList("testString"));
         assertTrue("Expected resource was not returned from the search",
-            multiCompartmentSearchReturnsResource(PATIENT, Arrays.asList(new String[]{PATIENT_ID, OTHER_ID}),
+            multiCompartmentSearchReturnsResource(PATIENT, new HashSet<>(Arrays.asList(new String[]{PATIENT_ID, OTHER_ID})),
                     queryParms, composition));
         assertTrue("Expected resource was not returned from the search",
-            multiCompartmentSearchReturnsResource(PATIENT, Arrays.asList(new String[]{OTHER_ID, PATIENT_ID}),
+            multiCompartmentSearchReturnsResource(PATIENT, new HashSet<>(Arrays.asList(new String[]{OTHER_ID, PATIENT_ID})),
                     queryParms, composition));
         assertFalse("Unexpected resource was returned from the search",
-            multiCompartmentSearchReturnsResource(PATIENT, Arrays.asList(new String[]{PRACTITIONER_ID, OTHER_ID}),
+            multiCompartmentSearchReturnsResource(PATIENT, new HashSet<>(Arrays.asList(new String[]{PRACTITIONER_ID, OTHER_ID})),
                     queryParms, composition));
     }
 
@@ -239,7 +241,7 @@ public void testSearchPatientCompartment_relativeReference_multiCompartment_stri
      * Executes the compartment query and returns whether the expected resource was in the result set
      * @throws Exception
      */
-    protected boolean multiCompartmentSearchReturnsResource(String compartmentType, List<String> compartmentIds,
+    protected boolean multiCompartmentSearchReturnsResource(String compartmentType, Set<String> compartmentIds,
             Map<String, List<String>> queryParms, Resource expectedResource) throws Exception {
 
         List<? extends Resource> resources = runCompartmentQueryTest(compartmentType, compartmentIds,
diff --git a/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchNumberTest.java b/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchNumberTest.java
index 2bdf2d4585e..ba2b8918e4f 100644
--- a/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchNumberTest.java
+++ b/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchNumberTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2018, 2020
+ * (C) Copyright IBM Corp. 2018, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -132,7 +132,7 @@ public void testSearchNumber_integer_or() throws Exception {
 
     @Test
     public void testSearchNumber_decimal() throws Exception {
-        // Targeted Value is 99.99
+        // Targeted Value is 99.99, range is 99.985, 99.995
 
         // Range: 98.5, 99.5
         assertSearchDoesntReturnSavedResource("decimal", "99");
@@ -167,7 +167,7 @@ public void testSearchNumber_decimal() throws Exception {
         // Range: Not in 99.984985, 99.984995
         assertSearchReturnsSavedResource("decimal", "ne99.98499");
 
-        // Range: 99.85, 99.95
+        // Range: Not in 99.85, 99.95
         assertSearchReturnsSavedResource("decimal", "ne99.9");
 
         // Range: 99.985, 99.995
@@ -214,7 +214,7 @@ public void testSearchNumber_decimal() throws Exception {
 
         assertSearchDoesntReturnSavedResource("decimal", "le99");
         assertSearchDoesntReturnSavedResource("decimal", "le99.98499");
-        assertSearchReturnsSavedResource("decimal", "le99.985");
+        assertSearchDoesntReturnSavedResource("decimal", "le99.985");
         assertSearchReturnsSavedResource("decimal", "le99.99");
         assertSearchReturnsSavedResource("decimal", "le9999e-2");
         assertSearchReturnsSavedResource("decimal", "le99.99499");
@@ -227,11 +227,9 @@ public void testSearchNumber_decimal() throws Exception {
         assertSearchReturnsSavedResource("decimal", "ge99.99");
         assertSearchReturnsSavedResource("decimal", "ge9999e-2");
         assertSearchReturnsSavedResource("decimal", "ge99.99499");
-        // We need to track whether the high is inclusive or not to get this right
-        // For decimals, the high is exclusive, but for Range the high is inclusive
-//        assertSearchDoesntReturnSavedResource("decimal", "ge99.995");
+        assertSearchDoesntReturnSavedResource("decimal", "ge99.995");
         assertSearchDoesntReturnSavedResource("decimal", "ge99.996");
-        assertSearchDoesntReturnSavedResource("decimal", "ge100");
+        assertSearchReturnsSavedResource("decimal", "ge100");
 
         assertSearchReturnsSavedResource("decimal", "sa99");
         assertSearchReturnsSavedResource("decimal", "sa99.98499");
@@ -248,11 +246,9 @@ public void testSearchNumber_decimal() throws Exception {
         assertSearchDoesntReturnSavedResource("decimal", "eb99.99");
         assertSearchDoesntReturnSavedResource("decimal", "eb9999e-2");
         assertSearchDoesntReturnSavedResource("decimal", "eb99.99499");
-        // We need to track whether the high is inclusive or not to get this right
-        // For decimals, the high is exclusive, but for Range the high is inclusive
-//        assertSearchReturnsSavedResource("decimal", "eb99.995");
+        assertSearchDoesntReturnSavedResource("decimal", "eb99.995");
         assertSearchReturnsSavedResource("decimal", "eb99.996");
-        assertSearchReturnsSavedResource("decimal", "eb100");
+        assertSearchDoesntReturnSavedResource("decimal", "eb100");
     }
 
     @Test(expectedExceptions = { FHIRSearchException.class })
diff --git a/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchQuantityTest.java b/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchQuantityTest.java
index 448c4fd1276..f61a5ebfe91 100644
--- a/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchQuantityTest.java
+++ b/fhir-persistence/src/test/java/com/ibm/fhir/persistence/search/test/AbstractSearchQuantityTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2018, 2020
+ * (C) Copyright IBM Corp. 2018, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -81,6 +81,7 @@ public void testSearchQuantity_Quantity_revinclude() throws Exception {
 
     @Test
     public void testSearchQuantity_Quantity_withPrefix_NE() throws Exception {
+        // Implicit range of indexed 'Quantity' value is 24.5 to 25.5
         assertSearchReturnsSavedResource("Quantity", "ne24|http://unitsofmeasure.org|s");
         assertSearchReturnsSavedResource("Quantity", "ne24.4999||s");
         assertSearchReturnsSavedResource("Quantity", "ne24.5||s");
@@ -92,6 +93,7 @@ public void testSearchQuantity_Quantity_withPrefix_NE() throws Exception {
 
     @Test
     public void testSearchQuantity_Quantity_withPrefix_AP() throws Exception {
+        // Implicit range of indexed 'Quantity' value is 24.5 to 25.5
         assertSearchReturnsSavedResource("Quantity", "ap24|http://unitsofmeasure.org|s");
         assertSearchReturnsSavedResource("Quantity", "ap24.4999||s");
         assertSearchReturnsSavedResource("Quantity", "ap24.5||s");
@@ -104,6 +106,7 @@ public void testSearchQuantity_Quantity_withPrefix_AP() throws Exception {
 
     @Test
     public void testSearchQuantity_Quantity_withPrefix_LT() throws Exception {
+        // Implicit range of indexed 'Quantity' value is 24.5 to 25.5
         assertSearchDoesntReturnSavedResource("Quantity", "lt24|http://unitsofmeasure.org|s");
         assertSearchDoesntReturnSavedResource("Quantity", "lt24.4999||s");
         assertSearchDoesntReturnSavedResource("Quantity", "lt24.5||s");
@@ -116,6 +119,7 @@ public void testSearchQuantity_Quantity_withPrefix_LT() throws Exception {
 
     @Test
     public void testSearchQuantity_Quantity_withPrefix_GT() throws Exception {
+        // Implicit range of indexed 'Quantity' value is 24.5 to 25.5
         assertSearchReturnsSavedResource("Quantity", "gt24|http://unitsofmeasure.org|s");
         assertSearchReturnsSavedResource("Quantity", "gt24.4999||s");
         assertSearchReturnsSavedResource("Quantity", "gt24.5||s");
@@ -128,9 +132,11 @@ public void testSearchQuantity_Quantity_withPrefix_GT() throws Exception {
 
     @Test
     public void testSearchQuantity_Quantity_withPrefix_LE() throws Exception {
+        // Implicit range of indexed 'Quantity' value is 24.5 to 25.5
         assertSearchDoesntReturnSavedResource("Quantity", "le24|http://unitsofmeasure.org|s");
         assertSearchDoesntReturnSavedResource("Quantity", "le24.4999||s");
-        assertSearchReturnsSavedResource("Quantity", "le24.5||s");
+        assertSearchDoesntReturnSavedResource("Quantity", "le24.5||s");
+        assertSearchReturnsSavedResource("Quantity", "le24.5001||s");
         assertSearchReturnsSavedResource("Quantity", "le25||s");
         assertSearchReturnsSavedResource("Quantity", "le25.4999||s");
         assertSearchReturnsSavedResource("Quantity", "le25.5||s");
@@ -139,42 +145,40 @@ public void testSearchQuantity_Quantity_withPrefix_LE() throws Exception {
 
     @Test
     public void testSearchQuantity_Quantity_withPrefix_GE() throws Exception {
+        // Implicit range of indexed 'Quantity' value is 24.5 to 25.5
         assertSearchReturnsSavedResource("Quantity", "ge24|http://unitsofmeasure.org|s");
         assertSearchReturnsSavedResource("Quantity", "ge24.4999||s");
         assertSearchReturnsSavedResource("Quantity", "ge24.5||s");
         assertSearchReturnsSavedResource("Quantity", "ge25||s");
         assertSearchReturnsSavedResource("Quantity", "ge25.4999||s");
-        // We need to track whether the high is inclusive or not to get this right
-        // For decimals, the high is exclusive, but for Range the high is inclusive
-//        assertSearchDoesntReturnSavedResource("Quantity", "ge25.5||s");
+        assertSearchDoesntReturnSavedResource("Quantity", "ge25.5||s");
         assertSearchDoesntReturnSavedResource("Quantity", "ge25.5001||s");
         assertSearchDoesntReturnSavedResource("Quantity", "ge26|http://unitsofmeasure.org|s");
     }
 
     @Test
     public void testSearchQuantity_Quantity_withPrefix_SA() throws Exception {
-        assertSearchReturnsSavedResource("Quantity", "sa24|http://unitsofmeasure.org|s");
-        assertSearchReturnsSavedResource("Quantity", "sa24.4999||s");
-        assertSearchDoesntReturnSavedResource("Quantity", "sa24.5||s");
-        assertSearchDoesntReturnSavedResource("Quantity", "sa25||s");
-        assertSearchDoesntReturnSavedResource("Quantity", "sa25.4999||s");
-        assertSearchDoesntReturnSavedResource("Quantity", "sa25.5||s");
-        assertSearchDoesntReturnSavedResource("Quantity", "sa26|http://unitsofmeasure.org|s");
+        // Implicit range of indexed 'Quantity' value is 24.5 to 25.5
+        assertSearchDoesntReturnSavedResource("Quantity", "sa24|http://unitsofmeasure.org|s"); // 24.5 !> 24.5
+        assertSearchReturnsSavedResource("Quantity", "sa24.4999||s"); // 24.5 > 24.49995
+        assertSearchDoesntReturnSavedResource("Quantity", "sa24.5||s"); // 24.5 !> 24.55
+        assertSearchDoesntReturnSavedResource("Quantity", "sa25||s"); // 24.5 !> 25.5
+        assertSearchDoesntReturnSavedResource("Quantity", "sa25.4999||s"); // 24.5 !> 25.49995
+        assertSearchDoesntReturnSavedResource("Quantity", "sa25.5||s"); // 24.5 !> 25.55
+        assertSearchDoesntReturnSavedResource("Quantity", "sa26|http://unitsofmeasure.org|s"); // 24.5 !> 26.5
     }
 
     @Test
     public void testSearchQuantity_Quantity_withPrefix_EB() throws Exception {
-        assertSearchReturnsSavedResource("Quantity", "eb25.5001||s");
+        // Implicit range of indexed 'Quantity' value is 24.5 to 25.5
+        assertSearchReturnsSavedResource("Quantity", "eb25.5001||s"); // 25.5 < 25.50005
         assertSearchDoesntReturnSavedResource("Quantity", "eb24|http://unitsofmeasure.org|s");
-        assertSearchDoesntReturnSavedResource("Quantity", "eb24.4999||s");
-        assertSearchDoesntReturnSavedResource("Quantity", "eb24.5||s");
-        assertSearchDoesntReturnSavedResource("Quantity", "eb25||s");
-        assertSearchDoesntReturnSavedResource("Quantity", "eb25.4999||s");
-        // We need to track whether the high is inclusive or not to get this right
-        // For decimals, the high is exclusive, but for Range the high is inclusive
-//        assertSearchReturnsSavedResource("Quantity", "eb25.5||s");
-        assertSearchReturnsSavedResource("Quantity", "eb25.5001||s");
-        assertSearchReturnsSavedResource("Quantity", "eb26|http://unitsofmeasure.org|s");
+        assertSearchDoesntReturnSavedResource("Quantity", "eb24.4999||s"); // 25.5 !< 24.49985
+        assertSearchDoesntReturnSavedResource("Quantity", "eb24.5||s"); // 25.5 !< 24.45
+        assertSearchDoesntReturnSavedResource("Quantity", "eb25||s"); // 25.5 !< 24.5
+        assertSearchDoesntReturnSavedResource("Quantity", "eb25.4999||s"); // 25.5 !< 25.49985
+        assertSearchDoesntReturnSavedResource("Quantity", "eb25.5||s"); // 25.5 !< 25.45
+        assertSearchDoesntReturnSavedResource("Quantity", "eb26|http://unitsofmeasure.org|s"); // 25.5 !< 25.5
     }
 
     @Test
@@ -200,83 +204,244 @@ public void testSearchQuantity_Quantity_NoCode() throws Exception {
 
     @Test
     public void testSearchQuantity_Quantity_NoCodeOrUnit() throws Exception {
-        // spec isn't clear about whether quantities with no unit should be indexed
-        // but since we require the unit while searching, it doesn't really matter
-        assertSearchDoesntReturnSavedResource("Quantity-noCodeOrUnit", "1||eq");
+        assertSearchReturnsSavedResource("Quantity-noCodeOrUnit", "1");
+        assertSearchReturnsSavedResource("Quantity-noCodeOrUnit", "1||");
     }
 
-    /*
-     * FHIR Server does not yet use quantity comparator to calculate search results.
-     */
     // Quantity search is of the form <prefix><number>|<unit_system>|<unit>.
     // We use custom units to mark the quantity comparators so we can scope our searches in the tests.
 
+    @Test
+    public void testSearchQuantity_Quantity_UnicodeLessThan() throws Exception {
+        // Implicit range of indexed 'Quantity-unicodeLessThan' value is negative infinity to 2.999999999.
+
+        // eq, ne
+        // The target lower bound (negative infinity) can never be contained within the range of the search
+        // value, so will never match an equals search, but will always match a not-equals search.
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "5||ult");
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "-1000000||ult");
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "ne5||ult");
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "ne-1000000||ult");
+
+        // gt, ge
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "gt2||ult"); // < 3 may be > 2
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "gt4||ult"); // < 3 is not > 4
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "gt2.999999999||ult"); // < 3 is not > 2.999999999 (due to ranges)
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "gt2.999999998||ult"); // < 3 may be > 2.999999998
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "ge2||ult"); // < 3 may be >= 2
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "ge4||ult"); // < 3 is not >= 4
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "ge2.999999999||ult"); // < 3 is not >= 2.999999999 (due to ranges)
+
+        // lt, le
+        // The target lower bound (negative infinity) ensures that range of the target will always
+        // intersect with the range below the search value, so a less-than or less-than-or-equals
+        // search will always match.
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "lt4||ult");
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "lt-1000000||ult");
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "le1E-100||ult");
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "le1E+100||ult");
+
+        // sa
+        // The target lower bound (negative infinity) ensures that range of the target cannot be
+        // contained by the range above the search value, so a starts-after search will never match.
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "sa4||ult");
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "sa-1000000||ult");
+
+        // eb
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "eb2||ult"); // < 3 does not end before 2
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "eb4||ult"); // < 3 does end before 4
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "eb3||ult"); // < 3 does not end before 3 (due to ranges)
+
+        // ap
+        assertSearchDoesntReturnSavedResource("Quantity-unicodeLessThan", "ap4||ult"); // < 3 is not approximately 4
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "ap3.25||ult"); // < 3 is approximately 3.25
+        assertSearchReturnsSavedResource("Quantity-unicodeLessThan", "ap-1000000||ult"); // < 3 is approximately anything under 3
+    }
+
     @Test
     public void testSearchQuantity_Quantity_LessThan() throws Exception {
-        // For more details, please see Quantity search does not consider the quantity comparator field #493 https://github.com/IBM/FHIR/issues/493
-        // assertSearchReturnsSavedResource("Quantity-lessThan", "2||lt");
-        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "4||lt");
+        // Implicit range of indexed 'Quantity-lessThan' value is negative infinity to 2.999999999.
 
-        // For more details, please see Quantity search does not consider the quantity comparator field #493 https://github.com/IBM/FHIR/issues/493
-        // assertSearchDoesntReturnSavedResource("Quantity-lessThan", "3||lt");
-        // assertSearchReturnsSavedResource("Quantity-lessThan", "lt2||lt");      // < 3 may be < 2
+        // eq, ne
+        // The target lower bound (negative infinity) can never be contained within the range of the search
+        // value, so will never match an equals search, but will always match a not-equals search.
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "5||lt");
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "-1000000||lt");
+        assertSearchReturnsSavedResource("Quantity-lessThan", "ne5||lt");
+        assertSearchReturnsSavedResource("Quantity-lessThan", "ne-1000000||lt");
+
+        // gt, ge
         assertSearchReturnsSavedResource("Quantity-lessThan", "gt2||lt"); // < 3 may be > 2
-        assertSearchReturnsSavedResource("Quantity-lessThan", "lt4||lt"); // < 3 may be < 4
         assertSearchDoesntReturnSavedResource("Quantity-lessThan", "gt4||lt"); // < 3 is not > 4
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "gt2.999999999||lt"); // < 3 is not > 2.999999999 (due to ranges)
+        assertSearchReturnsSavedResource("Quantity-lessThan", "gt2.999999998||lt"); // < 3 may be > 2.999999998
+        assertSearchReturnsSavedResource("Quantity-lessThan", "ge2||lt"); // < 3 may be >= 2
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "ge4||lt"); // < 3 is not >= 4
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "ge2.999999999||lt"); // < 3 is not >= 2.999999999 (due to ranges)
+
+        // lt, le
+        // The target lower bound (negative infinity) ensures that range of the target will always
+        // intersect with the range below the search value, so a less-than or less-than-or-equals
+        // search will always match.
+        assertSearchReturnsSavedResource("Quantity-lessThan", "lt4||lt");
+        assertSearchReturnsSavedResource("Quantity-lessThan", "lt-1000000||lt");
+        assertSearchReturnsSavedResource("Quantity-lessThan", "le1E-100||lt");
+        assertSearchReturnsSavedResource("Quantity-lessThan", "le1E+100||lt");
+
+        // sa
+        // The target lower bound (negative infinity) ensures that range of the target cannot be
+        // contained by the range above the search value, so a starts-after search will never match.
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "sa4||lt");
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "sa-1000000||lt");
+
+        // eb
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "eb2||lt"); // < 3 does not end before 2
+        assertSearchReturnsSavedResource("Quantity-lessThan", "eb4||lt"); // < 3 does end before 4
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "eb3||lt"); // < 3 does not end before 3 (due to ranges)
+
+        // ap
+        assertSearchDoesntReturnSavedResource("Quantity-lessThan", "ap4||lt"); // < 3 is not approximately 4
+        assertSearchReturnsSavedResource("Quantity-lessThan", "ap3.25||lt"); // < 3 is approximately 3.25
+        assertSearchReturnsSavedResource("Quantity-lessThan", "ap-1000000||lt"); // < 3 is approximately anything under 3
     }
 
     @Test
     public void testSearchQuantity_Quantity_GreaterThan() throws Exception {
-        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "2||gt");
-
-        // For more details, please see Quantity search does not consider the quantity comparator field #493 https://github.com/IBM/FHIR/issues/493
-        // In this test, the comparator should be from the DB
-        // assertSearchReturnsSavedResource("Quantity-greaterThan", "4||gt");
-
-        // In this test, the comparator should be from the DB
-        // With implicit ranges, 3 (+/-0.5) actually might be > 3
-        // For more details, please see Quantity search does not consider the quantity comparator field #493 https://github.com/IBM/FHIR/issues/493
-        //assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "3||gt");
-        assertSearchReturnsSavedResource("Quantity-greaterThan", "3||gt");
+        // Implicit range of indexed 'Quantity-greaterThan' value is 3.000000001 to positive infinity.
 
+        // eq, ne
+        // The target upper bound (positive infinity) can never be contained within the range of the search
+        // value, so will never match an equals search, but will always match a not-equals search.
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "2||gt");
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "1000000||gt");
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "ne2||gt");
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "ne1000000||gt");
+
+        // gt, ge
+        // The target upper bound (positive infinity) ensures that range of target will always intersect
+        // with the range above the search value, so a greater-than or greater-than-or-equals
+        // search will always match.
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "gt2||gt");
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "gt1000000||gt");
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "ge1E-100||gt");
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "ge1E100||gt");
+
+        // lt, le
         assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "lt2||gt"); // > 3 is not < 2
-        assertSearchReturnsSavedResource("Quantity-greaterThan", "gt2||gt"); // > 3 may be > 2
         assertSearchReturnsSavedResource("Quantity-greaterThan", "lt4||gt"); // > 3 may be < 4
-
-        // For more details, please see Quantity search does not consider the quantity comparator field #493 https://github.com/IBM/FHIR/issues/493
-        // assertSearchReturnsSavedResource("Quantity-greaterThan", "gt4||gt");      // > 3 may be > 4
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "lt3.000000001||gt"); // < 3.000000001 is not > 3 (due to ranges)
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "lt3.000000002||gt"); // < 3.000000002 can be > 3
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "le2||gt"); // > 3 is not <= 2
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "le4||gt"); // > 3 may be <= 4
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "le3.000000001||gt"); // <= 3.000000001 is not > 3 (due to ranges)
+
+        // sa
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "sa2||gt"); // > 3 starts after 2
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "sa4||gt"); // > 3 does not start after 4
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "sa3||gt"); // > 3 does not start after 3 (due to ranges)
+        
+        // eb
+        // The target upper bound (positive infinity) ensures that range of target cannot be contained
+        // by the range below the search value, so an ends-before search will never match.
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "eb2||gt");
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "eb1000000||gt");
+
+        // ap
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThan", "ap2||gt"); // > 3 is not approximately 2
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "ap2.75||gt"); // > 3 is approximately 2.75
+        assertSearchReturnsSavedResource("Quantity-greaterThan", "ap1000000||gt"); // > 3 is approximately anything over 3
     }
 
     @Test
     public void testSearchQuantity_Quantity_LessThanOrEqual() throws Exception {
-        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "2||lte");
-        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "3||lte");
-        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "4||lte");
+        // Implicit range of indexed 'Quantity-lessThanOrEqual' value is negative infinity to 3.
 
-        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "lt2||lte"); // <= 3 may be < 2
+        // eq, ne
+        // The target lower bound (negative infinity) can never be contained within the range of the search
+        // value, so will never match an equals search, but will always match a not-equals search.
+        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "3||lte");
+        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "-1000000||lte");
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "ne3||lte");
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "ne-1000000||lte");
+
+        // gt, ge
         assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "gt2||lte"); // <= 3 may be > 2
-        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "lt4||lte"); // <= 3 may be < 4
         assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "gt4||lte"); // <= 3 is not > 4
-
-        // <= 3 may be <= 3
-        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "le3||lte");
-        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "ge3||lte"); // <= 3 may be >= 3
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "gt2.999999999||lte"); // <= 3 may be > 2.999999999
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "ge2||lte"); // <= 3 may be >= 2
+        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "ge4||lte"); // <= 3 is not >= 4
+        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "ge3||lte"); // <= 3 is not >= 3 (due to ranges)
+
+        // lt, le
+        // The target lower bound (negative infinity) ensures that range of target will always intersect
+        // with the range below the search value, so a less-than or less-than-or-equals
+        // search will always match.
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "lt4||lte");
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "lt-1000000||lte");
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "le1E-100||lte");
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "le1E+100||lte");
+
+        // sa
+        // The target lower bound (negative infinity) ensures that range of target cannot be contained
+        // by the range above the search value, so a starts-after search will never match.
+        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "sa4||lte");
+        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "sa-1000000||lte");
+
+        // eb
+        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "eb2||lte"); // <= 3 does not end before 2
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "eb4||lte"); // <= 3 does end before 4
+        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "eb3||lte"); // <= 3 does not end before 3
+
+        // ap
+        assertSearchDoesntReturnSavedResource("Quantity-lessThanOrEqual", "ap4||lte"); // <= 3 is not approximately 4
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "ap3.25||lte"); // <= 3 is approximately 3.25
+        assertSearchReturnsSavedResource("Quantity-lessThanOrEqual", "ap-1000000||lte"); // <= 3 is approximately anything under 3
     }
 
     @Test
     public void testSearchQuantity_Quantity_GreaterThanOrEqual() throws Exception {
-        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "2||gte");
-        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "3||gte");
-        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "4||gte");
+        // Implicit range of indexed 'Quantity-greaterThanOrEqual' value is 3 to positive infinity.
 
+        // eq, ne
+        // The target upper bound (positive infinity) can never be contained within the range of the search
+        // value, so will never match an equals search, but will always match a not-equals search.
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "2||gte");
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "1000000||gte");
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "ne2||gte");
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "ne1000000||gte");
+
+        // gt, ge
+        // The target upper bound (positive infinity) ensures that range of target will always intersect
+        // with the range above the search value, so a greater-than or greater-than-or-equals
+        // search will always match.
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "gt2||gte");
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "gt1000000||gte");
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "ge1E-100||gte");
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "ge1E100||gte");
+
+        // lt, le
         assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "lt2||gte"); // >= 3 is not < 2
-        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "gt2||gte"); // >= 3 may be > 2
         assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "lt4||gte"); // >= 3 may be < 4
-        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "gt4||gte"); // >= 3 may be > 4
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "lt3.000000001||gte"); // < 3.000000001 may be >= 3
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "le2||gte"); // >= 3 is not <= 2
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "le4||gte"); // >= 3 may be <= 4
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "le3||gte"); // <= 3 is not >= 3 (due to ranges)
 
-        // >= 3 may be <= 3
-        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "le3||gte");
-        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "ge3||gte"); // >= 3 is >= 3
+        // sa
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "sa2||gte"); // >= 3 starts after 2
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "sa4||gte"); // >= 3 does not start after 4
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "sa3||gte"); // >= 3 does not start after 3
+        
+        // eb
+        // The target upper bound (positive infinity) ensures that range of target cannot be contained
+        // by the range below the search value, so an ends-before search will never match.
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "eb2||gte");
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "eb1000000||gte");
+
+        // ap
+        assertSearchDoesntReturnSavedResource("Quantity-greaterThanOrEqual", "ap2||gte"); // >= 3 is not approximately 2
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "ap2.75||gte"); // >= 3 is approximately 2.75
+        assertSearchReturnsSavedResource("Quantity-greaterThanOrEqual", "ap1000000||gte"); // >= 3 is approximately anything over 3
     }
 
     @Test
@@ -337,11 +502,10 @@ public void testSearchQuantity_Range_NE() throws Exception {
     // Range is 5-10 seconds
     @Test
     public void testSearchQuantity_Range_AP() throws Exception {
-        assertSearchDoesntReturnSavedResource("Range", "ap11||s");
         assertSearchDoesntReturnSavedResource("Range", "ap4||s");
         assertSearchReturnsSavedResource("Range", "ap5||s");
         assertSearchReturnsSavedResource("Range", "ap10||s");
-        assertSearchDoesntReturnSavedResource("Range", "ap11||s");
+        assertSearchReturnsSavedResource("Range", "ap11||s");
     }
 
     // Range is 5-10 seconds
@@ -386,7 +550,7 @@ public void testSearchQuantity_Range_SA() throws Exception {
     public void testSearchQuantity_Range_GE() throws Exception {
         assertSearchReturnsSavedResource("Range", "ge4||s");
         assertSearchReturnsSavedResource("Range", "ge5||s");
-        assertSearchReturnsSavedResource("Range", "ge10||s");
+        assertSearchDoesntReturnSavedResource("Range", "ge10||s");
         assertSearchDoesntReturnSavedResource("Range", "ge11||s");
     }
 
@@ -394,12 +558,214 @@ public void testSearchQuantity_Range_GE() throws Exception {
     @Test
     public void testSearchQuantity_Range_LE() throws Exception {
         assertSearchDoesntReturnSavedResource("Range", "le4||s");
-        assertSearchReturnsSavedResource("Range", "le5||s");
+        assertSearchDoesntReturnSavedResource("Range", "le5||s");
         assertSearchReturnsSavedResource("Range", "le10||s");
         assertSearchReturnsSavedResource("Range", "le10.01||s");
         assertSearchReturnsSavedResource("Range", "le11||s");
     }
 
+    // Range is 5-unknown seconds
+    @Test
+    public void testSearchQuantity_Range_NoHigh_EQ_Implied() throws Exception {
+        // The range of the search value cannot fully contain the range
+        // of the target value because the target has no high value,
+        // so an equals search will never succeed.
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "1e1||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "4||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "5||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "10||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "11||s");
+    }
+
+    // Range is 5-unknown seconds
+    @Test
+    public void testSearchQuantity_Range_NoHigh_NE() throws Exception {
+        // The range of the search value cannot fully contain the range
+        // of the target value because the target has no high value,
+        // so a not-equals search will always succeed.
+        assertSearchReturnsSavedResource("Range-noHigh", "ne1e1||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "ne4||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "ne5||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "ne10||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "ne11||s");
+    }
+
+    // Range is 5-unknown seconds
+    @Test
+    public void testSearchQuantity_Range_NoHigh_AP() throws Exception {
+        assertSearchReturnsSavedResource("Range-noHigh", "ap1e1||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "ap4||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "ap5||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "ap5.7||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "ap6||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "ap10||s");
+    }
+
+    // Range is 5-unknown seconds
+    @Test
+    public void testSearchQuantity_Range_NoHigh_LT() throws Exception {
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "lt4||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "lt5||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "lt5.000000001||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "lt10||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "lt11||s");
+    }
+
+    // Range is 5-unknown seconds
+    @Test
+    public void testSearchQuantity_Range_NoHigh_GT() throws Exception {
+        assertSearchReturnsSavedResource("Range-noHigh", "gt4||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "gt4.99999999||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "gt5||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "gt10||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "gt11||s");
+    }
+
+    // Range is 5-unknown seconds
+    @Test
+    public void testSearchQuantity_Range_NoHigh_EB() throws Exception {
+        // The range below the search value cannot fully contain the range
+        // of the target value because the target has no high value,
+        // so an ends-before search will never succeed.
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "eb4||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "eb5||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "eb10||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "eb1000||s");
+    }
+
+    // Range is 5-unknown seconds
+    @Test
+    public void testSearchQuantity_Range_NoHigh_SA() throws Exception {
+        assertSearchReturnsSavedResource("Range-noHigh", "sa4||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "sa4.99999999||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "sa5||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "sa10||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "sa10.0||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "sa11||s");
+    }
+
+    // Range is 5-unknown seconds
+    @Test
+    public void testSearchQuantity_Range_NoHigh_GE() throws Exception {
+        assertSearchReturnsSavedResource("Range-noHigh", "ge4||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "ge5||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "ge5.0||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "ge5.000000001||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "ge10||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "ge11||s");
+    }
+
+    // Range is 5-unknown seconds
+    @Test
+    public void testSearchQuantity_Range_NoHigh_LE() throws Exception {
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "le4||s");
+        assertSearchDoesntReturnSavedResource("Range-noHigh", "le5||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "le5.000000001||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "le10||s");
+        assertSearchReturnsSavedResource("Range-noHigh", "le11||s");
+    }
+
+    // Range is unknown-10 seconds
+    @Test
+    public void testSearchQuantity_Range_NoLow_EQ_Implied() throws Exception {
+        // The range of the search value cannot fully contain the range
+        // of the target value because the target has no low value,
+        // so an equals search will never succeed.
+        assertSearchDoesntReturnSavedResource("Range-noLow", "1e1||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "4||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "5||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "10||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "11||s");
+    }
+
+    // Range is unknown-10 seconds
+    @Test
+    public void testSearchQuantity_Range_NoLow_NE() throws Exception {
+        // The range of the search value cannot fully contain the range
+        // of the target value because the target has no low value,
+        // so a not-equals search will always succeed.
+        assertSearchReturnsSavedResource("Range-noLow", "ne1e1||s");
+        assertSearchReturnsSavedResource("Range-noLow", "ne4||s");
+        assertSearchReturnsSavedResource("Range-noLow", "ne5||s");
+        assertSearchReturnsSavedResource("Range-noLow", "ne10||s");
+        assertSearchReturnsSavedResource("Range-noLow", "ne11||s");
+    }
+
+    // Range is unknown-10 seconds
+    @Test
+    public void testSearchQuantity_Range_NoLow_AP() throws Exception {
+        assertSearchReturnsSavedResource("Range-noLow", "ap1e1||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "ap4||s");
+        assertSearchReturnsSavedResource("Range-noLow", "ap9||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "ap9.05||s");
+        assertSearchReturnsSavedResource("Range-noLow", "ap10||s");
+        assertSearchReturnsSavedResource("Range-noLow", "ap11||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "ap11.5||s");
+    }
+
+    // Range is unknown-10 seconds
+    @Test
+    public void testSearchQuantity_Range_NoLow_LT() throws Exception {
+        assertSearchDoesntReturnSavedResource("Range-noLow", "lt4||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "lt5||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "lt10||s");
+        assertSearchReturnsSavedResource("Range-noLow", "lt10.000000001||s");
+        assertSearchReturnsSavedResource("Range-noLow", "lt11||s");
+    }
+
+    // Range is unknown-10 seconds
+    @Test
+    public void testSearchQuantity_Range_NoLow_GT() throws Exception {
+        assertSearchReturnsSavedResource("Range-noLow", "gt4||s");
+        assertSearchReturnsSavedResource("Range-noLow", "gt5||s");
+        assertSearchReturnsSavedResource("Range-noLow", "gt9.99999999||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "gt10||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "gt11||s");
+    }
+
+    // Range is unknown-10 seconds
+    @Test
+    public void testSearchQuantity_Range_NoLow_EB() throws Exception {
+        assertSearchDoesntReturnSavedResource("Range-noLow", "eb4||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "eb5||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "eb10||s");
+        assertSearchReturnsSavedResource("Range-noLow", "eb10.000000001||s");
+        assertSearchReturnsSavedResource("Range-noLow", "eb11||s");
+    }
+
+    // Range is unknown-10 seconds
+    @Test
+    public void testSearchQuantity_Range_NoLow_SA() throws Exception {
+        // The range above the search value cannot fully contain the range
+        // of the target value because the target has no low value,
+        // so a starts-after search will never succeed.
+        assertSearchDoesntReturnSavedResource("Range-noLow", "sa4||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "sa5||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "sa10||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "sa10.0||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "sa1000||s");
+    }
+
+    // Range is unknown-10 seconds
+    @Test
+    public void testSearchQuantity_Range_NoLow_GE() throws Exception {
+        assertSearchReturnsSavedResource("Range-noLow", "ge4||s");
+        assertSearchReturnsSavedResource("Range-noLow", "ge5||s");
+        assertSearchReturnsSavedResource("Range-noLow", "ge9.99999999||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "ge10||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "ge11||s");
+    }
+
+    // Range is unknown-10 seconds
+    @Test
+    public void testSearchQuantity_Range_NoLow_LE() throws Exception {
+        assertSearchDoesntReturnSavedResource("Range-noLow", "le4||s");
+        assertSearchDoesntReturnSavedResource("Range-noLow", "le5||s");
+        assertSearchReturnsSavedResource("Range-noLow", "le10||s");
+        assertSearchReturnsSavedResource("Range-noLow", "le10.000000001||s");
+        assertSearchReturnsSavedResource("Range-noLow", "le11||s");
+    }
+
     @Test
     public void testSearchQuantity_Range_missing() throws Exception {
         assertSearchReturnsSavedResource("Range:missing", "false");
@@ -413,7 +779,10 @@ public void testSearchQuantity_Exponent() throws Exception {
         // Value 1.2E+2 should return the value
         // The value is extracted, and stored in the values tables.
         assertSearchReturnsSavedResource("Quantity-withExponent", "1.2E+2");
-        assertSearchReturnsSavedResource("Quantity-withExponent", "120");
+        // Value 120 should not return the value since the range of 120
+        // (119.5-120.5) is smaller than the range of the indexed value
+        // 1.2E+2 (115-125) due to the difference in scale of those values.
+        assertSearchDoesntReturnSavedResource("Quantity-withExponent", "120");
     }
 
     @Test
diff --git a/fhir-persistence/src/test/java/com/ibm/fhir/persistence/test/common/AbstractPersistenceTest.java b/fhir-persistence/src/test/java/com/ibm/fhir/persistence/test/common/AbstractPersistenceTest.java
index 1abd9841691..131c166afac 100644
--- a/fhir-persistence/src/test/java/com/ibm/fhir/persistence/test/common/AbstractPersistenceTest.java
+++ b/fhir-persistence/src/test/java/com/ibm/fhir/persistence/test/common/AbstractPersistenceTest.java
@@ -15,6 +15,7 @@
 import java.util.HashMap;
 import java.util.List;
 import java.util.Map;
+import java.util.Set;
 import java.util.logging.LogManager;
 import java.util.logging.Logger;
 
@@ -217,7 +218,7 @@ protected List<Resource> runCompartmentQueryTest(String compartmentName, String
         return executeCompartmentQuery(resourceType, maxPageSize, searchContext);
     }
 
-    protected List<Resource> runCompartmentQueryTest(String compartmentName, List<String> compartmentLogicalIds, Class<? extends Resource> resourceType, Map<String, List<String>> queryParms, Integer maxPageSize) throws Exception {
+    protected List<Resource> runCompartmentQueryTest(String compartmentName, Set<String> compartmentLogicalIds, Class<? extends Resource> resourceType, Map<String, List<String>> queryParms, Integer maxPageSize) throws Exception {
         FHIRSearchContext searchContext = SearchUtil.parseQueryParameters(resourceType, queryParms);
         QueryParameter inclusionCriteria = SearchUtil.buildInclusionCriteria(compartmentName, compartmentLogicalIds, resourceType.getSimpleName());
         if (inclusionCriteria != null) {
diff --git a/fhir-persistence/src/test/resources/config/quantity/extension-search-parameters.json b/fhir-persistence/src/test/resources/config/quantity/extension-search-parameters.json
index 776115d62c4..4a2c33f3737 100644
--- a/fhir-persistence/src/test/resources/config/quantity/extension-search-parameters.json
+++ b/fhir-persistence/src/test/resources/config/quantity/extension-search-parameters.json
@@ -342,6 +342,23 @@
             "xpathUsage": "normal"
         }
     },
+    {
+        "fullUrl": "http://ibm.com/watsonhealth/fhir/SearchParameter/Basic-Quantity-unicodeLessThan",
+        "resource": {
+            "resourceType": "SearchParameter",
+            "id": "Basic-Quantity-unicodeLessThan",
+            "url": "http://ibm.com/fhir/SearchParameter/Basic-Quantity-unicodeLessThan",
+            "name": "Quantity-unicodeLessThan",
+            "status": "active",
+            "description": "test param",
+            "code": "Quantity-unicodeLessThan",
+            "base": ["Basic"],
+            "type": "quantity",
+            "expression": "Basic.extension.where(url='http://example.org/Quantity-unicodeLessThan').value",
+            "xpath": "f:Basic/f:extension[@url='http://example.org/Quantity-unicodeLessThan']/f:valueQuantity",
+            "xpathUsage": "normal"
+        }
+    },
     {
         "fullUrl": "http://ibm.com/watsonhealth/fhir/SearchParameter/Basic-Quantity-lessThan",
         "resource": {
@@ -444,7 +461,40 @@
             "xpathUsage": "normal"
         }
     },
-    
+    {
+        "fullUrl": "http://ibm.com/watsonhealth/fhir/SearchParameter/Basic-Range-noHigh",
+        "resource": {
+            "resourceType": "SearchParameter",
+            "id": "Basic-Range-noHigh",
+            "url": "http://ibm.com/fhir/SearchParameter/Basic-Range-noHigh",
+            "name": "Range-noHigh",
+            "status": "active",
+            "description": "test param",
+            "code": "Range-noHigh",
+            "base": ["Basic"],
+            "type": "quantity",
+            "expression": "Basic.extension.where(url='http://example.org/Range-noHigh').value",
+            "xpath": "f:Basic/f:extension[@url='http://example.org/Range-noHigh']/f:valueRange",
+            "xpathUsage": "normal"
+        }
+    },
+    {
+        "fullUrl": "http://ibm.com/watsonhealth/fhir/SearchParameter/Basic-Range-noLow",
+        "resource": {
+            "resourceType": "SearchParameter",
+            "id": "Basic-Range-noLow",
+            "url": "http://ibm.com/fhir/SearchParameter/Basic-Range-noLow",
+            "name": "Range-noLow",
+            "status": "active",
+            "description": "test param",
+            "code": "Range-noLow",
+            "base": ["Basic"],
+            "type": "quantity",
+            "expression": "Basic.extension.where(url='http://example.org/Range-noLow').value",
+            "xpath": "f:Basic/f:extension[@url='http://example.org/Range-noLow']/f:valueRange",
+            "xpathUsage": "normal"
+        }
+    },
     {
         "fullUrl": "http://ibm.com/watsonhealth/fhir/SearchParameter/Basic-missing-Quantity",
         "resource": {
diff --git a/fhir-profile/pom.xml b/fhir-profile/pom.xml
index 781d3402a6f..820d70aaf35 100644
--- a/fhir-profile/pom.xml
+++ b/fhir-profile/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-profile/src/main/java/com/ibm/fhir/profile/ConstraintGenerator.java b/fhir-profile/src/main/java/com/ibm/fhir/profile/ConstraintGenerator.java
index 8e26d4c098d..65e995fc7b8 100644
--- a/fhir-profile/src/main/java/com/ibm/fhir/profile/ConstraintGenerator.java
+++ b/fhir-profile/src/main/java/com/ibm/fhir/profile/ConstraintGenerator.java
@@ -8,7 +8,6 @@
 
 import static com.ibm.fhir.model.util.ModelSupport.delimit;
 import static com.ibm.fhir.model.util.ModelSupport.isKeyword;
-import static com.ibm.fhir.model.util.ModelSupport.isResourceType;
 import static com.ibm.fhir.profile.ProfileSupport.HL7_STRUCTURE_DEFINITION_URL_PREFIX;
 import static com.ibm.fhir.profile.ProfileSupport.createConstraint;
 import static com.ibm.fhir.profile.ProfileSupport.getBinding;
@@ -562,14 +561,8 @@ private String generateProfileConstraint(Node node, boolean discriminator) {
             sb.append(".");
         }
 
-        Type type = getTypes(elementDefinition).get(0);
-        String profile = getProfiles(type).get(0);
-        String code = type.getCode().getValue();
-        if (isResourceType(code)) {
-            sb.append("conformsTo('").append(profile).append("', true)");
-        } else {
-            sb.append("conformsTo('").append(profile).append("')");
-        }
+        String profile = getProfiles(getTypes(elementDefinition).get(0)).get(0);
+        sb.append("conformsTo('").append(profile).append("')");
 
         if (isRepeating(elementDefinition)) {
             sb.append(")");
diff --git a/fhir-profile/src/main/java/com/ibm/fhir/profile/ProfileSupport.java b/fhir-profile/src/main/java/com/ibm/fhir/profile/ProfileSupport.java
index 3d58ca0bbd0..42df662d1de 100644
--- a/fhir-profile/src/main/java/com/ibm/fhir/profile/ProfileSupport.java
+++ b/fhir-profile/src/main/java/com/ibm/fhir/profile/ProfileSupport.java
@@ -228,6 +228,34 @@ public static List<String> getResourceAssertedProfiles(Resource resource) {
         return Collections.emptyList();
     }
 
+    public static boolean hasResourceAssertedProfile(Resource resource, StructureDefinition profile) {
+        Meta meta = resource.getMeta();
+        if (meta != null) {
+            for (Canonical canonical : meta.getProfile()) {
+                String value = canonical.getValue();
+
+                if (value == null) {
+                    continue;
+                }
+
+                String uri = value;
+                String version = null;
+
+                int index = value.indexOf("|");
+                if (index != -1) {
+                    uri = value.substring(0, index);
+                    version = value.substring(index + 1);
+                }
+
+                if (uri.equals(profile.getUrl().getValue()) &&
+                        (version == null || profile.getVersion() == null || version.equals(profile.getVersion().getValue()))) {
+                    return true;
+                }
+            }
+        }
+        return false;
+    }
+
     public static List<Constraint> getConstraints(String url, Class<?> type) {
         return getConstraints(Collections.singletonList(url), type);
     }
diff --git a/fhir-provider/pom.xml b/fhir-provider/pom.xml
index 4cfad9f39ad..dc6f71b883b 100644
--- a/fhir-provider/pom.xml
+++ b/fhir-provider/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRJsonPatchProvider.java b/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRJsonPatchProvider.java
index 490e70acb16..66ef224387e 100644
--- a/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRJsonPatchProvider.java
+++ b/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRJsonPatchProvider.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -23,13 +23,13 @@
 import java.util.logging.Level;
 import java.util.logging.Logger;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonException;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonWriter;
-import javax.json.JsonWriterFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonException;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonWriter;
+import jakarta.json.JsonWriterFactory;
 import javax.ws.rs.Consumes;
 import javax.ws.rs.Produces;
 import javax.ws.rs.RuntimeType;
diff --git a/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRJsonProvider.java b/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRJsonProvider.java
index b8016281940..63636282247 100644
--- a/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRJsonProvider.java
+++ b/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRJsonProvider.java
@@ -23,13 +23,13 @@
 import java.util.logging.Level;
 import java.util.logging.Logger;
 
-import javax.json.Json;
-import javax.json.JsonException;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonWriter;
-import javax.json.JsonWriterFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonException;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonWriter;
+import jakarta.json.JsonWriterFactory;
 import javax.ws.rs.Consumes;
 import javax.ws.rs.Produces;
 import javax.ws.rs.RuntimeType;
@@ -46,7 +46,7 @@
 import com.ibm.fhir.model.type.code.IssueType;
 
 /**
- * Maps entity streams to/from javax.json objects
+ * Maps entity streams to/from jakarta.json objects
  */
 @Consumes({ FHIRMediaType.APPLICATION_FHIR_JSON, MediaType.APPLICATION_JSON })
 @Produces({ FHIRMediaType.APPLICATION_FHIR_JSON, MediaType.APPLICATION_JSON })
diff --git a/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRProvider.java b/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRProvider.java
index 2fddb22cd0f..a36818cd410 100644
--- a/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRProvider.java
+++ b/fhir-provider/src/main/java/com/ibm/fhir/provider/FHIRProvider.java
@@ -85,10 +85,7 @@ public Resource readFrom(Class<Resource> type, Type genericType, Annotation[] an
             FHIRRequestContext requestContext = FHIRRequestContext.get();
             Format format = getFormat(mediaType);
             FHIRParser parser = FHIRParser.parser(format);
-            if (parser.isPropertySupported(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS)) {
-                parser.setProperty(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS,
-                        HTTPHandlingPreference.LENIENT.equals(requestContext.getHandlingPreference()));
-            }
+            parser.setIgnoringUnrecognizedElements(HTTPHandlingPreference.LENIENT.equals(requestContext.getHandlingPreference()));
             return parser.parse(entityStream);
         } catch (FHIRParserException e) {
             if (RuntimeType.SERVER.equals(runtimeType)) {
diff --git a/fhir-registry/pom.xml b/fhir-registry/pom.xml
index a8b32e6a2f8..80c5e880b4d 100644
--- a/fhir-registry/pom.xml
+++ b/fhir-registry/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-registry</artifactId>
diff --git a/fhir-registry/src/main/java/com/ibm/fhir/registry/util/FHIRRegistryResourceProviderAdapter.java b/fhir-registry/src/main/java/com/ibm/fhir/registry/util/FHIRRegistryResourceProviderAdapter.java
new file mode 100644
index 00000000000..2a59d996b46
--- /dev/null
+++ b/fhir-registry/src/main/java/com/ibm/fhir/registry/util/FHIRRegistryResourceProviderAdapter.java
@@ -0,0 +1,41 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.registry.util;
+
+import java.util.Collection;
+import java.util.Collections;
+
+import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.registry.resource.FHIRRegistryResource;
+import com.ibm.fhir.registry.spi.FHIRRegistryResourceProvider;
+
+public class FHIRRegistryResourceProviderAdapter implements FHIRRegistryResourceProvider {
+    @Override
+    public FHIRRegistryResource getRegistryResource(Class<? extends Resource> resourceType, String url, String version) {
+        return null;
+    }
+
+    @Override
+    public Collection<FHIRRegistryResource> getRegistryResources(Class<? extends Resource> resourceType) {
+        return Collections.emptyList();
+    }
+
+    @Override
+    public Collection<FHIRRegistryResource> getRegistryResources() {
+        return Collections.emptyList();
+    }
+
+    @Override
+    public Collection<FHIRRegistryResource> getProfileResources(String type) {
+        return Collections.emptyList();
+    }
+
+    @Override
+    public Collection<FHIRRegistryResource> getSearchParameterResources(String type) {
+        return Collections.emptyList();
+    }
+}
diff --git a/fhir-registry/src/main/java/com/ibm/fhir/registry/util/Index.java b/fhir-registry/src/main/java/com/ibm/fhir/registry/util/Index.java
index 40f26004c80..2449331bc0a 100644
--- a/fhir-registry/src/main/java/com/ibm/fhir/registry/util/Index.java
+++ b/fhir-registry/src/main/java/com/ibm/fhir/registry/util/Index.java
@@ -23,12 +23,12 @@
 import java.util.logging.Level;
 import java.util.logging.Logger;
 
-import javax.json.spi.JsonProvider;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
-import javax.json.stream.JsonParser;
-import javax.json.stream.JsonParser.Event;
-import javax.json.stream.JsonParserFactory;
+import jakarta.json.spi.JsonProvider;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
+import jakarta.json.stream.JsonParser;
+import jakarta.json.stream.JsonParser.Event;
+import jakarta.json.stream.JsonParserFactory;
 
 import com.ibm.fhir.model.resource.Resource;
 import com.ibm.fhir.model.resource.SearchParameter;
diff --git a/fhir-registry/src/main/resources/hl7/fhir/core/package/.index.json b/fhir-registry/src/main/resources/hl7/fhir/core/package/.index.json
index 17479f3e91f..63479e59d99 100644
--- a/fhir-registry/src/main/resources/hl7/fhir/core/package/.index.json
+++ b/fhir-registry/src/main/resources/hl7/fhir/core/package/.index.json
@@ -1,4 +1,3 @@
-
 {
     "index-version": 1,
     "files": [
diff --git a/fhir-registry/src/test/java/com/ibm/fhir/registry/tool/IndexGenerator.java b/fhir-registry/src/test/java/com/ibm/fhir/registry/tool/IndexGenerator.java
index bb9894ac07c..2d491f29aa5 100644
--- a/fhir-registry/src/test/java/com/ibm/fhir/registry/tool/IndexGenerator.java
+++ b/fhir-registry/src/test/java/com/ibm/fhir/registry/tool/IndexGenerator.java
@@ -64,7 +64,8 @@ public static void main(String[] args) throws Exception {
                         continue;
                     }
 
-                    if (resource instanceof SearchParameter && id.equals("clinical-patient")) {
+                    if (resource instanceof SearchParameter &&
+                            (id.equals("clinical-patient") || id.equals("Provenance-patient"))) {
                         // Workaround for https://jira.hl7.org/browse/FHIR-13601
                         resource = ((SearchParameter) resource).toBuilder()
                                 .target(Collections.singleton(ResourceType.PATIENT))
diff --git a/fhir-search/pom.xml b/fhir-search/pom.xml
index 0aac9a56bbd..454dea49ea1 100644
--- a/fhir-search/pom.xml
+++ b/fhir-search/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-search/src/main/java/com/ibm/fhir/search/SearchConstants.java b/fhir-search/src/main/java/com/ibm/fhir/search/SearchConstants.java
index 220810d8c89..ef50bc124d4 100644
--- a/fhir-search/src/main/java/com/ibm/fhir/search/SearchConstants.java
+++ b/fhir-search/src/main/java/com/ibm/fhir/search/SearchConstants.java
@@ -15,6 +15,7 @@
 import java.util.Map;
 import java.util.Set;
 
+import com.ibm.fhir.core.FHIRConstants;
 import com.ibm.fhir.model.type.Code;
 import com.ibm.fhir.model.type.Coding;
 import com.ibm.fhir.model.type.Uri;
@@ -94,8 +95,7 @@ private SearchConstants() {
     // _has
     public static final String HAS = "_has";
 
-    public static final String BASE_SYSTEM_EXT_URL = "http://ibm.com/fhir/extension/";
-    public static final String IMPLICIT_SYSTEM_EXT_URL = BASE_SYSTEM_EXT_URL + "implicit-system";
+    public static final String IMPLICIT_SYSTEM_EXT_URL = FHIRConstants.EXT_BASE + "implicit-system";
 
     // Extracted search parameter suffix for :identifier modifier
     public static final String IDENTIFIER_MODIFIER_SUFFIX = ":identifier";
@@ -181,6 +181,7 @@ private SearchConstants() {
 
     /**
      * Prefixes for Search parameters
+     * @implNote please keep in sync with {@link com.ibm.fhir.client.FHIRParameters.ValuePrefix}
      */
     public enum Prefix {
         EQ("eq"),
@@ -252,6 +253,7 @@ public static Type fromValue(String value) {
 
     /**
      * Search Modifiers
+     * @implNote please keep in sync with {@link com.ibm.fhir.client.FHIRParameters.Modifier}
      */
     public enum Modifier {
         MISSING("missing"),
diff --git a/fhir-search/src/main/java/com/ibm/fhir/search/compartment/CompartmentUtil.java b/fhir-search/src/main/java/com/ibm/fhir/search/compartment/CompartmentUtil.java
index ee1d731fb42..564828f8604 100644
--- a/fhir-search/src/main/java/com/ibm/fhir/search/compartment/CompartmentUtil.java
+++ b/fhir-search/src/main/java/com/ibm/fhir/search/compartment/CompartmentUtil.java
@@ -14,8 +14,11 @@
 import java.util.Objects;
 import java.util.Set;
 
+import com.ibm.fhir.core.FHIRConstants;
 import com.ibm.fhir.model.resource.CompartmentDefinition;
 import com.ibm.fhir.model.resource.CompartmentDefinition.Resource;
+import com.ibm.fhir.model.type.code.CompartmentType;
+import com.ibm.fhir.model.util.FHIRUtil;
 import com.ibm.fhir.registry.FHIRRegistry;
 import com.ibm.fhir.search.exception.FHIRSearchException;
 import com.ibm.fhir.search.exception.SearchExceptionUtil;
@@ -36,6 +39,9 @@
  * Call {@link #init()} to initialize static members and avoid a slight performance hit on first use.
  */
 public class CompartmentUtil {
+    // The URL of the compartment subtype extension...useful for defining new compartments
+    public static final String CUSTOM_COMPARTMENT_TYPE_EXT = FHIRConstants.EXT_BASE + "custom-compartment-type";
+
     // Map of Compartment name to CompartmentCache
     private static final Map<String, CompartmentCache> compartmentMap = new HashMap<>();
 
@@ -76,7 +82,10 @@ public static final void buildMaps(Map<String, CompartmentCache> compMap, Map<St
 
         Collection<CompartmentDefinition> definitions = FHIRRegistry.getInstance().getResources(CompartmentDefinition.class);
         for (CompartmentDefinition compartmentDefinition : definitions) {
-            String compartmentName = compartmentDefinition.getCode().getValue();
+            CompartmentType type = compartmentDefinition.getCode();
+
+            String compartmentName = type.hasValue() ? type.getValue()
+                    : FHIRUtil.getExtensionStringValue(type, CUSTOM_COMPARTMENT_TYPE_EXT);
 
             // The cached object (a smaller/lighter lookup resource) used for point lookups
             CompartmentCache compartmentDefinitionCache = new CompartmentCache();
@@ -131,7 +140,7 @@ public static List<String> getCompartmentResourceTypeInclusionCriteria(final Str
     }
 
     /**
-     * checks that the compartment is valid, and throws and exception if, not
+     * checks that the compartment is valid and throws an exception if not
      *
      * @param compartment
      * @throws FHIRSearchException
@@ -144,7 +153,7 @@ public static void checkValidCompartment(final String compartment) throws FHIRSe
     }
 
     /**
-     * checks that the compartment and resource are valid, and throws and exception if, not
+     * checks that the compartment and resource are valid and throws an exception if not
      *
      * @param compartment
      * @throws FHIRSearchException
diff --git a/fhir-search/src/main/java/com/ibm/fhir/search/date/DateTimeHandler.java b/fhir-search/src/main/java/com/ibm/fhir/search/date/DateTimeHandler.java
index 1589e30e414..a129cd6403f 100644
--- a/fhir-search/src/main/java/com/ibm/fhir/search/date/DateTimeHandler.java
+++ b/fhir-search/src/main/java/com/ibm/fhir/search/date/DateTimeHandler.java
@@ -101,8 +101,8 @@ public static Timestamp generateTimestamp(Instant inst) {
      * Calculates a lower bound absolutely.
      * No matter if the time is AFTER the current time.
      *
-     * @param now
-     * @param cur
+     * @param now the instant representing "now"...the now to compare against for computing the "approximation" range
+     * @param cur the search parameter value instant
      * @return
      */
     public static Instant generateLowerBoundApproximation(Instant now, Instant cur) {
@@ -121,7 +121,7 @@ public static Instant generateLowerBoundApproximation(Instant now, Instant cur)
     public static Instant generateLowerBound(Prefix prefix, TemporalAccessor value, String originalString) {
         Instant response;
 
-        if (prefix != null && Prefix.AP.compareTo(prefix) == 0) {
+        if (prefix == Prefix.AP) {
             Instant cur = generateValue(value, originalString);
             Instant now = java.time.Instant.now();
             response = generateLowerBoundApproximation(now, cur);
diff --git a/fhir-search/src/main/java/com/ibm/fhir/search/reference/value/CompartmentReference.java b/fhir-search/src/main/java/com/ibm/fhir/search/reference/value/CompartmentReference.java
index 988d27aed9b..de214e59289 100644
--- a/fhir-search/src/main/java/com/ibm/fhir/search/reference/value/CompartmentReference.java
+++ b/fhir-search/src/main/java/com/ibm/fhir/search/reference/value/CompartmentReference.java
@@ -6,6 +6,7 @@
 
 package com.ibm.fhir.search.reference.value;
 
+import java.util.Objects;
 
 /**
  * Represents a reference to a resource compartment extracted by SearchUtil
@@ -25,6 +26,9 @@ public class CompartmentReference {
      * @param referenceResourceValue
      */
     public CompartmentReference(String parameterName, String referenceResourceType, String referenceResourceValue) {
+        Objects.requireNonNull(parameterName, "parameterName");
+        Objects.requireNonNull(referenceResourceType, "referenceResourceType");
+        Objects.requireNonNull(referenceResourceValue, "referenceResourceValue");
         this.parameterName = parameterName;
         this.referenceResourceType = referenceResourceType;
         this.referenceResourceValue = referenceResourceValue;
diff --git a/fhir-search/src/main/java/com/ibm/fhir/search/util/SearchUtil.java b/fhir-search/src/main/java/com/ibm/fhir/search/util/SearchUtil.java
index 1edba568398..9033f6044bd 100644
--- a/fhir-search/src/main/java/com/ibm/fhir/search/util/SearchUtil.java
+++ b/fhir-search/src/main/java/com/ibm/fhir/search/util/SearchUtil.java
@@ -6,6 +6,8 @@
 
 package com.ibm.fhir.search.util;
 
+import static com.ibm.fhir.model.util.ModelSupport.FHIR_STRING;
+
 import java.io.FileNotFoundException;
 import java.math.BigDecimal;
 import java.net.URISyntaxException;
@@ -43,6 +45,7 @@
 import com.ibm.fhir.model.resource.ValueSet;
 import com.ibm.fhir.model.type.Canonical;
 import com.ibm.fhir.model.type.Code;
+import com.ibm.fhir.model.type.Element;
 import com.ibm.fhir.model.type.Reference;
 import com.ibm.fhir.model.type.Uri;
 import com.ibm.fhir.model.type.code.IssueSeverity;
@@ -54,12 +57,10 @@
 import com.ibm.fhir.model.util.FHIRUtil;
 import com.ibm.fhir.model.util.JsonSupport;
 import com.ibm.fhir.model.util.ModelSupport;
-import com.ibm.fhir.path.FHIRPathBooleanValue;
 import com.ibm.fhir.path.FHIRPathNode;
 import com.ibm.fhir.path.evaluator.FHIRPathEvaluator;
 import com.ibm.fhir.path.evaluator.FHIRPathEvaluator.EvaluationContext;
 import com.ibm.fhir.path.exception.FHIRPathException;
-import com.ibm.fhir.path.function.ResolveFunction;
 import com.ibm.fhir.search.SearchConstants;
 import com.ibm.fhir.search.SearchConstants.Modifier;
 import com.ibm.fhir.search.SearchConstants.Prefix;
@@ -698,7 +699,6 @@ public static Map<SearchParameter, List<FHIRPathNode>> extractParameterValues(Re
         // Create one time.
         FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
         EvaluationContext evaluationContext = new EvaluationContext(resource);
-        evaluationContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.FALSE);
 
         List<SearchParameter> parameters = getApplicableSearchParameters(resourceType.getSimpleName());
 
@@ -1561,7 +1561,7 @@ public static boolean useStoredCompartmentParam() {
     public static FHIRSearchContext parseCompartmentQueryParameters(String compartmentName, String compartmentLogicalId,
             Class<?> resourceType, Map<String, List<String>> queryParameters, boolean lenient) throws Exception {
 
-        List<String> compartmentLogicalIds = Collections.singletonList(compartmentLogicalId);
+        Set<String> compartmentLogicalIds = Collections.singleton(compartmentLogicalId);
         QueryParameter inclusionCriteria = buildInclusionCriteria(compartmentName, compartmentLogicalIds, resourceType.getSimpleName());
         FHIRSearchContext context = parseQueryParameters(resourceType, queryParameters, lenient);
 
@@ -1582,7 +1582,7 @@ public static FHIRSearchContext parseCompartmentQueryParameters(String compartme
      * @return
      * @throws FHIRSearchException
      */
-    public static QueryParameter buildInclusionCriteria(String compartmentName, List<String> compartmentLogicalIds, String resourceType)
+    public static QueryParameter buildInclusionCriteria(String compartmentName, Set<String> compartmentLogicalIds, String resourceType)
             throws FHIRSearchException {
         QueryParameter rootParameter = null;
 
@@ -2564,7 +2564,6 @@ public static Map<String, Set<CompartmentReference>> extractCompartmentParameter
 
         try {
             EvaluationContext resourceContext = new FHIRPathEvaluator.EvaluationContext(fhirResource);
-            resourceContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.FALSE);
 
             // Extract any references we find matching parameters representing compartment membership.
             // For example CareTeam.participant can be used to refer to a Patient or RelatedPerson resource:
@@ -2591,24 +2590,50 @@ public static Map<String, Set<CompartmentReference>> extractCompartmentParameter
                         }
 
                         for (FHIRPathNode node : nodes) {
-                            Reference reference = node.asElementNode().element().as(Reference.class);
-                            ReferenceValue rv = ReferenceUtil.createReferenceValueFrom(reference, baseUrl);
-                            if (rv.getType() != ReferenceType.DISPLAY_ONLY && rv.getType() != ReferenceType.INVALID) {
+                            String compartmentName = null;
+                            String compartmentId = null;
+
+                            Element element = node.asElementNode().element();
+                            if (element.is(Reference.class)) {
+                                Reference reference = element.as(Reference.class);
+                                ReferenceValue rv = ReferenceUtil.createReferenceValueFrom(reference, baseUrl);
+                                if (rv.getType() == ReferenceType.DISPLAY_ONLY || rv.getType() == ReferenceType.INVALID) {
+                                    if (log.isLoggable(Level.FINE)) {
+                                        log.fine("Skipping reference of type " + rv.getType());
+                                    }
+                                    continue;
+                                }
+                                compartmentName = rv.getTargetResourceType();
+                                compartmentId = rv.getValue();
 
                                 // Check that the target resource type of the reference matches one of the
                                 // target resource types in the compartment definition.
-                                final String compartmentName = rv.getTargetResourceType();
-                                if (paramEntry.getValue().contains(compartmentName)) {
-                                    // Add this reference to the set of references we're collecting for each compartment
-                                    CompartmentReference cref = new CompartmentReference(searchParm, compartmentName, rv.getValue());
-                                    Set<CompartmentReference> references = result.computeIfAbsent(compartmentName, k -> new HashSet<>());
-                                    references.add(cref);
+                                if (!paramEntry.getValue().contains(compartmentName)) {
+                                    if (log.isLoggable(Level.FINE)) {
+                                        log.fine("Skipping reference with value " + reference.getReference() + ";"
+                                                + " target resource type does not match any of the allowed compartment types: " + paramEntry);
+                                    }
+                                    continue;
                                 }
+                            } else if (element.is(FHIR_STRING)) {
+                                if (paramEntry.getValue().size() != 1) {
+                                    log.warning("CompartmentDefinition inclusion criteria must be of type Reference unless they have 1 and only 1 resource target");
+                                    continue;
+                                }
+                                compartmentName = paramEntry.getValue().iterator().next();
+                                compartmentId = element.as(FHIR_STRING).getValue();
                             }
+
+                            // Add this reference to the set of references we're collecting for each compartment
+                            CompartmentReference cref = new CompartmentReference(searchParm, compartmentName, compartmentId);
+                            Set<CompartmentReference> references = result.computeIfAbsent(compartmentName, k -> new HashSet<>());
+                            references.add(cref);
                         }
                     } else if (!useStoredCompartmentParam()) {
-                       log.warning("Compartment parameter not found: [" + resourceType + "] '" + searchParm + "'. This will stop compartment searches from working correctly.");
+                       log.warning("Compartment parameter not found: [" + resourceType + "] '" + searchParm + "'. "
+                               + "This will stop compartment searches from working correctly.");
                     }
+
                 }
             }
         } catch (Exception e) {
diff --git a/fhir-server-test/pom.xml b/fhir-server-test/pom.xml
index da279b51789..5abd7a2605b 100644
--- a/fhir-server-test/pom.xml
+++ b/fhir-server-test/pom.xml
@@ -7,7 +7,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
@@ -52,12 +52,6 @@
             <version>${project.version}</version>
             <scope>test</scope>
         </dependency>
-        <dependency>
-            <groupId>${project.groupId}</groupId>
-            <artifactId>fhir-cli</artifactId>
-            <version>${project.version}</version>
-            <scope>test</scope>
-        </dependency>
         <dependency>
             <groupId>${project.groupId}</groupId>
             <artifactId>fhir-examples</artifactId>
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/cli/test/FHIRCliTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/cli/test/FHIRCliTest.java
deleted file mode 100644
index de8b547556f..00000000000
--- a/fhir-server-test/src/test/java/com/ibm/fhir/cli/test/FHIRCliTest.java
+++ /dev/null
@@ -1,332 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2017, 2021
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.cli.test;
-
-import static org.testng.Assert.assertNotNull;
-import static org.testng.Assert.fail;
-
-import java.io.ByteArrayOutputStream;
-import java.io.File;
-import java.io.FileInputStream;
-import java.io.PrintStream;
-import java.time.LocalDate;
-import java.util.Arrays;
-import java.util.UUID;
-import java.util.regex.Matcher;
-import java.util.regex.Pattern;
-
-import org.testng.annotations.BeforeClass;
-import org.testng.annotations.Test;
-import org.testng.reporters.Files;
-
-import com.ibm.fhir.cli.FHIRCLI;
-import com.ibm.fhir.server.test.FHIRServerTestBase;
-
-/**
- * Tests the FHIR-CLI (FHIR Command Line Interface) tool.
- *
- */
-public class FHIRCliTest extends FHIRServerTestBase {
-    // To see testcase output for debugging, set this to true.
-    private boolean debug = false;
-
-    private FHIRCLI cli = null;
-    private String consoleOutput = null;
-    private static final String dirPrefix = "target/test-classes";
-
-    private static String patientId = null;
-
-    // used to limit the number of result from searchAll to avoid timeouts for large dbs
-    private static LocalDate dateOfTest = LocalDate.now();
-
-    private static final Pattern locationURIPattern = Pattern.compile("URI:\\s*(\\S*)");
-
-    private boolean deleteSupported = false;
-
-    /**
-     * Retrieve the server's conformance statement to determine the status of certain runtime options.
-     *
-     * @throws Exception
-     */
-    @BeforeClass
-    public void retrieveConfig() throws Exception {
-        deleteSupported = isDeleteSupported();
-        System.out.println("Delete operation supported?: " + Boolean.valueOf(deleteSupported).toString());
-    }
-
-    @Test(expectedExceptions = {
-            IllegalStateException.class
-    })
-    public void testMetadataError1() throws Exception {
-        runTest("testMetadataError1", "-p", propsFile());
-    }
-
-    @Test
-    public void testMetadataToConsole() throws Exception {
-        runTest("testMetadataToConsole", "-p", propsFile(), "--operation", "metadata");
-        verifyConsoleOutput("IBM FHIR Server", "(C) Copyright IBM Corporation 2016, 2021", "4.0.1");
-    }
-
-    @Test
-    public void testMetadataToFile() throws Exception {
-        runTest("testMetadataToFile", "-p", propsFile(), "--operation", "metadata", "--output", dirPrefix("metadata.json"));
-        verifyFileContents("metadata.json", "IBM FHIR Server", "(C) Copyright IBM Corporation 2016, 2021", "4.0.1");
-    }
-
-    @Test
-    public void testHelp() throws Exception {
-        runTest("testHelp", "--help");
-        verifyConsoleOutput("Provides access to the FHIR Client API via the command line");
-    }
-
-    @Test(expectedExceptions = {
-            IllegalArgumentException.class
-    })
-    public void testBadOption() throws Exception {
-        runTest("testBadOption", "--BADOPTION");
-    }
-
-    @Test
-    public void testCreatePatient() throws Exception {
-        runTest("testCreatePatient", "-p", propsFile(), "--operation", "create", "--resource", testData("Patient_MookieBetts.json"));
-        verifyConsoleOutput("Status code: 201", "ETag: W/\"1\"", "Location URI: http", "Last modified:");
-        patientId = getResourceIdFromConsoleOutput();
-        assertNotNull(patientId);
-    }
-
-    @Test(dependsOnMethods={"testCreatePatient"})
-    public void testReadPatient() throws Exception {
-        assertNotNull(patientId);
-        runTest("testReadPatient", "-p", propsFile(), "--operation", "read", "--type", "Patient", "--resourceId", patientId, "-o", dirPrefix("readPatient.json"));
-        verifyConsoleOutput("Status code: 200", "ETag: W/\"1\"");
-    }
-
-    @Test(dependsOnMethods={"testReadPatient"})
-    public void testUpdatePatient() throws Exception {
-        assertNotNull(patientId);
-        runTest("testUpdatePatient", "-p", propsFile(), "--operation", "update", "--resource", dirPrefix("readPatient.json"));
-        verifyConsoleOutput("Status code: 200", "ETag: W/\"2\"");
-    }
-
-    @Test(dependsOnMethods={"testUpdatePatient"})
-    public void testVreadPatient() throws Exception {
-        assertNotNull(patientId);
-        runTest("testVreadPatient", "-p", propsFile(), "--operation", "vread", "--type", "Patient", "--resourceId", patientId, "--versionId", "2", "-o", dirPrefix("vreadPatient.json"));
-        verifyConsoleOutput("Status code: 200", "ETag: W/\"2\"");
-    }
-
-    @Test(dependsOnMethods={"testVreadPatient"})
-    public void testHistoryPatient() throws Exception {
-        assertNotNull(patientId);
-        runTest("testHistoryPatient", "-p", propsFile(), "--operation", "history", "--type", "Patient", "--resourceId", patientId);
-        verifyConsoleOutput("Status code: 200", patientId, "\"total\":2");
-    }
-
-    @Test(dependsOnMethods={"testHistoryPatient"})
-    public void testSearchPatient() throws Exception {
-        assertNotNull(patientId);
-        runTest("testSearchPatient", "-p", propsFile(), "--operation", "search", "--type", "Patient", "--queryParam", "_id=" + patientId, "-o", dirPrefix("searchPatients.json"));
-        verifyConsoleOutput("Status code: 200");
-        verifyFileContents("searchPatients.json", "\"total\":1");
-    }
-
-    @Test(dependsOnMethods={"testSearchPatient"})
-    public void testSearchAll() throws Exception {
-        runTest("testSearchAll", "-p", propsFile(), "--operation", "search-all", "-qp", "_count=100", "-qp", "_lastUpdated=ge" + dateOfTest , "-o", dirPrefix("searchAll.json"));
-        verifyConsoleOutput("Status code: 200");
-    }
-
-    @Test(dependsOnMethods={"testSearchAll"})
-    public void testDeletePatient() throws Exception {
-        assertNotNull(patientId);
-        runTest("testDeletePatient", "-p", propsFile(), "--operation", "delete", "--type", "Patient", "--resourceId", patientId);
-        if (deleteSupported) {
-            verifyConsoleOutput("Status code: 200", "ETag: W/\"3\"");
-        } else {
-            verifyConsoleOutput("Status code: 405");
-
-            // Next, do an update so that future version checks can work consistently
-            // with or without delete support.
-            runTest("testUpdatePatient", "-p", propsFile(), "--operation", "update", "--resource", dirPrefix("readPatient.json"));
-            verifyConsoleOutput("Status code: 200", "ETag: W/\"3\"");
-        }
-    }
-
-    @Test(dependsOnMethods={"testDeletePatient"})
-    public void testReadDeletedPatient() throws Exception {
-        assertNotNull(patientId);
-        runTest("testReadDeletedPatient", "-p", propsFile(), "--operation", "read", "--type", "Patient", "--resourceId", patientId);
-        if (deleteSupported) {
-            verifyConsoleOutput("Status code: 410", "Resource", "is deleted.");
-        } else {
-            verifyConsoleOutput("Status code: 200");
-        }
-    }
-
-    @Test(dependsOnMethods={"testReadDeletedPatient"})
-    public void testUpdateDeletedPatient() throws Exception {
-        String currentVersion = "3";
-        String newVersion = "4";
-        String ifMatchValue = "W/\"" + currentVersion + "\"";
-        runTest("testUpdateDeletedPatient", "-p", propsFile(), "--operation", "update", "--resource", dirPrefix("vreadPatient.json"), "-H", "If-Match=" + ifMatchValue);
-        verifyConsoleOutput("Status code: 201", "ETag: W/\"" + newVersion + "\"");
-    }
-
-    @Test(dependsOnMethods={"testUpdateDeletedPatient"})
-    public void testConditionalUpdatePatient() throws Exception {
-        assertNotNull(patientId);
-        runTest("testConditionalUpdatePatient", "-p", propsFile(), "--operation", "conditional-update", "--resource", dirPrefix("vreadPatient.json"), "-qp", "_id=" + patientId);
-        verifyConsoleOutput("Status code: 200", "ETag: W/\"5\"");
-    }
-
-    @Test(dependsOnMethods={"testConditionalUpdatePatient"})
-    public void testConditionalDeletePatient() throws Exception {
-        if (!deleteSupported) {
-            return;
-        }
-
-        assertNotNull(patientId);
-        runTest("testConditionalDeletePatient", "-p", propsFile(), "--operation", "conditional-delete", "--type", "Patient", "-qp", "_id=" + patientId);
-        verifyConsoleOutput("Status code: 200", "ETag: W/\"6\"");
-    }
-
-    @Test(dependsOnMethods={"testConditionalDeletePatient"})
-    public void testConditionalDeletePatientTwice() throws Exception {
-        if (!deleteSupported) {
-            return;
-        }
-
-        runTest("testConditionalDeletePatientError", "-p", propsFile(), "--operation", "conditional-delete", "--type", "Patient", "-qp", "_id=" + UUID.randomUUID().toString());
-        verifyConsoleOutput("Status code: 200");
-    }
-
-    @Test(dependsOnMethods={"testCreatePatient"})
-    public void testConditionalCreatePatient() throws Exception {
-        runTest("testConditionalCreatePatient", "-p", propsFile(), "--operation", "conditional-create", "--resource", testData("Patient_MookieBetts.json"), "-qp", "_id=" + patientId);
-        // According to https://www.hl7.org/fhir/R4/http.html#ccreate , conditional create against an existing resource should return 200
-        verifyConsoleOutput("Status code: 200");
-    }
-
-    @Test(dependsOnMethods={"testCreatePatient"})
-    public void testConditionalCreatePatientMultipleMatch() throws Exception {
-        // Create an additional patient just to make sure there's multiple
-        runTest("testCreatePatient", "-p", propsFile(), "--operation", "create", "--resource", testData("Patient_DavidOrtiz.json"));
-        // Now the real test
-        runTest("testConditionalCreatePatientError", "-p", propsFile(), "--operation", "conditional-create", "--resource", testData("Patient_MookieBetts.json"), "-qp", "gender=male");
-        verifyConsoleOutput("Status code: 412");
-    }
-
-    @Test(dependsOnMethods={"testCreatePatient"})
-    public void testConditionalCreatePatientError() throws Exception {
-        runTest("testConditionalCreatePatientError", "-p", propsFile(), "--operation", "conditional-create", "--resource", testData("Patient_MookieBetts.json"), "-qp", "BADSEARCHPARAM=XXX");
-        // Assumes the server is in "strict" mode by default
-        verifyConsoleOutput("Status code: 400");
-    }
-
-    @Test
-    public void testBatch() throws Exception {
-        runTest("testBatch", "-p", propsFile(), "--operation", "batch", "-r", testData("batchCreates.json"));
-        verifyConsoleOutput("Status code: 200");
-    }
-
-    @Test
-    public void testTransaction() throws Exception {
-        runTest("testTransaction", "-p", propsFile(), "--operation", "transaction", "-r", testData("transactionCreates.json"));
-        verifyConsoleOutput("Status code: 200");
-    }
-
-    @Test
-    public void testValidate() throws Exception {
-        runTest("testValidate", "-p", propsFile(), "--operation", "validate", "-r", testData("Patient_MookieBetts.json"));
-        verifyConsoleOutput("Status code: 200");
-    }
-
-    /**
-     * Retrieves the resource id value from the location URI string contained in the console output.
-     */
-    private String getResourceIdFromConsoleOutput() {
-        String resourceId = null;
-        String locationURI = null;
-        Matcher m = locationURIPattern.matcher(consoleOutput);
-        if (m.find()) {
-            locationURI = m.group(1);
-            print("Found location uri: " + locationURI);
-            String[] tokens = parseLocationURI(locationURI);
-            resourceId = tokens[1];
-            print("Resource id: " + resourceId);
-        }
-
-        return resourceId;
-    }
-
-
-    /**
-     * Runs a fhir-cli test with the specified list of arguments
-     *
-     * @param methodName
-     *            the name of the test method running the test
-     * @param args
-     *            the list of strings that represent the fhir-cli command-line arguments
-     * @throws Exception
-     */
-    private void runTest(String methodName, String... args) throws Exception {
-        print("\n*************** Test method: " + methodName + " ***************");
-        print("Command-line arguments:");
-        print(Arrays.asList(args).toString());
-
-        try {
-            ByteArrayOutputStream baos = new ByteArrayOutputStream();
-            PrintStream printStream = new PrintStream(baos);
-            FHIRCLI.setConsoleStream(printStream);
-            cli = new FHIRCLI(args);
-            cli.processCommand();
-            consoleOutput = baos.toString();
-
-            print("\nConsole output:");
-            print(consoleOutput);
-        } catch (Throwable t) {
-            print("\nException:");
-            print(FHIRCLI.getStackTrace(t));
-            throw t;
-        }
-    }
-
-    private void verifyConsoleOutput(String... expectedMsgs) {
-        for (int i = 0; i < expectedMsgs.length; i++) {
-            if (!consoleOutput.contains(expectedMsgs[i])) {
-                fail("Console output didn't contain: '" + expectedMsgs[i] + "'");
-            }
-        }
-    }
-
-    private void verifyFileContents(String fname, String... expectedMsgs) throws Exception {
-        String fileContents = Files.readFile(new FileInputStream(dirPrefix(fname)));
-        for (int i = 0; i < expectedMsgs.length; i++) {
-            if (!fileContents.contains(expectedMsgs[i])) {
-                fail("File contents didn't contain: '" + expectedMsgs[i] + "'");
-            }
-        }
-    }
-
-    private void print(String msg) {
-        if (debug) {
-            System.out.println(msg);
-        }
-    }
-
-    private static String dirPrefix(String fname) {
-        return dirPrefix + File.separator + fname;
-    }
-
-    private static String testData(String fname) {
-        return dirPrefix("testdata"+ File.separator + fname);
-    }
-
-    private static String propsFile() {
-        return dirPrefix("test.properties");
-    }
-}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/client/test/FHIRClientTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/client/test/FHIRClientTest.java
index 147d7d36a40..ebe103726d9 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/client/test/FHIRClientTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/client/test/FHIRClientTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2017, 2020
+ * (C) Copyright IBM Corp. 2017, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -15,7 +15,7 @@
 
 import java.util.Properties;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 import javax.ws.rs.client.WebTarget;
 import javax.ws.rs.core.Response;
 
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/client/test/FHIRClientTestBase.java b/fhir-server-test/src/test/java/com/ibm/fhir/client/test/FHIRClientTestBase.java
index 9be6c52c1c8..95a4b68bd8e 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/client/test/FHIRClientTestBase.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/client/test/FHIRClientTestBase.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2017,2019
+ * (C) Copyright IBM Corp. 2017,2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -31,11 +31,12 @@
  */
 public abstract class FHIRClientTestBase {
     protected Properties testProperties = null;
+    protected Properties testPropertiesOAuth2 = null;
     protected FHIRClient client = null;
-    
+    protected FHIRClient clientOAuth2 = null;
+
     public FHIRClientTestBase() {
     }
-    
 
     /**
      * Do one-time setup to enable tests to run.
@@ -43,13 +44,19 @@ public FHIRClientTestBase() {
     @BeforeClass
     public void setUp() throws Exception {
         testProperties = TestUtil.readTestProperties("test.properties");
+        testPropertiesOAuth2 = TestUtil.readTestProperties("test.oauth2.properties");
     }
-    
+
     @BeforeMethod
-    public void createClient() throws Exception {
+    public void createClientAuthClient() throws Exception {
         client = FHIRClientFactory.getClient(testProperties);
     }
-    
+
+    @BeforeMethod
+    public void createOauthClient() throws Exception {
+        clientOAuth2 = FHIRClientFactory.getClient(testPropertiesOAuth2);
+    }
+
     /**
      * Verify that the status code in the Response is equal to the expected status code.
      *
@@ -60,7 +67,7 @@ protected void assertResponse(Response response, int expectedStatusCode) {
         assertNotNull(response);
         assertEquals(expectedStatusCode, response.getStatus());
     }
-    
+
     /**
      * Validate the specified OperationOutcome object to make sure it contains
      * an exception.
@@ -68,12 +75,12 @@ protected void assertResponse(Response response, int expectedStatusCode) {
      */
     protected void assertExceptionOperationOutcome(OperationOutcome oo, String msgPart) {
         assertNotNull(oo);
-        
+
         // Verify the id attribute.
         assertNotNull(oo.getId());
         assertNotNull(oo.getId());
         assertEquals("exception", oo.getId());
-        
+
         // Make sure the OperationOutcomeIssue has a message containing 'msgPart'.
         assertNotNull(oo.getIssue());
         assertEquals(1, oo.getIssue().size());
@@ -82,26 +89,26 @@ protected void assertExceptionOperationOutcome(OperationOutcome oo, String msgPa
         assertNotNull(ooi.getCode());
         assertNotNull(ooi.getCode().getValue());
         assertEquals(IssueType.EXCEPTION.getValue(), ooi.getCode().getValue());
-        
+
         assertNotNull(ooi.getSeverity());
         assertNotNull(ooi.getSeverity().getValue());
         assertEquals(IssueSeverity.FATAL.getValue(), ooi.getSeverity().getValue());
-        
+
         assertNotNull(ooi.getDiagnostics());
         String msg = ooi.getDiagnostics().getValue();
         assertNotNull(msg);
         assertTrue(msg.contains(msgPart));
     }
-    
+
 
     protected void assertValidationOperationOutcome(OperationOutcome oo, String msgPart) {
         assertNotNull(oo);
-        
+
         // Verify the id attribute.
         assertNotNull(oo.getId());
         assertNotNull(oo.getId());
         assertEquals("validationfail", oo.getId());
-        
+
         // Make sure that we can find the 'msgPart' in one of the OperationOutcomeIssue objects.
         boolean foundIt = false;
         assertNotNull(oo.getIssue());
@@ -110,22 +117,22 @@ protected void assertValidationOperationOutcome(OperationOutcome oo, String msgP
             assertNotNull(ooi.getCode());
             assertNotNull(ooi.getCode().getValue());
             assertEquals(IssueType.INVALID.getValue(), ooi.getCode().getValue());
-                        
+
             assertNotNull(ooi.getSeverity());
             assertNotNull(ooi.getSeverity().getValue());
             assertEquals(IssueSeverity.ERROR.getValue(), ooi.getSeverity().getValue());
-            
+
             assertNotNull(ooi.getDiagnostics());
             String msg = ooi.getDiagnostics().getValue();
             assertNotNull(msg);
-            
+
             if (msg.contains(msgPart)) {
                 foundIt = true;
             }
         }
         assertTrue("Could not find '" + msgPart + "' in OperationOutcomeIssue list!", foundIt);
     }
-    
+
     /**
      * For the specified response, this function will extract the logical id value from the
      * response's Location header.
@@ -139,15 +146,15 @@ protected String getLocationLogicalId(Response response) {
         assertNotNull(location);
         assertFalse(location.isEmpty());
         // System.out.println("Location value: " + location);
-        
+
         String[] tokens = location.split("/");
         assertNotNull(tokens);
         assertTrue(tokens.length >= 4);
-    
+
         String logicalId = tokens[tokens.length-3];
         assertNotNull(logicalId);
         assertFalse(logicalId.isEmpty());
-    
+
         return logicalId;
     }
 }
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/client/test/oauth/FHIROAuth2Test.java b/fhir-server-test/src/test/java/com/ibm/fhir/client/test/oauth/FHIROAuth2Test.java
index 8a1f6d94564..966e7ee05e2 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/client/test/oauth/FHIROAuth2Test.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/client/test/oauth/FHIROAuth2Test.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2017, 2020
+ * (C) Copyright IBM Corp. 2017, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -13,10 +13,10 @@
 import java.io.StringReader;
 import java.util.Properties;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
 import javax.ws.rs.client.Entity;
 import javax.ws.rs.client.Invocation;
 import javax.ws.rs.client.WebTarget;
@@ -39,10 +39,10 @@ public class FHIROAuth2Test extends FHIRClientTestBase {
     private String accessToken = null;
     private String clientID = null;
     private String clientSecret = null;
+
     private final String oidcRegURL = "https://localhost:9443/oidc/endpoint/oidc-provider/registration";
     private final String tokenURL = "https://localhost:9443/oauth2/endpoint/oauth2-provider/token";
-    private final String clientAdminUsername = "fhiruser";
-    private final String clientAdminPwd = "fhiruser";
+
 
     @BeforeClass
     public void setup() throws Exception {
@@ -72,7 +72,7 @@ public void testRegisterClient() throws Exception {
                 assertNotNull(jsonObj);
             }
 
-            WebTarget endpoint = client.getWebTargetUsingBasicAuth(oidcRegURL, clientAdminUsername, clientAdminPwd);
+            WebTarget endpoint = clientOAuth2.getWebTarget(oidcRegURL);
             Entity<JsonObject> entity = Entity.entity(jsonObj, "application/json");
             Invocation.Builder builder = endpoint.request("application/json");
             Response response = builder.post(entity);
@@ -86,8 +86,8 @@ public void testRegisterClient() throws Exception {
             clientID = resJson.get("client_id").toString();
             clientSecret = resJson.get("client_secret").toString();
 
-            // System.out.println("clientID = " + clientID);
-            // System.out.println("clientSecret = " + clientSecret);
+            System.out.println("clientID = " + clientID);
+            System.out.println("clientSecret = " + clientSecret);
         } else {
             System.out.println("testTokenRequest Disabled, Skipping");
         }
@@ -96,7 +96,7 @@ public void testRegisterClient() throws Exception {
     @Test(dependsOnMethods = { "testRegisterClient" })
     public void testTokenRequest() throws Exception {
         if (ON) {
-            WebTarget endpoint = client.getWebTarget(tokenURL);
+            WebTarget endpoint = clientOAuth2.getWebTarget(tokenURL);
             Form form = new Form();
             form.param("grant_type", "client_credentials").param("client_id", clientID.replaceAll("\"", "")).param("client_secret", clientSecret.replaceAll("\"", ""));
 
@@ -112,4 +112,4 @@ public void testTokenRequest() throws Exception {
             System.out.println("testTokenRequest Disabled, Skipping");
         }
     }
-}
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/BasicServerTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/BasicServerTest.java
index 40e2eb4fb96..bd4d7ad0384 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/BasicServerTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/BasicServerTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2017, 2020
+ * (C) Copyright IBM Corp. 2017, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -7,6 +7,7 @@
 package com.ibm.fhir.server.test;
 
 import static com.ibm.fhir.model.type.String.string;
+import static org.testng.Assert.assertFalse;
 import static org.testng.AssertJUnit.assertEquals;
 import static org.testng.AssertJUnit.assertNotNull;
 import static org.testng.AssertJUnit.assertTrue;
@@ -14,11 +15,15 @@
 
 import java.io.StringWriter;
 import java.util.ArrayList;
+import java.util.Collection;
+import java.util.Collections;
+import java.util.Iterator;
 import java.util.List;
+import java.util.stream.Collectors;
 
-import javax.json.JsonObject;
 import javax.ws.rs.client.Entity;
 import javax.ws.rs.client.WebTarget;
+import javax.ws.rs.core.MediaType;
 import javax.ws.rs.core.Response;
 
 import org.testng.annotations.Test;
@@ -31,8 +36,10 @@
 import com.ibm.fhir.model.resource.Immunization;
 import com.ibm.fhir.model.resource.Observation;
 import com.ibm.fhir.model.resource.OperationOutcome;
+import com.ibm.fhir.model.resource.OperationOutcome.Issue;
 import com.ibm.fhir.model.resource.Patient;
 import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.resource.TerminologyCapabilities;
 import com.ibm.fhir.model.test.TestUtil;
 import com.ibm.fhir.model.type.ContactPoint;
 import com.ibm.fhir.model.type.Narrative;
@@ -40,6 +47,16 @@
 import com.ibm.fhir.model.type.code.ContactPointSystem;
 import com.ibm.fhir.model.type.code.ContactPointUse;
 import com.ibm.fhir.model.type.code.NarrativeStatus;
+import com.ibm.fhir.path.FHIRPathBooleanValue;
+import com.ibm.fhir.path.FHIRPathNode;
+import com.ibm.fhir.path.evaluator.FHIRPathEvaluator;
+import com.ibm.fhir.path.evaluator.FHIRPathEvaluator.EvaluationContext;
+import com.ibm.fhir.path.exception.FHIRPathException;
+import com.ibm.fhir.validation.FHIRValidator;
+import com.ibm.fhir.validation.exception.FHIRValidationException;
+import com.ibm.fhir.validation.util.FHIRValidationUtil;
+
+import jakarta.json.JsonObject;
 
 /**
  * Basic sniff test of the FHIR Server.
@@ -52,7 +69,7 @@ public class BasicServerTest extends FHIRServerTestBase {
      * Verify the 'metadata' API.
      */
     @Test(groups = { "server-basic" })
-    public void testMetadataAPI() {
+    public void testMetadataAPI() throws FHIRPathException, FHIRValidationException {
         WebTarget target = getWebTarget();
         Response response = target.path("metadata").request().get();
         assertResponse(response, Response.Status.OK.getStatusCode());
@@ -63,6 +80,58 @@ public void testMetadataAPI() {
         assertEquals(6, conf.getFormat().size());
         assertNotNull(conf.getVersion());
         assertNotNull(conf.getName());
+
+        FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
+        EvaluationContext evaluationContext = new EvaluationContext(conf);
+        Collection<FHIRPathNode> result = evaluator.evaluate(evaluationContext, "(kind != 'instance') or implementation.exists()");
+        Iterator<FHIRPathNode> iter = result.iterator();
+        boolean instance = false;
+        while (iter.hasNext()) {
+            FHIRPathBooleanValue node = iter.next().as(FHIRPathBooleanValue.class);
+            instance = node._boolean();
+        }
+        assertTrue(instance);
+
+        List<Issue> issues = FHIRValidator.validator().validate(conf);
+        assertFalse(FHIRValidationUtil.hasErrors(issues));
+        if (FHIRValidationUtil.hasWarnings(issues)) {
+            System.out.println("CapabilityStatement warnings: \n" +
+                    FHIRValidationUtil.getWarnings(issues).stream()
+                        .map(i -> i.getDetails().getText().getValue())
+                        .collect(Collectors.joining("\n")));
+        }
+    }
+
+    @Test(groups = { "server-basic" })
+    public void testMetadataAPITerminology() throws FHIRPathException, FHIRValidationException {
+        WebTarget target = getWebTarget();
+        Response response = target.path("metadata").queryParam("mode", "terminology").request().get();
+        assertResponse(response, Response.Status.OK.getStatusCode());
+
+        TerminologyCapabilities conf = response.readEntity(TerminologyCapabilities.class);
+        assertNotNull(conf);
+        assertNotNull(conf.getVersion());
+        assertNotNull(conf.getName());
+
+        FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
+        EvaluationContext evaluationContext = new EvaluationContext(conf);
+        Collection<FHIRPathNode> result = evaluator.evaluate(evaluationContext, "(kind != 'instance') or implementation.exists()");
+        Iterator<FHIRPathNode> iter = result.iterator();
+        boolean instance = false;
+        while (iter.hasNext()) {
+            FHIRPathBooleanValue node = iter.next().as(FHIRPathBooleanValue.class);
+            instance = node._boolean();
+        }
+        assertTrue(instance);
+
+        List<Issue> issues = FHIRValidator.validator().validate(conf);
+        assertFalse(FHIRValidationUtil.hasErrors(issues));
+        if (FHIRValidationUtil.hasWarnings(issues)) {
+            System.out.println("TerminologyStatement warnings: \n" +
+                    FHIRValidationUtil.getWarnings(issues).stream()
+                    .map(i -> i.getDetails().getText().getValue())
+                    .collect(Collectors.joining("\n")));
+        }
     }
 
     /**
@@ -83,6 +152,38 @@ public void testMetadataAPI_XML() {
         assertNotNull(conf.getName());
     }
 
+    /**
+     * Verify the 'metadata' API with valid fhirVersion in Accept header.
+     */
+    @Test(groups = { "server-basic" })
+    public void testMetadataAPI_validFhirVersion() {
+        WebTarget target = getWebTarget();
+        MediaType mediaType = new MediaType("application", "fhir+json",
+            Collections.singletonMap(FHIRMediaType.FHIR_VERSION_PARAMETER, "4.0"));
+        Response response = target.path("metadata").request(mediaType).get();
+        assertResponse(response, Response.Status.OK.getStatusCode());
+        assertEquals(mediaType, response.getMediaType());
+
+        CapabilityStatement conf = response.readEntity(CapabilityStatement.class);
+        assertNotNull(conf);
+        assertNotNull(conf.getFormat());
+        assertEquals(6, conf.getFormat().size());
+        assertNotNull(conf.getVersion());
+        assertNotNull(conf.getName());
+    }
+
+    /**
+     * Verify the 'metadata' API with invalid fhirVersion in Accept header.
+     */
+    @Test(groups = { "server-basic" })
+    public void testMetadataAPI_invalidFhirVersion() {
+        WebTarget target = getWebTarget();
+        MediaType mediaType = new MediaType("application", "fhir+json",
+            Collections.singletonMap(FHIRMediaType.FHIR_VERSION_PARAMETER, "3.0"));
+        Response response = target.path("metadata").request(mediaType).get();
+        assertResponse(response, Response.Status.NOT_ACCEPTABLE.getStatusCode());
+    }
+
     /**
      * Create a Patient, then make sure we can retrieve it.
      */
@@ -133,6 +234,50 @@ public void testCreatePatient_minimal() throws Exception {
         TestUtil.assertResourceEquals(patient, responsePatient);
     }
 
+    /**
+     * Create a minimal Patient with valid fhirVersion in Content-Type header, then make sure we can retrieve it.
+     */
+    @Test(groups = { "server-basic" })
+    public void testCreatePatient_minimal_validFhirVersion() throws Exception {
+        WebTarget target = getWebTarget();
+
+        // Build a new Patient and then call the 'create' API.
+        Patient patient = TestUtil.readLocalResource("Patient_DavidOrtiz.json");
+
+        MediaType mediaType = new MediaType("application", "fhir+json",
+            Collections.singletonMap(FHIRMediaType.FHIR_VERSION_PARAMETER, "4.0"));
+        Entity<Patient> entity = Entity.entity(patient, mediaType);
+        Response response = target.path("Patient").request().post(entity, Response.class);
+        assertResponse(response, Response.Status.CREATED.getStatusCode());
+
+        // Get the patient's logical id value.
+        String patientId = getLocationLogicalId(response);
+
+        // Next, call the 'read' API to retrieve the new patient and verify it.
+        response = target.path("Patient/" + patientId).request(mediaType).get();
+        assertResponse(response, Response.Status.OK.getStatusCode());
+        Patient responsePatient = response.readEntity(Patient.class);
+
+        TestUtil.assertResourceEquals(patient, responsePatient);
+    }
+
+    /**
+     * Attempt to create a minimal Patient with invalid fhirVersion in Content-Type header.
+     */
+    @Test( groups = { "server-basic" })
+    public void testCreatePatient_minimal_invalidFhirVersion() throws Exception {
+        WebTarget target = getWebTarget();
+
+        // Build a new Patient and then call the 'create' API.
+        Patient patient = TestUtil.readLocalResource("Patient_DavidOrtiz.json");
+
+        MediaType mediaType = new MediaType("application", "fhir+json",
+            Collections.singletonMap(FHIRMediaType.FHIR_VERSION_PARAMETER, "3.0"));
+        Entity<Patient> entity = Entity.entity(patient, mediaType);
+        Response response = target.path("Patient").request().post(entity, Response.class);
+        assertResponse(response, Response.Status.UNSUPPORTED_MEDIA_TYPE.getStatusCode());
+    }
+
     /**
      * Create a minimal Patient, then make sure we can retrieve it with varying format
      */
@@ -151,13 +296,60 @@ public void testCreatePatientMinimalWithFormat() throws Exception {
         String patientId = getLocationLogicalId(response);
 
         // Next, call the 'read' API to retrieve the new patient and verify it.
-        response = target.path("Patient/" + patientId).request(FHIRMediaType.APPLICATION_FHIR_JSON).header("_format", "application/fhir+json").get();
+        response = target.path("Patient/" + patientId).queryParam("_format", "application/fhir+json").request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
         assertResponse(response, Response.Status.OK.getStatusCode());
         Patient responsePatient = response.readEntity(Patient.class);
 
         TestUtil.assertResourceEquals(patient, responsePatient);
     }
 
+    /**
+     * Create a minimal Patient, then make sure we can retrieve it with varying format with valid FHIR version
+     */
+    @Test(groups = { "server-basic" })
+    public void testCreatePatientMinimalWithFormat_validFhirVersion() throws Exception {
+        WebTarget target = getWebTarget();
+
+        // Build a new Patient and then call the 'create' API.
+        Patient patient = TestUtil.readLocalResource("Patient_DavidOrtiz.json");
+
+        Entity<Patient> entity = Entity.entity(patient, FHIRMediaType.APPLICATION_FHIR_JSON);
+        Response response = target.path("Patient").request().post(entity, Response.class);
+        assertResponse(response, Response.Status.CREATED.getStatusCode());
+
+        // Get the patient's logical id value.
+        String patientId = getLocationLogicalId(response);
+
+        // Next, call the 'read' API to retrieve the new patient and verify it.
+        response = target.path("Patient/" + patientId).queryParam("_format", "application/fhir+json;fhirVersion=4.0").request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
+        assertResponse(response, Response.Status.OK.getStatusCode());
+        Patient responsePatient = response.readEntity(Patient.class);
+
+        TestUtil.assertResourceEquals(patient, responsePatient);
+    }
+
+    /**
+     * Create a minimal Patient, then attempt to retrieve it with varying format with invalid FHIR version
+     */
+    @Test(groups = { "server-basic" })
+    public void testCreatePatientMinimalWithFormat_invalidFhirVersion() throws Exception {
+        WebTarget target = getWebTarget();
+
+        // Build a new Patient and then call the 'create' API.
+        Patient patient = TestUtil.readLocalResource("Patient_DavidOrtiz.json");
+
+        Entity<Patient> entity = Entity.entity(patient, FHIRMediaType.APPLICATION_FHIR_JSON);
+        Response response = target.path("Patient").request().post(entity, Response.class);
+        assertResponse(response, Response.Status.CREATED.getStatusCode());
+
+        // Get the patient's logical id value.
+        String patientId = getLocationLogicalId(response);
+
+        // Next, call the 'read' API to attempt to retrieve the new patient
+        response = target.path("Patient/" + patientId).queryParam("_format", "application/fhir+json;fhirVersion=3.0").request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
+        assertResponse(response, Response.Status.NOT_ACCEPTABLE.getStatusCode());
+    }
+
     /**
      * Create a minimal Patient, then make sure we can retrieve it.
      */
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/BundleTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/BundleTest.java
index 11496dac557..03604ab65e8 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/BundleTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/BundleTest.java
@@ -16,10 +16,10 @@
 import java.util.List;
 import java.util.UUID;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
 import javax.ws.rs.client.Entity;
 import javax.ws.rs.client.WebTarget;
 import javax.ws.rs.core.Response;
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/ConcurrentUpdateTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/ConcurrentUpdateTest.java
new file mode 100644
index 00000000000..84898e34e0d
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/ConcurrentUpdateTest.java
@@ -0,0 +1,126 @@
+/*
+ * (C) Copyright IBM Corp. 2017, 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test;
+
+import static org.testng.AssertJUnit.assertEquals;
+import static org.testng.AssertJUnit.assertNotNull;
+import static org.testng.AssertJUnit.assertTrue;
+
+import java.util.ArrayList;
+import java.util.List;
+import java.util.UUID;
+import java.util.concurrent.Callable;
+import java.util.concurrent.ExecutorService;
+import java.util.concurrent.Executors;
+import java.util.concurrent.Future;
+
+import javax.ws.rs.core.Response;
+
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.client.FHIRParameters;
+import com.ibm.fhir.client.FHIRResponse;
+import com.ibm.fhir.model.resource.Bundle;
+import com.ibm.fhir.model.resource.Patient;
+import com.ibm.fhir.model.test.TestUtil;
+
+/**
+ * Tests the concurrent creation and updating of a single patient, with the updateCreate feature enabled.
+ * The idea is to ensure that:
+ * 1. No updates are "lost".
+ * 2. No deadlocks occur.
+ * 3. No duplicate logical ids are created.
+ * 4. The resource is searchable in the end.
+ */
+public class ConcurrentUpdateTest extends FHIRServerTestBase {
+
+    @Test
+    public void testConcurrentUpdateCreate() throws Exception {
+        List<Callable<Patient>> concurrentUpdates = new ArrayList<>();
+        List<Future<Patient>> futureResults = new ArrayList<>();
+        int maxThreads = 12;
+        FHIRParameters parameters;
+        FHIRResponse response;
+
+        if (this.isUpdateCreateSupported()) {
+
+            // Read a JSON Patient and set the id.
+            String patientLogicalId = UUID.randomUUID().toString();
+            Patient patient = TestUtil.readLocalResource("Patient_SalMonella.json");
+            patient = patient.toBuilder().id(patientLogicalId).build();
+
+            // Initialize multi-thread Executor Service.
+            ExecutorService executor = Executors.newFixedThreadPool(maxThreads);
+
+            // Prepare PatientUpdater instances for running each on its own thread.
+            for (int i = 0; i < maxThreads; i++) {
+                concurrentUpdates.add(new PatientUpdater(patient));
+            }
+
+            // Run each PatientUpdater on its own thread.
+            futureResults = executor.invokeAll(concurrentUpdates);
+            assertNotNull(futureResults);
+
+            // Search on the patient id, and see how many results we get. There should only
+            // be one.
+            parameters = new FHIRParameters().searchParam("_id", patientLogicalId);
+            response = client.search("Patient", parameters);
+            assertResponse(response.getResponse(), Response.Status.OK.getStatusCode());
+            Bundle searchResults = response.getResource(Bundle.class);
+            assertEquals(1, searchResults.getEntry().size());
+            assertNotNull(searchResults.getEntry().get(0).getResource());
+            assertEquals(patientLogicalId, searchResults.getEntry().get(0).getResource().getId());
+
+            // Pull the history on the patient id. There should be the same number of
+            // versions as the value of maxThreads.
+            parameters = new FHIRParameters().count(maxThreads);
+            response = client.history("Patient", patientLogicalId, parameters);
+            assertResponse(response.getResponse(), Response.Status.OK.getStatusCode());
+            Bundle bundle = response.getResource(Bundle.class);
+            assertNotNull(bundle);
+            assertNotNull(bundle.getEntry());
+            assertEquals(maxThreads, bundle.getEntry().size());
+
+            // Make sure that the versions are in descending order, and that none are
+            // duplicates.
+            Integer previousVersionId = null;
+            Integer versionId;
+            for (Bundle.Entry entry : bundle.getEntry()) {
+                Patient bundlePatient = (Patient) entry.getResource();
+                versionId = Integer.valueOf(bundlePatient.getMeta().getVersionId().getValue());
+                if (previousVersionId != null) {
+                    assertTrue(previousVersionId > versionId);
+                }
+                previousVersionId = versionId;
+            }
+        }
+    }
+
+    /**
+     * This inner class invokes the FHIRClient update API for the Patient instance it encapsulates,
+     * retrying in a tight loop in the case of a 409 Conflict.
+     */
+    private class PatientUpdater implements Callable<Patient> {
+        private Patient patient;
+
+        PatientUpdater(Patient newPatient) {
+            this.patient = newPatient;
+        }
+
+        @Override
+        public Patient call() throws Exception {
+            int status;
+            do {
+                FHIRResponse response = client.update(this.patient);
+                status = response.getStatus();
+            } while (status == Response.Status.CONFLICT.getStatusCode());
+
+            assertTrue(status == Response.Status.OK.getStatusCode() || status == Response.Status.CREATED.getStatusCode());
+            return this.patient;
+        }
+    }
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/FHIRPatchTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/FHIRPatchTest.java
index 094cab976e5..bd1165911aa 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/FHIRPatchTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/FHIRPatchTest.java
@@ -18,8 +18,8 @@
 import java.util.List;
 import java.util.UUID;
 
-import javax.json.Json;
-import javax.json.JsonArray;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
 import javax.ws.rs.client.Entity;
 import javax.ws.rs.client.WebTarget;
 import javax.ws.rs.core.Response;
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/FHIRValidateOperationTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/FHIRValidateOperationTest.java
index bc65b71e500..2c1999a75ce 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/FHIRValidateOperationTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/FHIRValidateOperationTest.java
@@ -13,9 +13,9 @@
 import java.io.StringWriter;
 import java.util.Collections;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
 import javax.ws.rs.client.Entity;
 import javax.ws.rs.client.WebTarget;
 import javax.ws.rs.core.Response;
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/PrettyServerFormatTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/PrettyServerFormatTest.java
index c3fb8cdc5e3..229bcea3923 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/PrettyServerFormatTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/PrettyServerFormatTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2017,2019
+ * (C) Copyright IBM Corp. 2017, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -45,18 +45,18 @@ public void testPrettyFormatting() throws Exception {
 
         // Next, call the 'read' API to retrieve the new patient and verify it.
         response =
-                target.queryParam("_pretty", "true").path("Patient/" + patientId)
-                        .request(FHIRMediaType.APPLICATION_FHIR_JSON).header("_format", "application/fhir+json").get();
+                target.queryParam("_pretty", "true").queryParam("_format", "application/fhir+json").path("Patient/" + patientId)
+                        .request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
         assertResponse(response, Response.Status.OK.getStatusCode());
 
         String prettyOutput = response.readEntity(String.class);
 
         response =
-                target.queryParam("_pretty", "false").path("Patient/" + patientId)
-                        .request(FHIRMediaType.APPLICATION_FHIR_JSON).header("_format", "application/fhir+json").get();
+                target.queryParam("_pretty", "false").queryParam("_format", "application/fhir+json").path("Patient/" + patientId)
+                        .request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
 
         String notPrettyOutput = response.readEntity(String.class);
-        
+
         assertNotEquals(prettyOutput, notPrettyOutput);
         assertFalse(notPrettyOutput.contains("\n"));
         assertTrue(prettyOutput.contains("\n"));
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/RemoteTermServiceProviderTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/RemoteTermServiceProviderTest.java
index cff1998611d..a01c299a8f3 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/RemoteTermServiceProviderTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/RemoteTermServiceProviderTest.java
@@ -32,6 +32,7 @@
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider;
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration;
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration.BasicAuth;
+import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration.Header;
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration.Supports;
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration.TrustStore;
 import com.ibm.fhir.term.util.CodeSystemSupport;
@@ -47,11 +48,19 @@ public void testCreateCodeSystem() throws Exception {
         CodeSystem codeSystem = TestUtil.readLocalResource("CodeSystem-test.json");
         Entity<CodeSystem> entity = Entity.entity(codeSystem, FHIRMediaType.APPLICATION_FHIR_JSON);
 
-        Response response = target.path("CodeSystem").path("test").request().put(entity);
+        Response response = target.path("CodeSystem").path("test")
+                .request()
+                .header("X-FHIR-TENANT-ID", "tenant1")
+                .header("X-FHIR-DSID", "profile")
+                .put(entity);
         int status = response.getStatus();
         assertTrue(status == Response.Status.CREATED.getStatusCode() || status == Response.Status.OK.getStatusCode());
 
-        response = target.path("CodeSystem").path("test").request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
+        response = target.path("CodeSystem").path("test")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "tenant1")
+                .header("X-FHIR-DSID", "profile")
+                .get();
         assertResponse(response, Response.Status.OK.getStatusCode());
 
         CodeSystem responseCodeSystem = response.readEntity(CodeSystem.class);
@@ -60,7 +69,7 @@ public void testCreateCodeSystem() throws Exception {
         this.codeSystem = responseCodeSystem;
     }
 
-    @Test
+    @Test(dependsOnMethods = { "testCreateCodeSystem" })
     public void testCreateRemoteTermServiceProvider() {
         Configuration configuration = Configuration.builder()
             .base(getRestBaseURL())
@@ -72,6 +81,14 @@ public void testCreateRemoteTermServiceProvider() {
                 .username(getFhirUser())
                 .password(getFhirPassword())
                 .build())
+            .headers(Header.builder()
+                    .name("X-FHIR-TENANT-ID")
+                    .value("tenant1")
+                    .build(),
+                Header.builder()
+                    .name("X-FHIR-DSID")
+                    .value("profile")
+                    .build())
             .supports(Supports.builder()
                 .system(codeSystem.getUrl().getValue())
                 .version(codeSystem.getVersion().getValue())
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/SearchExtensionsTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/SearchExtensionsTest.java
index 284835f72bb..ca80fec100e 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/SearchExtensionsTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/SearchExtensionsTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2017, 2020
+ * (C) Copyright IBM Corp. 2017, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -17,6 +17,7 @@
 
 import org.testng.annotations.Test;
 
+import com.ibm.fhir.core.FHIRConstants;
 import com.ibm.fhir.core.FHIRMediaType;
 import com.ibm.fhir.model.generator.exception.FHIRGeneratorException;
 import com.ibm.fhir.model.resource.Bundle;
@@ -34,7 +35,7 @@
 import com.ibm.fhir.model.type.Uri;
 
 public class SearchExtensionsTest extends FHIRServerTestBase {
-    private static final String EXTENSION_BASE_URL = "http://ibm.com/fhir/extension/Patient/";
+    private static final String EXTENSION_BASE_URL = FHIRConstants.EXT_BASE + "Patient/";
 
     private static final boolean DEBUG_SEARCH = false;
 
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/ServerSpecTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/ServerSpecTest.java
index 0c8e89e5bee..2302a9f913e 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/ServerSpecTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/ServerSpecTest.java
@@ -18,9 +18,9 @@
 import java.time.ZoneOffset;
 import java.util.UUID;
 
-import javax.json.Json;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
+import jakarta.json.Json;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
 import javax.ws.rs.client.Entity;
 import javax.ws.rs.client.WebTarget;
 import javax.ws.rs.core.Response;
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ExportOperationAzureTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ExportOperationAzureTest.java
new file mode 100644
index 00000000000..19e6710e402
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ExportOperationAzureTest.java
@@ -0,0 +1,579 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test.bulkdata;
+
+import static com.ibm.fhir.model.type.String.string;
+import static org.junit.Assert.assertTrue;
+import static org.testng.Assert.assertEquals;
+import static org.testng.AssertJUnit.assertFalse;
+import static org.testng.AssertJUnit.assertNotNull;
+
+import java.io.IOException;
+import java.io.StringReader;
+import java.io.StringWriter;
+import java.net.URI;
+import java.util.ArrayList;
+import java.util.Arrays;
+import java.util.List;
+import java.util.Properties;
+import java.util.UUID;
+import java.util.stream.Collectors;
+
+import javax.ws.rs.client.Entity;
+import javax.ws.rs.client.WebTarget;
+import javax.ws.rs.core.Response;
+import javax.ws.rs.core.Response.Status;
+
+import org.testng.annotations.BeforeClass;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.core.FHIRMediaType;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.generator.FHIRGenerator;
+import com.ibm.fhir.model.generator.exception.FHIRGeneratorException;
+import com.ibm.fhir.model.resource.Condition;
+import com.ibm.fhir.model.resource.Group;
+import com.ibm.fhir.model.resource.Group.Member;
+import com.ibm.fhir.model.resource.Observation;
+import com.ibm.fhir.model.resource.Parameters;
+import com.ibm.fhir.model.resource.Parameters.Parameter;
+import com.ibm.fhir.model.resource.Patient;
+import com.ibm.fhir.model.test.TestUtil;
+import com.ibm.fhir.model.type.Instant;
+import com.ibm.fhir.model.type.Reference;
+import com.ibm.fhir.server.test.FHIRServerTestBase;
+
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReaderFactory;
+
+/**
+ * These tests exercise the $export operation with azure-blob, a BulkData specification defined operation
+ */
+public class ExportOperationAzureTest extends FHIRServerTestBase {
+    public static final String TEST_GROUP_NAME = "export-operation";
+    public static final String PATIENT_VALID_URL = "Patient/$export";
+    public static final String GROUP_VALID_URL = "Group/?/$export";
+    public static final String BASE_VALID_URL = "/$export";
+    public static final String BASE_VALID_STATUS_URL = "/$bulkdata-status";
+    public static final String FORMAT_NDJSON = "application/fhir+ndjson";
+    public static final String FORMAT_PARQUET = "application/fhir+parquet";
+    private final String tenantName = "default";
+    private final String dataStoreId = "default";
+
+    // Disabled by default
+    private static boolean ON = false;
+
+    public static final boolean DEBUG = false;
+    private String exportStatusUrl;
+    private String savedPatientId, savedPatientId2;
+    private String savedGroupId, savedGroupId2;
+
+    private static final JsonReaderFactory JSON_READER_FACTORY = Json.createReaderFactory(null);
+
+    @BeforeClass
+    public void setup() throws Exception {
+        Properties testProperties = TestUtil.readTestProperties("test.properties");
+        ON = Boolean.parseBoolean(testProperties.getProperty("test.bulkdata.export.azure.enabled", "false"));
+    }
+
+    public Response doPost(String path, String mimeType, String outputFormat, Instant since, List<String> types, List<String> typeFilters, String provider, String outcome)
+            throws FHIRGeneratorException, IOException {
+        WebTarget target = getWebTarget();
+        target = target.path(path);
+        target = addQueryParameter(target, "_outputFormat", outputFormat);
+        // target = addQueryParameter(target, "_since", since);
+        target = addQueryParameterList(target, "_type", types);
+        target = addQueryParameterList(target, "_typeFilter", typeFilters);
+        if (DEBUG) {
+            System.out.println("URL -> " + target.getUri());
+        }
+        Parameters parameters = generateParameters(outputFormat, since, types, null);
+        Entity<Parameters> entity = Entity.entity(parameters, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        //@formatter:off
+        return target
+                .request(mimeType)
+                .header("X-FHIR-TENANT-ID", tenantName)
+                .header("X-FHIR-DSID", dataStoreId)
+                .header("X-FHIR-BULKDATA-PROVIDER", provider)
+                .header("X-FHIR-BULKDATA-PROVIDER-OUTCOME", outcome)
+                .post(entity, Response.class);
+        //@formatter:on
+    }
+
+    /**
+     * @param outputFormat
+     * @param since
+     * @param types
+     * @param typeFilters
+     * @return
+     * @throws FHIRGeneratorException
+     * @throws IOException
+     */
+    private Parameters generateParameters(String outputFormat, Instant since, List<String> types, List<String> typeFilters) throws FHIRGeneratorException, IOException {
+        List<Parameter> parameters = new ArrayList<>();
+
+        if (outputFormat != null) {
+            //@formatter:off
+            parameters.add(
+                Parameter.builder()
+                    .name(string("_outputFormat"))
+                    .value(string(outputFormat))
+                    .build());
+            //@formatter:on
+        }
+
+        if (since != null) {
+            //@formatter:off
+            parameters.add(
+                Parameter.builder()
+                    .name(string("_since"))
+                    .value(since)
+                    .build());
+            //@formatter:on
+        }
+
+        if (types != null) {
+            //@formatter:off
+            parameters.add(
+                Parameter.builder()
+                    .name(string("_type"))
+                    .value(string(types.stream().collect(Collectors.joining(","))))
+                    .build());
+            //@formatter:on
+        }
+
+        if (typeFilters != null) {
+            //@formatter:off
+            parameters.add(
+                Parameter.builder()
+                    .name(string("_typeFilters"))
+                    .value(string(types.stream().collect(Collectors.joining(","))))
+                    .build());
+            //@formatter:on
+        }
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        try (StringWriter writer = new StringWriter();) {
+            FHIRGenerator.generator(Format.JSON, true).generate(ps, writer);
+            if (DEBUG) {
+                System.out.println(writer.toString());
+            }
+        }
+        return ps;
+    }
+
+    /**
+     * add query parameter list
+     */
+    public WebTarget addQueryParameterList(WebTarget target, String header, List<String> vals) {
+        if (header != null && vals != null && !vals.isEmpty()) {
+            target = target.queryParam(header, vals.stream().collect(Collectors.joining(",")));
+        }
+        return target;
+    }
+
+    /**
+     * adds the query parameter
+     */
+    public WebTarget addQueryParameter(WebTarget target, String header, String val) {
+        if (header != null && val != null) {
+            target = target.queryParam(header, val);
+        }
+        return target;
+    }
+
+    public Response doGet(String path, String mimeType, String provider, String outcome) {
+        WebTarget target = getWebTarget();
+        target = target.path(path);
+        // @formatter:off
+        return target.request(mimeType)
+                     .header("X-FHIR-TENANT-ID", tenantName)
+                     .header("X-FHIR-DSID", dataStoreId)
+                     .header("X-FHIR-BULKDATA-PROVIDER", provider)
+                     .header("X-FHIR-BULKDATA-PROVIDER-OUTCOME", outcome)
+                     .get(Response.class);
+        // @formatter:on
+    }
+
+    private void checkExportStatus(boolean isCheckPatient, List<String> types) throws Exception {
+        Response response;
+        do {
+            response = doGet(exportStatusUrl, FHIRMediaType.APPLICATION_FHIR_JSON, "default", "default");
+            // 202 accept means the request is still under processing
+            // 200 mean export is finished
+            assertEquals(Status.Family.familyOf(response.getStatus()), Status.Family.SUCCESSFUL);
+            Thread.sleep(1000);
+        } while (response.getStatus() == Response.Status.ACCEPTED.getStatusCode());
+
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+        // Export finished successfully, we should be about to find the "output" part in the message body
+        // which includes all the objects download urls.
+        String body = response.readEntity(String.class);
+        if (DEBUG) {
+            System.out.println(body);
+        }
+
+        if (isCheckPatient) {
+            assertTrue(body.contains("Patient_1.ndjson"));
+        }
+
+        assertTrue(body.contains("output"));
+    }
+
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testCreateTwoPatients() throws Exception {
+        WebTarget target = getWebTarget();
+        // Build a new Patient and then call the 'create' API.
+        Patient patient = TestUtil.readLocalResource("Patient_JohnDoe.json");
+        Entity<Patient> entity = Entity.entity(patient, FHIRMediaType.APPLICATION_FHIR_JSON);
+        //@formatter:off
+        Response response =
+                target.path("Patient")
+                    .request()
+                    .header("X-FHIR-TENANT-ID", tenantName)
+                    .header("X-FHIR-DSID", dataStoreId)
+                    .post(entity, Response.class);
+        //@formatter:on
+        assertResponse(response, Response.Status.CREATED.getStatusCode());
+        URI location = response.getLocation();
+        assertNotNull(location);
+        assertNotNull(location.toString());
+        assertFalse(location.toString().isEmpty());
+
+        // Get the patient's logical id value.
+        savedPatientId = getLocationLogicalId(response);
+
+        // Next, call the 'read' API to retrieve the new patient and verify it.
+        //@formatter:off
+        response = target.path("Patient/"+ savedPatientId)
+                            .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                            .header("X-FHIR-TENANT-ID", tenantName)
+                            .header("X-FHIR-DSID", dataStoreId)
+                            .get();
+        //@formatter:on
+        assertResponse(response, Response.Status.OK.getStatusCode());
+
+        // Create 2nd Patient.
+        entity = Entity.entity(patient, FHIRMediaType.APPLICATION_FHIR_JSON);
+        //@formatter:off
+        response = target.path("Patient")
+                            .request()
+                            .header("X-FHIR-TENANT-ID", tenantName)
+                            .header("X-FHIR-DSID", dataStoreId)
+                            .post(entity, Response.class);
+        //@formatter:on
+        assertResponse(response, Response.Status.CREATED.getStatusCode());
+        location = response.getLocation();
+        assertNotNull(location);
+        assertNotNull(location.toString());
+        assertFalse(location.toString().isEmpty());
+
+        // Get the 2nd patient's logical id value.
+        savedPatientId2 = getLocationLogicalId(response);
+
+        // Next, call the 'read' API to retrieve the new patient and verify it.
+        //@formatter:off
+        response = target.path("Patient/"+ savedPatientId2)
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", tenantName)
+                .header("X-FHIR-DSID", dataStoreId)
+                .get();
+        //@formatter:on
+        assertResponse(response, Response.Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { TEST_GROUP_NAME }, dependsOnMethods = { "testCreateTwoPatients" })
+    public void testCreateResourceForPatients() throws Exception {
+        WebTarget target = getWebTarget();
+
+        // Next, create an Observation for patient1.
+        Observation observation = TestUtil.buildPatientObservation(savedPatientId, "Observation1.json");
+        Entity<Observation> obs = Entity.entity(observation, FHIRMediaType.APPLICATION_FHIR_JSON);
+        //@formatter:off
+        Response response =
+                target.path("Observation")
+                      .request()
+                      .header("X-FHIR-TENANT-ID", tenantName)
+                      .header("X-FHIR-DSID", dataStoreId)
+                      .post(obs, Response.class);
+        //@formatter:on
+        assertResponse(response, Response.Status.CREATED.getStatusCode());
+
+        String observationId = getLocationLogicalId(response);
+        //@formatter:off
+        response = target.path("Observation/"+ observationId)
+                            .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                            .header("X-FHIR-TENANT-ID", tenantName)
+                            .header("X-FHIR-DSID", dataStoreId)
+                            .get();
+        //@formatter:on
+        assertResponse(response, Response.Status.OK.getStatusCode());
+
+        // Create a Condition for patient2.
+        Condition condition = buildCondition(savedPatientId2, "Condition.json");
+        Entity<Condition> cdt = Entity.entity(condition, FHIRMediaType.APPLICATION_FHIR_JSON);
+        //@formatter:off
+        response = target.path("Condition")
+                            .request()
+                            .header("X-FHIR-TENANT-ID", tenantName)
+                            .header("X-FHIR-DSID", dataStoreId)
+                            .post(cdt, Response.class);
+        //@formatter:on
+        assertResponse(response, Response.Status.CREATED.getStatusCode());
+
+        String conditionId = getLocationLogicalId(response);
+        //@formatter:off
+        response = target.path("Condition/"+ conditionId)
+                            .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                            .header("X-FHIR-TENANT-ID", tenantName)
+                            .header("X-FHIR-DSID", dataStoreId)
+                            .get();
+        //@formatter:on
+        assertResponse(response, Response.Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { TEST_GROUP_NAME }, dependsOnMethods = { "testCreateResourceForPatients" })
+    public void testGroup() throws Exception {
+        WebTarget target = getWebTarget();
+
+        // (1) Build a new Group.
+        Group group = TestUtil.readExampleResource("json/spec/group-example-member.json");
+        Entity<Group> entity = Entity.entity(group, FHIRMediaType.APPLICATION_FHIR_JSON);
+        //@formatter:off
+        Response response =
+                target.path("Group")
+                        .request()
+                        .header("X-FHIR-TENANT-ID", tenantName)
+                        .header("X-FHIR-DSID", dataStoreId)
+                        .post(entity, Response.class);
+        //@formatter:on
+        assertResponse(response, Response.Status.CREATED.getStatusCode());
+        URI location = response.getLocation();
+        assertNotNull(location);
+        assertNotNull(location.toString());
+        assertFalse(location.toString().isEmpty());
+
+        savedGroupId = getLocationLogicalId(response);
+
+        // Next, call the 'read' API to retrieve the new group and verify it.
+        //@formatter:off
+        response = target.path("Group/" + savedGroupId)
+                            .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                            .header("X-FHIR-TENANT-ID", tenantName)
+                            .header("X-FHIR-DSID", dataStoreId)
+                            .get();
+        //@formatter:on
+        assertResponse(response, Response.Status.OK.getStatusCode());
+        Group responseGroup = response.readEntity(Group.class);
+        assertNotNull(responseGroup);
+        assertTrue(responseGroup.getMember().size() == 4);
+
+        // (2) Build a new Group with patient2 and the above group only as members.
+        ArrayList<Member> members = new ArrayList<>();
+        group = group.toBuilder().member(members).build();
+        //@formatter:off
+        Member member = Member.builder()
+                                .entity(
+                                    Reference.builder()
+                                        .reference(string("Patient/" + savedPatientId2))
+                                        .build())
+                                .build();
+        //@formatter:on
+        members.add(member);
+        //@formatter:off
+        member = Member.builder()
+                            .entity(Reference.builder()
+                                        .reference(string("Group/" + savedGroupId))
+                                        .build())
+                            .build();
+        //@formatter:on
+        members.add(member);
+        group = group.toBuilder().member(members).build();
+        entity = Entity.entity(group, FHIRMediaType.APPLICATION_FHIR_JSON);
+        //@formatter:off
+        response = target.path("Group")
+                            .request()
+                            .header("X-FHIR-TENANT-ID", tenantName)
+                            .header("X-FHIR-DSID", dataStoreId)
+                            .post(entity, Response.class);
+        //@formatter:on
+        assertResponse(response, Response.Status.CREATED.getStatusCode());
+        location = response.getLocation();
+        assertNotNull(location);
+        assertNotNull(location.toString());
+        assertFalse(location.toString().isEmpty());
+
+        // Get the group logical id value.
+        savedGroupId2 = getLocationLogicalId(response);
+
+        // Next, call the 'read' API to retrieve the new group and verify it.
+        //@formatter:off
+        response = target.path("Group/" + savedGroupId2)
+                        .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                        .header("X-FHIR-TENANT-ID", tenantName)
+                        .header("X-FHIR-DSID", dataStoreId)
+                        .get();
+        //@formatter:off
+        assertResponse(response, Response.Status.OK.getStatusCode());
+        responseGroup = response.readEntity(Group.class);
+        assertNotNull(responseGroup);
+        assertTrue(responseGroup.getMember().size() == 2);
+
+        // (3) Modify the first group to contain the second group and patient1 only, this creates a circle reference
+        // situation.
+        members.clear();
+        //@formatter:off
+        member = Member.builder()
+                    .entity(Reference.builder()
+                        .reference(string("Patient/" + savedPatientId))
+                        .build())
+                    .build();
+        //@formatter:on
+        members.add(member);
+
+        //@formatter:off
+        member = Member.builder()
+                    .entity(Reference.builder()
+                        .reference(string("Group/" + savedGroupId2))
+                        .build())
+                    .build();
+        //@formatter:on
+        members.add(member);
+        group = group.toBuilder().id(savedGroupId).member(members).build();
+
+        // Update the patient and verify the response.
+        entity = Entity.entity(group, FHIRMediaType.APPLICATION_FHIR_JSON);
+        //@formatter:off
+        response = target.path("Group/" + savedGroupId).request()
+                .header("X-FHIR-TENANT-ID", tenantName)
+                .header("X-FHIR-DSID", dataStoreId)
+                .put(entity, Response.class);
+        //@formatter:on
+        assertResponse(response, Response.Status.OK.getStatusCode());
+
+        // Next, call the 'read' API to retrieve the new group and verify it.
+        //@formatter:off
+        response = target.path("Group/" + savedGroupId).request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", tenantName)
+                .header("X-FHIR-DSID", dataStoreId)
+                .get();
+        //@formatter:on
+        assertResponse(response, Response.Status.OK.getStatusCode());
+        responseGroup = response.readEntity(Group.class);
+        assertNotNull(responseGroup);
+        assertTrue(responseGroup.getMember().size() == 2);
+    }
+
+    @Test(groups = { TEST_GROUP_NAME }, dependsOnMethods = { "testGroup" }, enabled = true)
+    public void testSystemExportToAzure() throws Exception {
+        if (ON) {
+            List<String> types = Arrays.asList("Patient");
+            Response response = doPost(
+                    BASE_VALID_URL,
+                    FHIRMediaType.APPLICATION_FHIR_JSON,
+                    FORMAT_NDJSON,
+                    Instant.of("2019-01-01T08:21:26.94-04:00"),
+                    types,
+                    null,
+                    "default",
+                    "default");
+            assertEquals(response.getStatus(), Response.Status.ACCEPTED.getStatusCode());
+
+            // check the content-location that's returned.
+            String contentLocation = response.getHeaderString("Content-Location");
+            if (DEBUG) {
+                System.out.println("Content Location: " + contentLocation);
+            }
+
+            assertTrue(contentLocation.contains(BASE_VALID_STATUS_URL));
+            exportStatusUrl = contentLocation;
+            checkExportStatus(false, types);
+        } else {
+            System.out.println("System Export Test Disabled, Skipping");
+        }
+    }
+
+    @Test(groups = { TEST_GROUP_NAME }, dependsOnMethods = { "testGroup" })
+    public void testPatientExportToAzure() throws Exception {
+        if (ON) {
+            List<String> types = Arrays.asList("Observation", "Condition", "Patient");
+            Response response = doPost(
+                    PATIENT_VALID_URL,
+                    FHIRMediaType.APPLICATION_FHIR_JSON, FORMAT_NDJSON,
+                    Instant.of("2019-01-01T08:21:26.94-04:00"),
+                    types,
+                    null,
+                    "default",
+                    "default");
+            assertEquals(response.getStatus(), Response.Status.ACCEPTED.getStatusCode());
+
+            // check the content-location that's returned.
+            String contentLocation = response.getHeaderString("Content-Location");
+            if (DEBUG) {
+                System.out.println("Content Location: " + contentLocation);
+            }
+
+            assertTrue(contentLocation.contains(BASE_VALID_STATUS_URL));
+            exportStatusUrl = contentLocation;
+            checkExportStatus(true, types);
+        } else {
+            System.out.println("Patient Export Test Disabled, Skipping");
+        }
+    }
+
+    @Test(groups = { TEST_GROUP_NAME }, dependsOnMethods = { "testGroup" })
+    public void testGroupExportToAzure() throws Exception {
+        if (ON) {
+            List<String> types = Arrays.asList("Patient", "Group", "Condition", "Observation");
+            Response response = doPost(
+                    GROUP_VALID_URL.replace("?", savedGroupId2),
+                    FHIRMediaType.APPLICATION_FHIR_JSON, FORMAT_NDJSON,
+                    Instant.of("2019-01-01T08:21:26.94-04:00"),
+                    types,
+                    null,
+                    "default",
+                    "default");
+            assertEquals(response.getStatus(), Response.Status.ACCEPTED.getStatusCode());
+
+            // check the content-location that's returned.
+            String contentLocation = response.getHeaderString("Content-Location");
+            if (DEBUG) {
+                System.out.println("Content Location: " + contentLocation);
+            }
+
+            assertTrue(contentLocation.contains(BASE_VALID_STATUS_URL));
+            exportStatusUrl = contentLocation;
+            checkGroupExportStatus(types);
+        } else {
+            System.out.println("Group Export Test Disabled, Skipping");
+        }
+    }
+
+    private void checkGroupExportStatus(List<String> types) throws Exception {
+        Response response;
+        do {
+            response = doGet(exportStatusUrl, FHIRMediaType.APPLICATION_FHIR_JSON, "default", "default");
+            // 202 accept means the request is still under processing
+            // 200 mean export is finished
+            assertEquals(Status.Family.familyOf(response.getStatus()), Status.Family.SUCCESSFUL);
+            Thread.sleep(5000);
+        } while (response.getStatus() == Response.Status.ACCEPTED.getStatusCode());
+
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+        // Export finished successfully, we should be about to find the "output" part in the message body
+        // which includes all the objects download urls.
+        String body = response.readEntity(String.class);
+        JsonObject jsonObject = JSON_READER_FACTORY.createReader(new StringReader(body)).readObject();
+        assertTrue(jsonObject.containsKey("output"));
+    }
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ExportOperationTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ExportOperationTest.java
index 52d829c7535..434d63957cc 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ExportOperationTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ExportOperationTest.java
@@ -33,11 +33,11 @@
 import java.util.logging.Logger;
 import java.util.stream.Collectors;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
 import javax.net.ssl.HostnameVerifier;
 import javax.net.ssl.SSLContext;
 import javax.ws.rs.client.Entity;
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ImportOperationAzureTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ImportOperationAzureTest.java
new file mode 100644
index 00000000000..2343571e9f5
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ImportOperationAzureTest.java
@@ -0,0 +1,339 @@
+/*
+ * (C) Copyright IBM Corp. 2020, 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test.bulkdata;
+
+import static com.ibm.fhir.model.type.String.string;
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.assertNotNull;
+import static org.testng.Assert.assertTrue;
+import static org.testng.Assert.fail;
+
+import java.io.ByteArrayInputStream;
+import java.io.IOException;
+import java.io.StringWriter;
+import java.util.ArrayList;
+import java.util.List;
+import java.util.Properties;
+import java.util.UUID;
+import java.util.stream.Collectors;
+
+import javax.ws.rs.client.Entity;
+import javax.ws.rs.client.WebTarget;
+import javax.ws.rs.core.Response;
+
+import org.testng.annotations.BeforeClass;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.core.FHIRMediaType;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.generator.FHIRGenerator;
+import com.ibm.fhir.model.generator.exception.FHIRGeneratorException;
+import com.ibm.fhir.model.resource.Bundle;
+import com.ibm.fhir.model.resource.Parameters;
+import com.ibm.fhir.model.resource.Parameters.Parameter;
+import com.ibm.fhir.model.test.TestUtil;
+import com.ibm.fhir.model.type.Uri;
+import com.ibm.fhir.model.type.Url;
+import com.ibm.fhir.server.test.FHIRServerTestBase;
+
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+
+/**
+ * Azure Blob $import operation Integration Tests
+ */
+public class ImportOperationAzureTest extends FHIRServerTestBase {
+    private static final JsonReaderFactory JSON_READER_FACTORY = Json.createReaderFactory(null);
+
+    // Test Specific
+    public static final String TEST_GROUP_NAME = "import-operation";
+    private static boolean ON = false;
+    public static final boolean DEBUG = false;
+
+    // URLs to call against the instance
+    public static final String BASE_VALID_URL = "/$import";
+    public static final String BASE_VALID_STATUS_URL = "/$bulkdata-status";
+    public static final String FORMAT = "application/fhir+ndjson";
+    private final String tenantName = "default";
+    private final String dataStoreId = "default";
+
+    @BeforeClass
+    public void setup() throws Exception {
+        Properties testProperties = TestUtil.readTestProperties("test.properties");
+        ON = Boolean.parseBoolean(testProperties.getProperty("test.bulkdata.import.azure.enabled", "false"));
+    }
+
+    private Parameters generateParameters(String inputFormat, String inputSource, String resourceType, String url, String provider) throws FHIRGeneratorException, IOException {
+        List<Parameter> parameters = new ArrayList<>();
+
+        // Required: inputFormat
+        parameters.add(Parameter.builder().name(string("inputFormat")).value(string(inputFormat)).build());
+
+        // Required: inputSource - where it came from.
+        parameters.add(Parameter.builder().name(string("inputSource")).value(Uri.uri(inputSource)).build());
+
+        // Required: Input Values
+        Parameter part1 = Parameter.builder().name(string("type")).value(string(resourceType)).build();
+        Parameter part2 = Parameter.builder().name(string("url")).value(Url.of(url)).build();
+
+        // Required: Input (relative to bucket)
+        Parameter inputParameter = Parameter.builder().name(string("input")).part(part1, part2).build();
+        parameters.add(inputParameter);
+
+        // Optional: Storage Detail
+        if (provider.equals("default")) {
+            Parameter storageDetailParameter = Parameter.builder().name(string("storageDetail")).value(string("azure-blob")).build();
+            parameters.add(storageDetailParameter);
+        }
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        try (StringWriter writer = new StringWriter();) {
+            FHIRGenerator.generator(Format.JSON, true).generate(ps, writer);
+            if (DEBUG) {
+                System.out.println(writer.toString());
+            }
+        }
+        return ps;
+    }
+
+    /**
+     * add query parameter list
+     */
+    public WebTarget addQueryParameterList(WebTarget target, String header, List<String> vals) {
+        if (header != null && vals != null && !vals.isEmpty()) {
+            target = target.queryParam(header, vals.stream().collect(Collectors.joining(",")));
+        }
+        return target;
+    }
+
+    /**
+     * adds the query parameter
+     */
+    public WebTarget addQueryParameter(WebTarget target, String header, String val) {
+        if (header != null && val != null) {
+            target = target.queryParam(header, val);
+        }
+        return target;
+    }
+
+    public Response doGet(String path, String mimeType) {
+        WebTarget target = getWebTarget();
+        target = target.path(path);
+        return target.request(mimeType).header("X-FHIR-TENANT-ID", tenantName).header("X-FHIR-DSID", dataStoreId).get(Response.class);
+    }
+
+    public Response doPost(String path, String inputFormat, String inputSource, String resourceType, String url) throws FHIRGeneratorException, IOException {
+        return doPost(path, inputFormat, inputSource, resourceType, url, "default");
+    }
+
+    public Response doPost(String path, String inputFormat, String inputSource, String resourceType, String url, String provider)
+        throws FHIRGeneratorException, IOException {
+        WebTarget target = getWebTarget();
+        target = target.path(path);
+        if (DEBUG) {
+            System.out.println("URL -> " + target.getUri());
+        }
+        Parameters parameters = generateParameters(inputFormat, inputSource, resourceType, url, provider);
+        Entity<Parameters> entity = Entity.entity(parameters, FHIRMediaType.APPLICATION_FHIR_JSON);
+        return target.request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", tenantName)
+                .header("X-FHIR-DSID", dataStoreId)
+                .header("X-FHIR-BULKDATA-PROVIDER", provider)
+                .header("X-FHIR-BULKDATA-PROVIDER-OUTCOME", provider)
+                .post(entity, Response.class);
+    }
+
+    public Response polling(String statusUrl) throws InterruptedException {
+        int status = 202;
+        int totalTime = 0;
+        Response response = null;
+        System.out.println("Started Checking");
+        while (Response.Status.ACCEPTED.getStatusCode() == status) {
+            response = doGet(statusUrl, FHIRMediaType.APPLICATION_FHIR_JSON);
+            // 202 accept means the request is still under processing
+            // 200 mean export is finished
+            status = response.getStatus();
+
+            assertTrue(status == Response.Status.OK.getStatusCode() || status == Response.Status.ACCEPTED.getStatusCode());
+
+            Thread.sleep(5000);
+            totalTime += 5000;
+            if (totalTime > 10 * 60 * 1000) {
+                fail("Too Long a Wait");
+            }
+        }
+        assertEquals(status, Response.Status.OK.getStatusCode());
+        System.out.println("Finished Checking");
+        return response;
+    }
+
+    public void checkValidResponse(Response response) {
+        String body = response.readEntity(String.class);
+        try(JsonReader reader = JSON_READER_FACTORY.createReader(new ByteArrayInputStream(body.getBytes()))){
+            JsonObject obj = reader.readObject();
+            assertTrue(obj.containsKey("transactionTime"));
+            assertTrue(obj.containsKey("request"));
+            assertTrue(obj.containsKey("requiresAccessToken"));
+            assertTrue(obj.containsKey("output"));
+            assertTrue(obj.containsKey("error"));
+        } catch(Exception e) {
+            fail("Issue checking and validating", e);
+        }
+    }
+
+    public void checkOnFourResources() {
+        checkOnResource("72b0d93c-93d0-43d9-94a8-d5154ce07152");
+        checkOnResource("72b0d93c-93d0-43d9-94a8-d5154ce07153");
+        checkOnResource("72b0d93c-93d0-43d9-94a8-d5154ce07154");
+        checkOnResource("1772b6bb75a-fd1b2296-6666-4ac1-8b06-f3651eebcc0a");
+    }
+
+    /**
+     * verify that the resource exists and there is at least one
+     * @param id
+     */
+    public void checkOnResource(String id) {
+        WebTarget target = getWebTarget();
+        Response response =
+                target.path("Patient").queryParam("_id", id).request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
+        assertResponse(response, Response.Status.OK.getStatusCode());
+        Bundle bundle = response.readEntity(Bundle.class);
+        assertNotNull(bundle);
+        assertTrue(bundle.getEntry().size() >= 1);
+    }
+
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testImportFromAzure() throws Exception {
+        if (ON) {
+            String path = BASE_VALID_URL;
+            String inputFormat = FORMAT;
+            String inputSource = "https://localhost:9443/source-fhir-server";
+            String resourceType = "Patient";
+            String url = "test-import.ndjson";
+
+            Response response = doPost(path, inputFormat, inputSource, resourceType, url, "default");
+            assertEquals(response.getStatus(), Response.Status.ACCEPTED.getStatusCode());
+
+            // check the content-location that's returned.
+            String contentLocation = response.getHeaderString("Content-Location");
+            if (DEBUG) {
+                System.out.println("Content Location: " + contentLocation);
+            }
+
+            assertTrue(contentLocation.contains(BASE_VALID_STATUS_URL));
+
+            // Check eventual value
+            response = polling(contentLocation);
+            assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+            checkValidResponse(response);
+        } else {
+            System.out.println("Import Test Disabled, Skipping");
+        }
+    }
+
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testImportFromAzure_FileDoesNotExist() throws Exception {
+        if (ON) {
+            String path = BASE_VALID_URL;
+            String inputFormat = FORMAT;
+            String inputSource = "https://localhost:9443/source-fhir-server";
+            String resourceType = "Patient";
+            String url = "test-import-" + Math.random() + ".ndjson";
+
+            Response response = doPost(path, inputFormat, inputSource, resourceType, url, "default");
+            assertEquals(response.getStatus(), Response.Status.ACCEPTED.getStatusCode());
+
+            // check the content-location that's returned.
+            String contentLocation = response.getHeaderString("Content-Location");
+            if (DEBUG) {
+                System.out.println("Content Location: " + contentLocation);
+            }
+
+            assertTrue(contentLocation.contains(BASE_VALID_STATUS_URL));
+
+            // Check eventual value
+            response = pollingFailure(contentLocation);
+            assertEquals(response.getStatus(), Response.Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Import Test Disabled, Skipping");
+        }
+    }
+
+    public Response pollingFailure(String statusUrl) throws InterruptedException {
+        int status = 202;
+        int totalTime = 0;
+        Response response = null;
+        while (Response.Status.ACCEPTED.getStatusCode() == status) {
+            response = doGet(statusUrl, FHIRMediaType.APPLICATION_FHIR_JSON);
+            // 202 accept means the request is still under processing
+            // 200 mean export is finished
+            status = response.getStatus();
+
+            assertTrue(status == Response.Status.OK.getStatusCode() || status == Response.Status.ACCEPTED.getStatusCode() || status == Response.Status.BAD_REQUEST.getStatusCode());
+
+            Thread.sleep(5000);
+            totalTime += 5000;
+            if (totalTime > 10 * 60 * 1000) {
+                fail("Too Long a Wait");
+            }
+        }
+        return response;
+    }
+
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testImportFromAzureNegative() throws Exception {
+        if (ON) {
+            String path = BASE_VALID_URL;
+            String inputFormat = FORMAT;
+            String inputSource = "https://localhost:9443/source-fhir-server";
+            String resourceType = "Patient";
+            String url = "test-import-neg.ndjson";
+
+            Response response = doPost(path, inputFormat, inputSource, resourceType, url, "default");
+            assertEquals(response.getStatus(), Response.Status.ACCEPTED.getStatusCode());
+
+            // check the content-location that's returned.
+            String contentLocation = response.getHeaderString("Content-Location");
+            if (DEBUG) {
+                System.out.println("Content Location: " + contentLocation);
+            }
+
+            assertTrue(contentLocation.contains(BASE_VALID_STATUS_URL));
+
+            // Check eventual value
+            response = polling(contentLocation);
+            assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+            checkValidResponse(response);
+        } else {
+            System.out.println("Import Test Disabled, Skipping");
+        }
+    }
+
+    @Test(groups = { TEST_GROUP_NAME }, dependsOnMethods = { "testImportFromAzure" })
+    public void testImportCheckQuery() throws Exception {
+        if (ON) {
+            WebTarget target = getWebTarget();
+            Response response = target.path("Patient/1772b6bb75a-fd1b2296-6666-4ac1-8b06-f3651eebcc0a").request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
+            assertResponse(response, Response.Status.OK.getStatusCode());
+
+            response =
+                    target.path("Patient").queryParam("gender", "male").queryParam("_id", "1772b6bb75a-fd1b2296-6666-4ac1-8b06-f3651eebcc0a").request(FHIRMediaType.APPLICATION_FHIR_JSON).get();
+            assertResponse(response, Response.Status.OK.getStatusCode());
+            Bundle bundle = response.readEntity(Bundle.class);
+            assertNotNull(bundle);
+            assertTrue(bundle.getEntry().size() >= 1);
+        } else {
+            System.out.println("Import Test Disabled, Skipping");
+        }
+    }
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ImportOperationTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ImportOperationTest.java
index 9c7b1560985..6e6a41fbd2d 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ImportOperationTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/bulkdata/ImportOperationTest.java
@@ -22,10 +22,10 @@
 import java.util.UUID;
 import java.util.stream.Collectors;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
 import javax.ws.rs.client.Entity;
 import javax.ws.rs.client.WebTarget;
 import javax.ws.rs.core.Response;
@@ -229,7 +229,6 @@ public void testImportFromFileDefault() throws Exception {
             String inputFormat = FORMAT;
             String inputSource = "https://localhost:9443/source-fhir-server";
             String resourceType = "Patient";
-            // https://s3.us-east.cloud-object-storage.appdomain.cloud/fhir-integration-test/test-import.ndjson
             String url = "test-import.ndjson";
 
             Response response = doPost(path, inputFormat, inputSource, resourceType, url);
@@ -367,6 +366,57 @@ public void testImportFromS3() throws Exception {
         }
     }
 
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testImportFromS3_FileDoesNotExist() throws Exception {
+        if (ON) {
+            String path = BASE_VALID_URL;
+            String inputFormat = FORMAT;
+            String inputSource = "https://localhost:9443/source-fhir-server";
+            String resourceType = "Patient";
+            String url = "test-import-" + Math.random() + ".ndjson";
+
+            Response response = doPost(path, inputFormat, inputSource, resourceType, url, "minio");
+            assertEquals(response.getStatus(), Response.Status.ACCEPTED.getStatusCode());
+
+            // check the content-location that's returned.
+            String contentLocation = response.getHeaderString("Content-Location");
+            if (DEBUG) {
+                System.out.println("Content Location: " + contentLocation);
+            }
+
+            assertTrue(contentLocation.contains(BASE_VALID_STATUS_URL));
+
+            // Check eventual value
+            response = pollingFailure(contentLocation);
+            assertEquals(response.getStatus(), Response.Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Import Test Disabled, Skipping");
+        }
+    }
+
+    public Response pollingFailure(String statusUrl) throws InterruptedException {
+        int status = 202;
+        int totalTime = 0;
+        Response response = null;
+        System.out.println("Started Checking");
+        while (Response.Status.ACCEPTED.getStatusCode() == status) {
+            response = doGet(statusUrl, FHIRMediaType.APPLICATION_FHIR_JSON);
+            // 202 accept means the request is still under processing
+            // 200 mean export is finished
+            status = response.getStatus();
+
+            assertTrue(status == Response.Status.OK.getStatusCode() || status == Response.Status.ACCEPTED.getStatusCode() || status == Response.Status.BAD_REQUEST.getStatusCode());
+
+            Thread.sleep(5000);
+            totalTime += 5000;
+            if (totalTime > 10 * 60 * 1000) {
+                fail("Too Long a Wait");
+            }
+        }
+        System.out.println("Finished Checking");
+        return response;
+    }
+
     @Test(groups = { TEST_GROUP_NAME })
     public void testImportFromS3Negative() throws Exception {
         if (ON) {
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/db2/ConcurrentUpdateTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/db2/ConcurrentUpdateTest.java
deleted file mode 100644
index aa11267c0b6..00000000000
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/db2/ConcurrentUpdateTest.java
+++ /dev/null
@@ -1,134 +0,0 @@
-/*
- * (C) Copyright IBM Corp. 2017,2019
- *
- * SPDX-License-Identifier: Apache-2.0
- */
-
-package com.ibm.fhir.server.test.db2;
-
-import static org.testng.AssertJUnit.assertEquals;
-import static org.testng.AssertJUnit.assertNotNull;
-import static org.testng.AssertJUnit.assertTrue;
-
-import java.util.ArrayList;
-import java.util.List;
-import java.util.Properties;
-import java.util.UUID;
-import java.util.concurrent.Callable;
-import java.util.concurrent.ExecutorService;
-import java.util.concurrent.Executors;
-import java.util.concurrent.Future;
-
-import javax.ws.rs.core.Response;
-
-import org.testng.annotations.BeforeClass;
-import org.testng.annotations.Test;
-
-import com.ibm.fhir.client.FHIRParameters;
-import com.ibm.fhir.client.FHIRResponse;
-import com.ibm.fhir.model.resource.Bundle;
-import com.ibm.fhir.model.resource.Patient;
-import com.ibm.fhir.model.test.TestUtil;
-import com.ibm.fhir.server.test.FHIRServerTestBase;
-
-/**
- * Tests specifically the concurrent creation and updating of a single patient, with the updateCreate feature enabled.
- * The idea is to ensure that no patients with duplicate logical ids are created.
- * 
- * NOTE: This test is NOT included in the fhir-server testng suite because of an internal problem with Derby that
- * surfaces after the first execution of this test against a clean Derby DB. Subsequent test runs of this class will
- * fail with an XAException that has an unknown error code. It should only be run against a DB2 database.
- */
-public class ConcurrentUpdateTest extends FHIRServerTestBase {
-    private static boolean ON = false;
-
-    @BeforeClass
-    public void setup() throws Exception {
-        Properties testProperties = TestUtil.readTestProperties("test.properties");
-        ON = Boolean.parseBoolean(testProperties.getProperty("test.db2.enabled", "false"));
-    }
-
-    @Test
-    public void testConcurrentUpdateCreate() throws Exception {
-        if (ON) {
-            List<Callable<Patient>> concurrentUpdates = new ArrayList<>();
-            List<Future<Patient>> futureResults = new ArrayList<>();
-            int maxThreads = 12;
-            FHIRParameters parameters;
-            FHIRResponse response;
-
-            if (this.isUpdateCreateSupported()) {
-
-                // Read a JSON Patient and set the id.
-                String patientLogicalId = UUID.randomUUID().toString();
-                Patient patient = TestUtil.readLocalResource("Patient_SalMonella.json");
-                patient = patient.toBuilder().id(patientLogicalId).build();
-
-                // Initialize multi-thread Executor Service.
-                ExecutorService executor = Executors.newFixedThreadPool(maxThreads);
-
-                // Prepare PatientUpdater instances for running each on its own thread.
-                for (int i = 0; i < maxThreads; i++) {
-                    concurrentUpdates.add(new PatientUpdater(patient));
-                }
-
-                // Run each PatientUpdater on its own thread.
-                futureResults = executor.invokeAll(concurrentUpdates);
-                assertNotNull(futureResults);
-
-                // Search on the patient id, and see how many results we get. There should only
-                // be one.
-                parameters = new FHIRParameters().searchParam("_id", patientLogicalId);
-                response = client.search("Patient", parameters);
-                assertResponse(response.getResponse(), Response.Status.OK.getStatusCode());
-                Bundle searchResults = response.getResource(Bundle.class);
-                assertEquals(1, searchResults.getEntry().size());
-                assertNotNull(searchResults.getEntry().get(0).getResource());
-                assertEquals(patientLogicalId, searchResults.getEntry().get(0).getResource().getId());
-
-                // Pull the history on the patient id. There should be the same number of
-                // versions as the value of maxThreads.
-                parameters = new FHIRParameters().count(maxThreads);
-                response = client.history("Patient", patientLogicalId, parameters);
-                assertResponse(response.getResponse(), Response.Status.OK.getStatusCode());
-                Bundle bundle = response.getResource(Bundle.class);
-                assertNotNull(bundle);
-                assertNotNull(bundle.getEntry());
-                assertEquals(maxThreads, bundle.getEntry().size());
-
-                // Make sure that the versions are in descending order, and that none are
-                // duplicates.
-                Integer previousVersionId = null;
-                Integer versionId;
-                for (Bundle.Entry entry : bundle.getEntry()) {
-                    Patient bundlePatient = (Patient) entry.getResource();
-                    versionId = Integer.valueOf(bundlePatient.getMeta().getVersionId().getValue());
-                    if (previousVersionId != null) {
-                        assertTrue(previousVersionId > versionId);
-                    }
-                    previousVersionId = versionId;
-                }
-            }
-        }
-    }
-
-    /**
-     * This inner class invokes the FHIRClient update API for the Patient instance it encapsulates.
-     */
-    private class PatientUpdater implements Callable<Patient> {
-        private Patient patient;
-
-        PatientUpdater(Patient newPatient) {
-            this.patient = newPatient;
-        }
-
-        @Override
-        public Patient call() throws Exception {
-            FHIRResponse response = client.update(this.patient);
-            boolean goodResponse =
-                    (response.getStatus() == Response.Status.OK.getStatusCode() || response.getStatus() == Response.Status.CREATED.getStatusCode());
-            assertTrue(goodResponse);
-            return this.patient;
-        }
-    }
-}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/everything/EverythingOperationTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/everything/EverythingOperationTest.java
index 5ef8b116d69..b1dcb6553cc 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/everything/EverythingOperationTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/everything/EverythingOperationTest.java
@@ -192,6 +192,17 @@ public void testPatientEverythingWithCount() {
         assertResponseBundle(everythingBundle, BundleType.SEARCHSET, 895);
     }
 
+    @Test(groups = { "fhir-operation" })
+    public void testPatientEverythingAtTypeLevel() {
+        if (SKIP) {
+            logger.warning("Skipping integration test for $everything");
+            return;
+        }
+        Response response = getWebTarget().path("Patient/$everything").queryParam("_count", 1).request().get(Response.class);
+
+        assertResponse(response, Response.Status.BAD_REQUEST.getStatusCode());
+    }
+
     @Test(groups = { "fhir-operation" }, dependsOnMethods = { "testPatientEverything" })
     public void testPatientEverythingWithStartAndStop() {
         if (SKIP) {
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationLongRunTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationLongRunTest.java
new file mode 100644
index 00000000000..a973e0b5e9d
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationLongRunTest.java
@@ -0,0 +1,99 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test.operation;
+
+import static com.ibm.fhir.model.type.Integer.of;
+import static com.ibm.fhir.model.type.String.string;
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.assertTrue;
+import static org.testng.AssertJUnit.assertFalse;
+
+import java.util.ArrayList;
+import java.util.List;
+import java.util.Properties;
+import java.util.UUID;
+
+import javax.ws.rs.client.Entity;
+import javax.ws.rs.core.Response;
+import javax.ws.rs.core.Response.Status;
+
+import org.testng.annotations.BeforeClass;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.core.FHIRMediaType;
+import com.ibm.fhir.model.resource.Bundle;
+import com.ibm.fhir.model.resource.Bundle.Entry;
+import com.ibm.fhir.model.resource.Parameters;
+import com.ibm.fhir.model.resource.Parameters.Parameter;
+import com.ibm.fhir.model.test.TestUtil;
+import com.ibm.fhir.server.test.FHIRServerTestBase;
+
+/**
+ * This integration tests the <b>fhir-operation-reindex</b> $reindex operation.
+ * If there is a lot of data in the system, then this can take some time, over a 120s timeout
+ * so this is moved to a separate test that runs in the Integration Test workload
+ */
+public class ReindexOperationLongRunTest extends FHIRServerTestBase {
+    private boolean runIt = false;
+
+    @BeforeClass
+    public void setup() throws Exception {
+        Properties testProperties = TestUtil.readTestProperties("test.properties");
+        runIt = Boolean.parseBoolean(testProperties.getProperty("test.reindex.enabled", "false"));
+    }
+
+    @Test(groups = {"reindex"})
+    public void createResources() throws Exception {
+        if (runIt) {
+            System.out.println("Create Patient Details for Reindex");
+            return;
+        }
+        Bundle patientBundle = TestUtil.readLocalResource("everything-operation/Antonia30_Acosta403.json");
+        Entity<Bundle> entity = Entity.entity(patientBundle, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response response = getWebTarget().request().post(entity, Response.class);
+
+        assertResponse(response, Response.Status.OK.getStatusCode());
+        Bundle responseBundle = response.readEntity(Bundle.class);
+        assertFalse(responseBundle.getEntry().isEmpty());
+        for (Entry entry : responseBundle.getEntry()) {
+            com.ibm.fhir.model.resource.Bundle.Entry.Response transactionResponse = entry.getResponse();
+            assertEquals(transactionResponse.getStatus().getValue(), Integer.toString(Response.Status.CREATED.getStatusCode()));
+            String[] locationElements = transactionResponse.getLocation().getValue().split("/");
+            assertTrue(locationElements.length > 2, "Incorrect location URI format: " + transactionResponse.getLocation());
+        }
+    }
+
+    @Test(groups = {"reindex" }, dependsOnMethods = {"createResources"})
+    public void testReindexCountOverlimit() {
+        if (runIt) {
+            List<Parameter> parameters = new ArrayList<>();
+            parameters.add(Parameter.builder()
+                .name(string("resourceCount"))
+                .value(of(1001))
+                .build());
+
+            Parameters.Builder builder = Parameters.builder();
+            builder.id(UUID.randomUUID().toString());
+            builder.parameter(parameters);
+            Parameters ps = builder.build();
+
+            Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+            Response r = getWebTarget()
+                    .path("/$reindex")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .post(entity, Response.class);
+
+            assertEquals(r.getStatus(), Status.OK.getStatusCode());
+        } else {
+            System.out.println("Skipping over long run $reindex IT test");
+        }
+    }
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationPhase1Test.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationPhase1Test.java
new file mode 100644
index 00000000000..373950f227e
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationPhase1Test.java
@@ -0,0 +1,361 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test.operation;
+
+import static com.ibm.fhir.model.type.String.string;
+import static org.testng.Assert.assertEquals;
+
+import java.io.IOException;
+import java.io.Reader;
+import java.util.ArrayList;
+import java.util.Arrays;
+import java.util.Collection;
+import java.util.Properties;
+
+import javax.ws.rs.client.Entity;
+import javax.ws.rs.core.Response;
+import javax.ws.rs.core.Response.Status;
+
+import org.testng.annotations.BeforeClass;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.core.FHIRMediaType;
+import com.ibm.fhir.examples.ExamplesUtil;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.parser.FHIRParser;
+import com.ibm.fhir.model.parser.exception.FHIRParserException;
+import com.ibm.fhir.model.resource.Basic;
+import com.ibm.fhir.model.resource.Patient;
+import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.test.TestUtil;
+import com.ibm.fhir.model.type.Extension;
+import com.ibm.fhir.path.exception.FHIRPathException;
+import com.ibm.fhir.server.test.FHIRServerTestBase;
+
+/**
+ * This integration tests the <b>fhir-operation-reindex</b> $reindex operation.
+ * Phase 1: Populate and Confirm it's not found
+ * Followed by Server Side Restart
+ */
+public class ReindexOperationPhase1Test extends FHIRServerTestBase {
+
+    private boolean runIt = false;
+
+    @BeforeClass
+    public void setup() throws Exception {
+        Properties testProperties = TestUtil.readTestProperties("test.properties");
+        runIt = Boolean.parseBoolean(testProperties.getProperty("test.reindex.enabled", "false"));
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_ChangedExpression_Phase1() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Patient r = null;
+            // Create ID with 2 Special Extensions
+            try (Reader example = ExamplesUtil.resourceReader(("json/ibm/fhir-operation-erase/Patient-1.json"))) {
+                r = FHIRParser.parser(Format.JSON).parse(example);
+                Extension ext1 = Extension.builder()
+                        .url("NAME1")
+                        .value(string("VALUE1"))
+                    .build();
+                Extension ext2 = Extension.builder()
+                        .url("NAME2")
+                        .value(string("VALUE2"))
+                    .build();
+                Collection<Extension> exts = Arrays.asList(ext1, ext2);
+                r = r.toBuilder()
+                        .id("REIN-DEX-TEST-1")
+                        .extension(
+                            Extension.builder()
+                                .url("http://ibm.com/fhir/test")
+                                .extension(exts)
+                                .build())
+                        .build();
+                Entity<Resource> entity = Entity.entity(r, FHIRMediaType.APPLICATION_FHIR_JSON);
+                Response response = getWebTarget()
+                        .path("Patient/REIN-DEX-TEST-1")
+                        .request()
+                        .put(entity, Response.class);
+                assertEquals(Response.Status.Family.familyOf(response.getStatus()), Response.Status.Family.SUCCESSFUL);
+            }
+
+            // Search and Confirm the search using the test-code1 fails with BAD_REQUEST as the code does not yet exist
+            Response response = getWebTarget().path("/Patient")
+                    .queryParam("test-code1", "VALUE1")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertEquals(response.getStatus(), Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Skipping Phase 1 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_String_Phase1() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Basic r = null;
+            try (Reader example = ExamplesUtil.resourceReader(("json/ibm/basic/BasicString.json"))) {
+                r = FHIRParser.parser(Format.JSON).parse(example);
+                r = r.toBuilder()
+                        .id("REINDEX-STRING")
+                    .build();
+
+                Entity<Resource> entity = Entity.entity(r, FHIRMediaType.APPLICATION_FHIR_JSON);
+                Response response = getWebTarget()
+                        .path("Basic/REINDEX-STRING")
+                        .request()
+                        .put(entity, Response.class);
+                assertEquals(Response.Status.Family.familyOf(response.getStatus()), Response.Status.Family.SUCCESSFUL);
+            }
+
+            // Search and Confirm the search using the 'code' fails with BAD_REQUEST as the code does not yet exist
+            Response response = getWebTarget().path("/Basic")
+                    .queryParam("reindex-string", "testString")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertEquals(response.getStatus(), Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Skipping Phase 1 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Token_Phase1() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Basic r = null;
+            try (Reader example = ExamplesUtil.resourceReader(("json/ibm/basic/BasicToken.json"))) {
+                r = FHIRParser.parser(Format.JSON).parse(example);
+
+                // "http://example.org/ContactPoint-noSystem"
+                // This is a negative example which needs to be removed.
+                // As it generates {"text":"cpt-2: A system is required if a value is provided."}
+                java.util.List<Extension> exts = r.getExtension();
+                java.util.List<Extension> newExts = new ArrayList<>();
+
+                for (Extension ext : exts) {
+                    if (!"http://example.org/ContactPoint-noSystem".equals(ext.getUrl())) {
+                        newExts.add(ext);
+                    }
+                }
+
+                r = r.toBuilder()
+                        .id("REINDEX-TOKEN")
+                        .extension(newExts)
+                    .build();
+
+                Entity<Resource> entity = Entity.entity(r, FHIRMediaType.APPLICATION_FHIR_JSON);
+                Response response = getWebTarget()
+                        .path("Basic/REINDEX-TOKEN")
+                        .request()
+                        .put(entity, Response.class);
+                assertEquals(Response.Status.Family.familyOf(response.getStatus()), Response.Status.Family.SUCCESSFUL);
+            }
+
+            // Search and Confirm the search using the 'code' fails with BAD_REQUEST as the code does not yet exist
+            Response response = getWebTarget().path("/Basic")
+                    .queryParam("reindex-token", "http://example.org/codesystem|code")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertEquals(response.getStatus(), Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Skipping Phase 1 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_URI_Phase1() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Basic r = null;
+            try (Reader example = ExamplesUtil.resourceReader(("json/ibm/basic/BasicURI.json"))) {
+                r = FHIRParser.parser(Format.JSON).parse(example);
+                r = r.toBuilder()
+                        .id("REINDEX-URI")
+                    .build();
+
+                Entity<Resource> entity = Entity.entity(r, FHIRMediaType.APPLICATION_FHIR_JSON);
+                Response response = getWebTarget()
+                        .path("Basic/REINDEX-URI")
+                        .request()
+                        .put(entity, Response.class);
+                assertEquals(Response.Status.Family.familyOf(response.getStatus()), Response.Status.Family.SUCCESSFUL);
+            }
+
+            // Search and Confirm the search using the 'code' fails with BAD_REQUEST as the code does not yet exist
+            Response response = getWebTarget().path("/Basic")
+                    .queryParam("reindex-uri", "Basic/123")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertEquals(response.getStatus(), Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Skipping Phase 1 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Reference_Phase1() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Basic r = null;
+            try (Reader example = ExamplesUtil.resourceReader(("json/ibm/basic/BasicReference.json"))) {
+                r = FHIRParser.parser(Format.JSON).parse(example);
+                r = r.toBuilder()
+                        .id("REINDEX-REFERENCE")
+                    .build();
+
+                Entity<Resource> entity = Entity.entity(r, FHIRMediaType.APPLICATION_FHIR_JSON);
+                Response response = getWebTarget()
+                        .path("Basic/REINDEX-REFERENCE")
+                        .request()
+                        .put(entity, Response.class);
+                assertEquals(Response.Status.Family.familyOf(response.getStatus()), Response.Status.Family.SUCCESSFUL);
+            }
+
+            // Search and Confirm the search using the 'code' fails with BAD_REQUEST as the code does not yet exist
+            Response response = getWebTarget().path("/Basic")
+                    .queryParam("reindex-reference", "Basic/123")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertEquals(response.getStatus(), Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Skipping Phase 1 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Quantity_Phase1() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Basic r = null;
+            try (Reader example = ExamplesUtil.resourceReader(("json/ibm/basic/BasicQuantity.json"))) {
+                r = FHIRParser.parser(Format.JSON).parse(example);
+                r = r.toBuilder()
+                        .id("REINDEX-QUANTITY")
+                    .build();
+
+                Entity<Resource> entity = Entity.entity(r, FHIRMediaType.APPLICATION_FHIR_JSON);
+                Response response = getWebTarget()
+                        .path("Basic/REINDEX-QUANTITY")
+                        .request()
+                        .put(entity, Response.class);
+                assertEquals(Response.Status.Family.familyOf(response.getStatus()), Response.Status.Family.SUCCESSFUL);
+            }
+
+            // Search and Confirm the search using the 'code' fails with BAD_REQUEST as the code does not yet exist
+            Response response = getWebTarget().path("/Basic")
+                    .queryParam("reindex-quantity", "25|http://unitsofmeasure.org|s")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertEquals(response.getStatus(), Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Skipping Phase 1 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Number_Phase1() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Basic r = null;
+            try (Reader example = ExamplesUtil.resourceReader(("json/ibm/basic/BasicNumber.json"))) {
+                r = FHIRParser.parser(Format.JSON).parse(example);
+                r = r.toBuilder()
+                        .id("REINDEX-NUMBER")
+                    .build();
+
+                Entity<Resource> entity = Entity.entity(r, FHIRMediaType.APPLICATION_FHIR_JSON);
+                Response response = getWebTarget()
+                        .path("Basic/REINDEX-NUMBER")
+                        .request()
+                        .put(entity, Response.class);
+                assertEquals(Response.Status.Family.familyOf(response.getStatus()), Response.Status.Family.SUCCESSFUL);
+            }
+
+            // Search and Confirm the search using the 'code' fails with BAD_REQUEST as the code does not yet exist
+            Response response = getWebTarget().path("/Basic")
+                    .queryParam("reindex-decimal", "99.99")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertEquals(response.getStatus(), Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Skipping Phase 1 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Date_Phase1() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Basic r = null;
+            try (Reader example = ExamplesUtil.resourceReader(("json/ibm/basic/BasicDate.json"))) {
+                r = FHIRParser.parser(Format.JSON).parse(example);
+
+                r = r.toBuilder()
+                        .id("REINDEX-DATE")
+                    .build();
+
+                Entity<Resource> entity = Entity.entity(r, FHIRMediaType.APPLICATION_FHIR_JSON);
+                Response response = getWebTarget()
+                        .path("Basic/REINDEX-DATE")
+                        .request()
+                        .put(entity, Response.class);
+                assertEquals(Response.Status.Family.familyOf(response.getStatus()), Response.Status.Family.SUCCESSFUL);
+            }
+
+            // Search and Confirm the search using the 'code' fails with BAD_REQUEST as the code does not yet exist
+            Response response = getWebTarget().path("/Basic")
+                    .queryParam("reindex-date", "2018-10-29")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertEquals(response.getStatus(), Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Skipping Phase 1 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Composite_Phase1() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Basic r = null;
+            try (Reader example = ExamplesUtil.resourceReader(("json/ibm/basic/BasicComposite.json"))) {
+                r = FHIRParser.parser(Format.JSON).parse(example);
+                r = r.toBuilder()
+                        .id("REINDEX-COMPOSITE")
+                    .build();
+
+                Entity<Resource> entity = Entity.entity(r, FHIRMediaType.APPLICATION_FHIR_JSON);
+                Response response = getWebTarget()
+                        .path("Basic/REINDEX-COMPOSITE")
+                        .request()
+                        .put(entity, Response.class);
+                assertEquals(Response.Status.Family.familyOf(response.getStatus()), Response.Status.Family.SUCCESSFUL);
+            }
+
+            // Search and Confirm the search using the 'code' fails with BAD_REQUEST as the code does not yet exist
+            Response response = getWebTarget().path("/Basic")
+                    .queryParam("reindex-composite", "code$code")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertEquals(response.getStatus(), Status.BAD_REQUEST.getStatusCode());
+        } else {
+            System.out.println("Skipping Phase 1 of Reindex Operation Tests");
+        }
+    }
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationPhase2Test.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationPhase2Test.java
new file mode 100644
index 00000000000..b56ceaf63b6
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationPhase2Test.java
@@ -0,0 +1,297 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test.operation;
+
+import static com.ibm.fhir.model.type.Integer.of;
+import static com.ibm.fhir.model.type.String.string;
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.assertFalse;
+
+import java.io.IOException;
+import java.util.ArrayList;
+import java.util.List;
+import java.util.Properties;
+import java.util.UUID;
+
+import javax.ws.rs.client.Entity;
+import javax.ws.rs.core.Response;
+import javax.ws.rs.core.Response.Status;
+
+import org.testng.annotations.BeforeClass;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.core.FHIRMediaType;
+import com.ibm.fhir.model.parser.exception.FHIRParserException;
+import com.ibm.fhir.model.resource.Bundle;
+import com.ibm.fhir.model.resource.OperationOutcome;
+import com.ibm.fhir.model.resource.Parameters;
+import com.ibm.fhir.model.resource.Parameters.Parameter;
+import com.ibm.fhir.model.test.TestUtil;
+import com.ibm.fhir.path.exception.FHIRPathException;
+import com.ibm.fhir.server.test.FHIRServerTestBase;
+
+/**
+ * This integration tests the <b>fhir-operation-reindex</b> $reindex operation.
+ *
+ * <b>Phase 2</b>:
+ * Pre-condition: The Phase 1 loaded Resources which were not previously found.
+ * Completes the reindexes with the newly found SearchParameters (extension-search-parameters.json).
+ * These SearchParameters include the original FHIR Path Expressions important for the `ChangedExpression`.
+ *
+ * This test is followed by a Server Side Restart and then Phase3.
+ */
+public class ReindexOperationPhase2Test extends FHIRServerTestBase {
+    private boolean runIt = false;
+
+    @BeforeClass
+    public void setup() throws Exception {
+        Properties testProperties = TestUtil.readTestProperties("test.properties");
+        runIt = Boolean.parseBoolean(testProperties.getProperty("test.reindex.enabled", "false"));
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_ChangedExpression_Phase2_Reindex() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            List<Parameter> parameters = new ArrayList<>();
+            parameters.add(Parameter.builder()
+                .name(string("resourceLogicalId"))
+                .value(string("Patient/REIN-DEX-TEST-1"))
+                .build());
+
+            Parameters.Builder builder = Parameters.builder();
+            builder.id(UUID.randomUUID().toString());
+            builder.parameter(parameters);
+            Parameters ps = builder.build();
+
+            Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+            Response response = getWebTarget()
+                    .path("/$reindex")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .post(entity, Response.class);
+            assertResponse(response, Response.Status.OK.getStatusCode());
+            OperationOutcome oo = response.readEntity(OperationOutcome.class);
+            assertEquals(oo.getIssue().get(0).getDiagnostics().getValue(), "Processed Patient/REIN-DEX-TEST-1");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {"testReindex_ChangedExpression_Phase2_Reindex"})
+    public void testReindex_ChangedExpression_Phase2_Search() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Response response = getWebTarget().path("/Patient")
+                    .queryParam("test-code1", "VALUE1")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertResponse(response, Response.Status.OK.getStatusCode());
+            Bundle bundle = response.readEntity(Bundle.class);
+            assertFalse(bundle.getEntry().isEmpty());
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {"testReindex_ChangedExpression_Phase2_Search"})
+    public void testReindex_ChangedExpression_Phase2_Reindex_Type() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            List<Parameter> parameters = new ArrayList<>();
+            Parameters.Builder builder = Parameters.builder();
+            builder.id(UUID.randomUUID().toString());
+            builder.parameter(parameters);
+            Parameters ps = builder.build();
+
+            Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+            Response response = getWebTarget()
+                    .path("/Patient/$reindex")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .post(entity, Response.class);
+            assertResponse(response, Response.Status.OK.getStatusCode());
+            OperationOutcome oo = response.readEntity(OperationOutcome.class);
+            assertEquals(oo.getIssue().get(0).getDiagnostics().getValue(), "Processed Patient/REIN-DEX-TEST-1");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {"testReindex_ChangedExpression_Phase2_Reindex_Type"})
+    public void testReindex_ChangedExpression_Phase2_Search_Type() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Response response = getWebTarget().path("/Patient")
+                    .queryParam("test-code1", "VALUE1")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertResponse(response, Response.Status.OK.getStatusCode());
+            Bundle bundle = response.readEntity(Bundle.class);
+            assertFalse(bundle.getEntry().isEmpty());
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {"testReindex_ChangedExpression_Phase2_Search_Type"})
+    public void testReindexWithInstanceExists_Phase2() {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceCount"))
+            .value(of(5))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/Patient/REIN-DEX-TEST-1/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.OK.getStatusCode());
+    }
+
+    /**
+     * reindex a specific Basic/id resource
+     */
+    private void reindex(String id) {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceLogicalId"))
+            .value(string("Basic/" + id))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response response = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+        assertResponse(response, Response.Status.OK.getStatusCode());
+        OperationOutcome oo = response.readEntity(OperationOutcome.class);
+        assertEquals(oo.getIssue().get(0).getDiagnostics().getValue(), "Processed Basic/" + id);
+    }
+
+    /**
+     * checks the basic resource is found
+     * @param code
+     * @param id
+     * @param value
+     */
+    private void verifyFoundBySearch(String code, String id, String value) {
+        // Search and Confirm the search using the 'code' does returns a resource.
+        Response response = getWebTarget().path("/Basic")
+                .queryParam(code, value)
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .get(Response.class);
+        assertEquals(response.getStatus(), Status.OK.getStatusCode());
+        Bundle bundle = response.readEntity(Bundle.class);
+        assertFalse(bundle.getEntry().isEmpty());
+        assertEquals(bundle.getEntry().get(0).getId(), id);
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_String_Phase2() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            reindex("REINDEX-STRING");
+            verifyFoundBySearch("reindex-string", "REINDEX-STRING", "testString");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Token_Phase2() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            reindex("REINDEX-TOKEN");
+            verifyFoundBySearch("reindex-token", "REINDEX-TOKEN", "http://example.org/codesystem|code");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_URI_Phase2() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            reindex("REINDEX-URI");
+            verifyFoundBySearch("reindex-uri", "REINDEX-URI", "http://hl7.org/fhir/DSTU2");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Reference_Phase2() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            reindex("REINDEX-REFERENCE");
+            verifyFoundBySearch("reindex-reference", "REINDEX-REFERENCE", "Basic/123");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Quantity_Phase2() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            reindex("REINDEX-QUANTITY");
+            verifyFoundBySearch("reindex-quantity", "REINDEX-QUANTITY", "25|http://unitsofmeasure.org|s");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Number_Phase2() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            reindex("REINDEX-NUMBER");
+            verifyFoundBySearch("reindex-decimal", "REINDEX-NUMBER", "99.99");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Date_Phase2() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            reindex("REINDEX-DATE");
+            verifyFoundBySearch("reindex-date", "REINDEX-DATE", "2018-10-29");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_Composite_Phase2() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            reindex("REINDEX-COMPOSITE");
+            verifyFoundBySearch("reindex-composite", "REINDEX-COMPOSITE", "code$code");
+        } else {
+            System.out.println("Skipping Phase 2 of Reindex Operation Tests");
+        }
+    }
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationPhase3Test.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationPhase3Test.java
new file mode 100644
index 00000000000..1e1f46d49c9
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationPhase3Test.java
@@ -0,0 +1,94 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test.operation;
+
+import static com.ibm.fhir.model.type.String.string;
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.assertFalse;
+
+import java.io.IOException;
+import java.util.ArrayList;
+import java.util.List;
+import java.util.Properties;
+import java.util.UUID;
+
+import javax.ws.rs.client.Entity;
+import javax.ws.rs.core.Response;
+
+import org.testng.annotations.BeforeClass;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.core.FHIRMediaType;
+import com.ibm.fhir.model.parser.exception.FHIRParserException;
+import com.ibm.fhir.model.resource.Bundle;
+import com.ibm.fhir.model.resource.OperationOutcome;
+import com.ibm.fhir.model.resource.Parameters;
+import com.ibm.fhir.model.resource.Parameters.Parameter;
+import com.ibm.fhir.model.test.TestUtil;
+import com.ibm.fhir.path.exception.FHIRPathException;
+import com.ibm.fhir.server.test.FHIRServerTestBase;
+
+/**
+ * This integration tests the <b>fhir-operation-reindex</b> $reindex operation.
+ * Phase 3: Completes the reindex changes after Expression Change
+ */
+public class ReindexOperationPhase3Test extends FHIRServerTestBase {
+    private boolean runIt = false;
+
+    @BeforeClass
+    public void setup() throws Exception {
+        Properties testProperties = TestUtil.readTestProperties("test.properties");
+        runIt = Boolean.parseBoolean(testProperties.getProperty("test.reindex.enabled", "false"));
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {})
+    public void testReindex_ChangedExpression_Phase3_Reindex() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            List<Parameter> parameters = new ArrayList<>();
+            parameters.add(Parameter.builder()
+                .name(string("resourceLogicalId"))
+                .value(string("Patient/REIN-DEX-TEST-1"))
+                .build());
+
+            Parameters.Builder builder = Parameters.builder();
+            builder.id(UUID.randomUUID().toString());
+            builder.parameter(parameters);
+            Parameters ps = builder.build();
+
+            Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+            Response response = getWebTarget()
+                    .path("/$reindex")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .post(entity, Response.class);
+            assertResponse(response, Response.Status.OK.getStatusCode());
+            OperationOutcome oo = response.readEntity(OperationOutcome.class);
+            assertEquals(oo.getIssue().get(0).getDiagnostics().getValue(), "Processed Patient/REIN-DEX-TEST-1");
+        } else {
+            System.out.println("Skipping Phase 3 of Reindex Operation Tests");
+        }
+    }
+
+    @Test(groups = {"reindex"}, dependsOnMethods = {"testReindex_ChangedExpression_Phase3_Reindex"})
+    public void testReindex_ChangedExpression_Phase3_Search() throws IOException, FHIRParserException, FHIRPathException {
+        if (runIt) {
+            Response response = getWebTarget().path("/Patient")
+                    .queryParam("test-code1", "VALUE2")
+                    .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .header("X-FHIR-TENANT-ID", "default")
+                    .header("X-FHIR-DSID", "default")
+                    .get(Response.class);
+            assertResponse(response, Response.Status.OK.getStatusCode());
+            Bundle bundle = response.readEntity(Bundle.class);
+            assertFalse(bundle.getEntry().isEmpty());
+        } else {
+            System.out.println("Skipping Phase 3 of Reindex Operation Tests");
+        }
+    }
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationTest.java
index e34bfb99d42..53495485730 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/operation/ReindexOperationTest.java
@@ -10,12 +10,13 @@
 import static com.ibm.fhir.model.type.String.string;
 import static org.testng.Assert.assertEquals;
 
+import java.time.Instant;
+import java.time.ZonedDateTime;
 import java.util.ArrayList;
 import java.util.List;
 import java.util.UUID;
 
 import javax.ws.rs.client.Entity;
-import javax.ws.rs.client.WebTarget;
 import javax.ws.rs.core.Response;
 import javax.ws.rs.core.Response.Status;
 
@@ -27,32 +28,342 @@
 import com.ibm.fhir.server.test.FHIRServerTestBase;
 
 /**
- * This class tests the $reindex operation.
- *
+ * This integration tests the <b>fhir-operation-reindex</b> $reindex operation.
+ * These reindex test always run.
  */
 public class ReindexOperationTest extends FHIRServerTestBase {
 
-    @Test
+    @Test(groups = { "reindex" })
     public void testReindex() {
-        WebTarget target = getWebTarget();
-        target = target.path("/$reindex");
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceCount"))
+            .value(of(5))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
 
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" })
+    public void testReindexWithType() {
         List<Parameter> parameters = new ArrayList<>();
-        parameters.add(
-            Parameter.builder()
-                .name(string("resourceCount"))
-                .value(of(5))
-                .build());
+        parameters.add(Parameter.builder()
+            .name(string("resourceCount"))
+            .value(of(5))
+            .build());
 
         Parameters.Builder builder = Parameters.builder();
         builder.id(UUID.randomUUID().toString());
         builder.parameter(parameters);
         Parameters ps = builder.build();
 
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/Patient/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" })
+    public void testReindexWithType_BadResourceLogicalIdParameter() {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceCount"))
+            .value(of(5))
+            .build());
+        parameters.add(Parameter.builder()
+            .name(string("resourceLogicalId"))
+            .value(string("Patient"))
+            .build());
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/Patient/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.BAD_REQUEST.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" })
+    public void testReindexWithInstanceDoesntExist() {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceCount"))
+            .value(of(5))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/Patient/NOT-EXISTS/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {})
+    public void testReindexFromTimestampInstant() {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceCount"))
+            .value(of(5))
+            .build());
+        parameters.add(Parameter.builder()
+            .name(string("tstamp"))
+            .value(string(Instant.now().toString()))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {})
+    public void testReindexFromTimestampDayTimeFormat() {
+        ZonedDateTime zdt = ZonedDateTime.now();
+        String tstamp =
+                zdt.getYear()
+                + "-"
+                + String.format("%02d", zdt.getMonthValue())
+                + "-"
+                + zdt.getDayOfMonth();
+
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceCount"))
+            .value(of(5))
+            .build());
+        parameters.add(Parameter.builder()
+            .name(string("tstamp"))
+            .value(string(tstamp))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {})
+    public void testReindexFromTimestampMalformed() {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceCount"))
+            .value(of(5))
+            .build());
+        parameters.add(Parameter.builder()
+            .name(string("tstamp"))
+            .value(string("BAD_STRING"))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.BAD_REQUEST.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {})
+    public void testReindexUsingUnsupportedGet() {
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .get(Response.class);
+
+        assertEquals(r.getStatus(), Status.BAD_REQUEST.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {})
+    public void testReindexWithLogicalIdDoesntExist() {
+        /*
+         * Note, this still passes, and ends up reindexing the default number of resources.
+         */
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceLogicalId"))
+            .value(string("Patient/" + UUID.randomUUID()+"Doesntexist"))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {})
+    public void testReindexWithSpecificTypeLogicalId() {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceLogicalId"))
+            .value(string("Patient/1-2-3-4"))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {})
+    public void testReindexWithSpecificTypeMissingLogicalId() {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceLogicalId"))
+            .value(string("Patient/"))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.OK.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {})
+    public void testReindexWithSpecificTypeThatDoesntExist() {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceLogicalId"))
+            .value(string("BadType"))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
+
+        Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .header("X-FHIR-TENANT-ID", "default")
+                .header("X-FHIR-DSID", "default")
+                .post(entity, Response.class);
+
+        assertEquals(r.getStatus(), Status.BAD_REQUEST.getStatusCode());
+    }
+
+    @Test(groups = { "reindex" }, dependsOnMethods = {})
+    public void testReindexWithPatientResourceType() {
+        List<Parameter> parameters = new ArrayList<>();
+        parameters.add(Parameter.builder()
+            .name(string("resourceLogicalId"))
+            .value(string("Patient"))
+            .build());
+
+        Parameters.Builder builder = Parameters.builder();
+        builder.id(UUID.randomUUID().toString());
+        builder.parameter(parameters);
+        Parameters ps = builder.build();
 
         Entity<Parameters> entity = Entity.entity(ps, FHIRMediaType.APPLICATION_FHIR_JSON);
 
-        Response r = target.request(FHIRMediaType.APPLICATION_FHIR_JSON)
+        Response r = getWebTarget()
+                .path("/$reindex")
+                .request(FHIRMediaType.APPLICATION_FHIR_JSON)
                 .header("X-FHIR-TENANT-ID", "default")
                 .header("X-FHIR-DSID", "default")
                 .post(entity, Response.class);
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/CodeSystemClearCacheOperationTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/CodeSystemClearCacheOperationTest.java
new file mode 100644
index 00000000000..87dc715ea56
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/CodeSystemClearCacheOperationTest.java
@@ -0,0 +1,105 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test.terminology;
+
+import static org.testng.Assert.assertEquals;
+
+import java.io.ByteArrayInputStream;
+
+import javax.ws.rs.core.Response;
+
+import org.testng.annotations.BeforeClass;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.parser.FHIRParser;
+import com.ibm.fhir.model.resource.Parameters;
+
+/**
+ * These tests exercise the $clear-cache operation on a CodeSystem.
+ */
+public class CodeSystemClearCacheOperationTest extends TerminologyOperationTestBase {
+
+    private static final String SNOMED_CT = "http://snomed.info/sct";
+    // Test Specific
+    public static final String TEST_GROUP_NAME = "terminology";
+    public static final boolean DEBUG = false;
+
+    // URLs to call against the instance
+    public static final String BASE_VALID_URL = "/CodeSystem";
+
+    public static final String CODE_SYSTEM_ID = "test";
+    public static final String CODE_SYSTEM_URL = "http://ibm.com/fhir/CodeSystem/test";
+    public static final String CODE_SYSTEM_VERSION = "1.0.0";
+
+    @BeforeClass
+    public void setup() throws Exception {
+        Response response = doPut("CodeSystem", CODE_SYSTEM_ID, "testdata/CodeSystem-test.json");
+        assertEquals(response.getStatusInfo().getFamily(), Response.Status.Family.SUCCESSFUL);
+    }
+
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testClearCacheParameterVariations() throws Exception {
+        Response response;
+
+        response = doGet(BASE_VALID_URL + "/$clear-cache");
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+
+        response = doGet(BASE_VALID_URL + "/$clear-cache", "url", CODE_SYSTEM_URL);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+
+        response = doGet(BASE_VALID_URL + "/$clear-cache", "url", CODE_SYSTEM_URL, "codeSystemVersion", CODE_SYSTEM_VERSION);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+
+        clearCache();
+    }
+
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testClearCacheValidateCode() throws Exception {
+        Response response;
+        Parameters parameters;
+
+        // Make sure the resource is there
+        response = doPut("CodeSystem", CODE_SYSTEM_ID, "testdata/CodeSystem-test.json");
+        assertEquals(response.getStatusInfo().getFamily(), Response.Status.Family.SUCCESSFUL);
+
+        // Once to make sure it is gone from the cache
+        clearCache();
+
+        // Twice to see what happens when it is empty
+        clearCache();
+
+        // Subsumes to reload the cache
+        parameters = validateCode(SNOMED_CT, "K");
+        assertEquals(getBooleanParameterValue(parameters, "result"), Boolean.TRUE);
+
+        // Update the resource
+        response = doPut("CodeSystem", CODE_SYSTEM_ID, "testdata/CodeSystem-test-updated.json");
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+
+        parameters = validateCode(SNOMED_CT, "K");
+        assertEquals(getBooleanParameterValue(parameters, "result"), Boolean.TRUE);
+
+        // After cache is cleared, subsumes outcome should be updated
+        clearCache();
+
+        parameters = validateCode(SNOMED_CT, "K");
+        assertEquals(getBooleanParameterValue(parameters, "result"), Boolean.FALSE);
+    }
+
+    private Parameters validateCode(String system, String code) throws Exception {
+        Response response = doGet(BASE_VALID_URL + "/" + CODE_SYSTEM_ID + "/$validate-code", "system", system, "code", code);
+        String responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+        return FHIRParser.parser(Format.JSON).parse(new ByteArrayInputStream(responseBody.getBytes()));
+    }
+
+    private void clearCache() {
+        Response response = doGet(BASE_VALID_URL + "/" + CODE_SYSTEM_ID + "/$clear-cache");
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+    }
+}
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/LookupOperationTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/LookupOperationTest.java
index 783cd7c0d57..4d7543197ad 100644
--- a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/LookupOperationTest.java
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/LookupOperationTest.java
@@ -11,7 +11,7 @@
 
 import java.util.Properties;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 import javax.ws.rs.client.Entity;
 import javax.ws.rs.client.WebTarget;
 import javax.ws.rs.core.Response;
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/TerminologyOperationTestBase.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/TerminologyOperationTestBase.java
new file mode 100644
index 00000000000..3df7f8f2366
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/TerminologyOperationTestBase.java
@@ -0,0 +1,88 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test.terminology;
+
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.assertTrue;
+
+import java.io.ByteArrayInputStream;
+import java.util.Properties;
+
+import jakarta.json.JsonObject;
+import javax.ws.rs.client.Entity;
+import javax.ws.rs.client.WebTarget;
+import javax.ws.rs.core.Response;
+
+import org.testng.annotations.BeforeClass;
+
+import com.ibm.fhir.core.FHIRMediaType;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.parser.FHIRParser;
+import com.ibm.fhir.model.parser.exception.FHIRParserException;
+import com.ibm.fhir.model.resource.Parameters;
+import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.test.TestUtil;
+import com.ibm.fhir.server.test.FHIRServerTestBase;
+
+public abstract class TerminologyOperationTestBase extends FHIRServerTestBase {
+
+    public static final String FORMAT = "application/json";
+
+    private final String tenantName = "default";
+    private final String dataStoreId = "default";
+
+    @BeforeClass
+    public void setup() throws Exception {
+        Properties testProperties = TestUtil.readTestProperties("test.properties");
+        setUp(testProperties);
+    }
+
+    public Response doPut(String resourceType, String id, String resourcePath) throws Exception {
+        JsonObject jsonObject = TestUtil.readJsonObject(resourcePath);
+        Entity<JsonObject> entity = Entity.entity(jsonObject, FHIRMediaType.APPLICATION_FHIR_JSON);
+
+        Response response = getWebTarget().path(resourceType + "/" + id).request().put(entity, Response.class);
+        String responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatusInfo().getFamily(), Response.Status.Family.SUCCESSFUL, responseBody);
+        return response;
+    }
+
+    public Response doGet(String path, String... params) {
+
+        WebTarget target = getWebTarget();
+        target = target.path(path);
+
+        // When the path is passed in with the parameters, the ?, &, etc.
+        // get escaped and it causes failures, so we are doing some
+        // hacking here.
+        if (params != null && params.length > 0) {
+            assert (params.length % 2 == 0);
+            for (int i = 0; i < params.length; i += 2) {
+                target = target.queryParam(params[i], params[i + 1]);
+            }
+        }
+
+        return target.request(FORMAT).header("X-FHIR-TENANT-ID", tenantName).header("X-FHIR-DSID", dataStoreId).get(Response.class);
+    }
+
+    public Resource parseResource(String responseBody) throws FHIRParserException {
+        Resource resource = FHIRParser.parser(Format.JSON).parse(new ByteArrayInputStream(responseBody.getBytes()));
+        return resource;
+    }
+
+    public Parameters.Parameter getParameter(Resource resource, String propertyName) {
+        assertTrue(resource instanceof Parameters);
+        Parameters parameters = (Parameters) resource;
+        return parameters.getParameter().stream().filter(p -> p.getName().getValue().equals(propertyName)).reduce((a, b) -> {
+            throw new IllegalStateException("More than one parameter found with the same name '" + propertyName + "'");
+        }).get();
+    }
+
+    public Boolean getBooleanParameterValue(Resource resource, String propertyName) {
+        return ((com.ibm.fhir.model.type.Boolean) getParameter(resource, propertyName).getValue()).getValue();
+    }
+}
diff --git a/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/ValueSetClearCacheOperationTest.java b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/ValueSetClearCacheOperationTest.java
new file mode 100644
index 00000000000..78a29768afa
--- /dev/null
+++ b/fhir-server-test/src/test/java/com/ibm/fhir/server/test/terminology/ValueSetClearCacheOperationTest.java
@@ -0,0 +1,245 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.test.terminology;
+
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.assertFalse;
+import static org.testng.Assert.assertTrue;
+
+import javax.ws.rs.core.Response;
+
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.model.resource.Resource;
+
+/**
+ * These tests exercise the $clear-cache operation on a ValueSet
+ */
+public class ValueSetClearCacheOperationTest extends TerminologyOperationTestBase {
+
+    // Test Specific
+    public static final String TEST_GROUP_NAME = "terminology";
+    public static final boolean DEBUG = false;
+
+    // URLs to call against the instance
+    public static final String BASE_VALUE_SET_URL = "/ValueSet";
+    public static final String BASE_CODE_SYSTEM_URL = "/CodeSystem";
+
+    /**
+     * Check that various parameter combinations work for clearing the cache.
+     * 
+     * <pre>
+     * curl -k -v -X PUT -u "fhiruser:change-password" -H 'Content-Type: application/fhir+json' -d {@literal @}src/test/resources/testdata/ValueSet-extensional.json 'https://localhost:9443/fhir-server/api/v4/ValueSet/179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5'
+     *
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/$clear-cache?url=http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1114.7'
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/$clear-cache?url=http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1114.7|20200331'
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/$clear-cache?url=http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1114.7&valueSetVersion=20200331' 
+     *
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5/$clear-cache'
+     *
+     * </pre>
+     */
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testClearCacheParameterVariations() throws Exception {
+        Response response;
+
+        String id = "179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5";
+        String url = "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1114.7";
+        String version = "20200331";
+
+        // Initialize the resource
+        doPut(BASE_VALUE_SET_URL, id, "testdata/ValueSet-extensional.json");
+
+        // URL only
+        response = doGet(BASE_VALUE_SET_URL + "/$clear-cache", "url", url);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+
+        // Canonical URL with version
+        response = doGet(BASE_VALUE_SET_URL + "/$clear-cache", "url", url + "|" + version);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+
+        // Version as a separate param
+        response = doGet(BASE_VALUE_SET_URL + "/$clear-cache", "url", url, "valueSetVersion", version);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+
+        // Directly on the target resource
+        response = doGet(BASE_VALUE_SET_URL + "/" + id + "/$clear-cache");
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode());
+    }
+
+    /**
+     * Check that the result of validate-code for an extensional valueset is updated after the resource is changed and
+     * the cache is cleared.
+     * 
+     * <pre>
+     * curl -k -v -X PUT -u "fhiruser:change-password" -H 'Content-Type: application/fhir+json' -d {@literal @}src/test/resources/testdata/ValueSet-extensional.json 'https://localhost:9443/fhir-server/api/v4/ValueSet/179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5'
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5/$validate-code?code=9999&system=http://snomed.info/sct' 
+     * 
+     * curl -k -v -X PUT -u "fhiruser:change-password" -H 'Content-Type: application/fhir+json' -d {@literal @}src/test/resources/testdata/ValueSet-extensional-updated.json 'https://localhost:9443/fhir-server/api/v4/ValueSet/179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5'
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5/$validate-code?code=9999&system=http://snomed.info/sct'
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5/$clear-cache'
+     *      
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5/$validate-code?code=9999&system=http://snomed.info/sct'
+     * 
+     * </pre>
+     */
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testExtensionalValidateCodeChangedAfterUpdate() throws Exception {
+        Response response;
+        String responseBody;
+        Resource resource;
+
+        String id = "179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5";
+
+        // Create the resource initial state
+        doPut(BASE_VALUE_SET_URL, id, "testdata/ValueSet-extensional.json");
+
+        // Base Content expansion
+        response = doGet(BASE_VALUE_SET_URL + "/" + id + "/$validate-code", "code", "9999", "system", "http://snomed.info/sct");
+        responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+        resource = parseResource(responseBody);
+        assertEquals((boolean) getBooleanParameterValue(resource, "result"), false, responseBody);
+
+        // Update the resource
+        doPut(BASE_VALUE_SET_URL, id, "testdata/ValueSet-extensional-updated.json");
+
+        // Updated Content expansion
+        response = doGet(BASE_VALUE_SET_URL + "/" + id + "/$validate-code", "code", "9999", "system", "http://snomed.info/sct");
+        responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+        resource = parseResource(responseBody);
+        assertEquals((boolean) getBooleanParameterValue(resource, "result"), false, responseBody);
+
+        clearValueSetCache(id);
+
+        // Should have the correct result now
+        response = doGet(BASE_VALUE_SET_URL + "/" + id + "/$validate-code", "code", "9999", "system", "http://snomed.info/sct");
+        responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+        resource = parseResource(responseBody);
+        assertEquals((boolean) getBooleanParameterValue(resource, "result"), true, responseBody);
+    }
+
+    /**
+     * Check that the expansion of an intensional value set is updated after the value set resource changes. No caching
+     * is currently interrupting this operation from getting updated data.
+     * 
+     * <pre>
+     * curl -k -v -X PUT -u "fhiruser:change-password" -H 'Content-Type: application/fhir+json' -d {@literal @}src/test/resources/testdata/ValueSet-intensional.json 'https://localhost:9443/fhir-server/api/v4/ValueSet/test-intensional'
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/test-intensional/$expand' 
+     * 
+     * curl -k -v -X PUT -u "fhiruser:change-password" -H 'Content-Type: application/fhir+json' -d {@literal @}src/test/resources/testdata/ValueSet-intensional-updated.json 'https://localhost:9443/fhir-server/api/v4/ValueSet/test-intensional'
+     * </pre>
+     */
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testIntensionalExpansionChangedAfterValueSetUpdate() throws Exception {
+        Response response;
+        String responseBody;
+
+        String codeSystemId = "test";
+        String valueSetId = "test-intensional";
+
+        doPut(BASE_CODE_SYSTEM_URL, codeSystemId, "testdata/CodeSystem-test.json");
+        doPut(BASE_VALUE_SET_URL, valueSetId, "testdata/ValueSet-intensional.json");
+
+        // Base Content expansion
+        response = doGet(BASE_VALUE_SET_URL + "/" + valueSetId + "/$expand");
+        responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+        assertFalse(responseBody.contains("Concept A"), responseBody);
+
+        // Update the resource
+        doPut(BASE_VALUE_SET_URL, valueSetId, "testdata/ValueSet-intensional-updated.json");
+
+        // Updated Content expansion
+        response = doGet(BASE_VALUE_SET_URL + "/" + valueSetId + "/$expand");
+        responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+        assertTrue(responseBody.contains("Concept A"), responseBody);
+    }
+
+    /**
+     * Check that the expansion of an intensional value set is updated after the related code system resource changes.
+     * 
+     * <pre>
+     * curl -k -v -X PUT -u "fhiruser:change-password" -H 'Content-Type: application/fhir+json' -d {@literal @}src/test/resources/testdata/ValueSet-intensional.json 'https://localhost:9443/fhir-server/api/v4/ValueSet/test-intensional'
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/test-intensional/$expand' 
+     * 
+     * curl -k -v -X PUT -u "fhiruser:change-password" -H 'Content-Type: application/fhir+json' -d {@literal @}src/test/resources/testdata/CodeSystem-test-updated.json 'https://localhost:9443/fhir-server/api/v4/ValueSet/test-intensional'
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/test-intensional/$expand' 
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/test-intensional/$clear-cache'
+     * 
+     * curl -k -u "fhiruser:change-password" -v 'https://localhost:9443/fhir-server/api/v4/ValueSet/test-intensional/$expand'
+     * </pre>
+     */
+    @Test(groups = { TEST_GROUP_NAME })
+    public void testIntensionalExpansionChangedAfterCodeSystemUpdate() throws Exception {
+        Response response;
+        String responseBody;
+
+        String codeSystemId = "test";
+        String valueSetId = "test-intensional";
+
+        doPut("/CodeSystem", "test", "testdata/CodeSystem-test.json");
+        doPut(BASE_VALUE_SET_URL, valueSetId, "testdata/ValueSet-intensional.json");
+
+        clearCodeSystemCache(codeSystemId);
+        clearValueSetCache(valueSetId);
+
+        // Base Content expansion
+        response = doGet(BASE_VALUE_SET_URL + "/" + valueSetId + "/$expand");
+        responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+        assertTrue(responseBody.contains("Concept K"), responseBody);
+
+        // Update the CodeSystem
+        doPut("/CodeSystem", "test", "testdata/CodeSystem-test-updated.json");
+
+        // Check the expansion is the same after the codesystem change
+        response = doGet(BASE_VALUE_SET_URL + "/" + valueSetId + "/$expand");
+        responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+        assertTrue(responseBody.contains("Concept K"), responseBody);
+
+        // Clear the ValueSet cache
+        clearCodeSystemCache(codeSystemId);
+        clearValueSetCache(valueSetId);
+
+        // Check the expansion after the cache is cleared
+        response = doGet(BASE_VALUE_SET_URL + "/" + valueSetId + "/$expand");
+        responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+        assertFalse(responseBody.contains("Concept K"), responseBody);
+        assertTrue(responseBody.contains("Concept ZZ"), responseBody);
+    }
+
+    private void clearValueSetCache(String id) {
+        clearCache(BASE_VALUE_SET_URL, id);
+    }
+
+    private void clearCodeSystemCache(String id) {
+        clearCache(BASE_CODE_SYSTEM_URL, id);
+    }
+
+    private void clearCache(String baseUrl, String id) {
+        Response response;
+        String responseBody;
+        response = doGet(baseUrl + "/" + id + "/$clear-cache");
+        responseBody = response.readEntity(String.class);
+        assertEquals(response.getStatus(), Response.Status.OK.getStatusCode(), responseBody);
+    }
+}
diff --git a/fhir-server-test/src/test/resources/test.oauth2.properties b/fhir-server-test/src/test/resources/test.oauth2.properties
new file mode 100644
index 00000000000..a08c2aa801c
--- /dev/null
+++ b/fhir-server-test/src/test/resources/test.oauth2.properties
@@ -0,0 +1,53 @@
+# Properties file used by server integration tests
+
+# FHIRClient properties:
+fhirclient.rest.base.url = https://localhost:9443/fhir-server/api/v4
+fhirclient.default.mimetype = application/fhir+json
+
+fhirclient.basicauth.enabled = false
+fhirclient.basicauth.username = fhiruser
+fhirclient.basicauth.password = change-password
+
+fhirclient.basicauth.admin.username = fhiradmin
+fhirclient.basicauth.admin.password = change-password
+
+fhirclient.clientauth.enabled = false
+fhirclient.keystore.location = fhirClientKeyStore.p12
+fhirclient.keystore.password = change-password
+fhirclient.keystore.key.password = change-password
+fhirclient.truststore.location = fhirClientTrustStore.p12
+fhirclient.truststore.password = change-password
+
+fhirclient.oAuth2.enabled = true
+#Use fhir-client > FHIROAuth2Test.java to generate the accessToken and encode it using "wlp/bin/securityUtility encode" command
+fhirclient.oAuth2.accessToken = change-password
+
+#fhirclient.encryption.enabled = false
+#fhirclient.encryption.keystore.location = fhirkeys.jceks
+#fhirclient.encryption.keystore.password = change-password
+#fhirclient.encryption.key.password = change-password
+
+# Properties supported by FHIRServerTestBase:
+test.websocket.url = wss://localhost:9443/fhir-server/api/v4/notification
+test.kafka.connectionInfo = localhost:9092
+test.kafka.topicName = fhirNotifications
+
+fhirclient.logging.enabled = false
+
+fhirclient.hostnameVerification.enabled = false
+fhirclient.http.receive.timeout = 60000
+fhirclient.http.return.pref = minimal
+
+# Used to turn on or off tests or throttle
+test.client.oauth.enabled = false
+test.websocket.enabled = false
+test.kafka.enabled = false
+
+test.db2.enabled = false
+test.performance.default = 1
+
+# Bulk Data
+test.bulkdata.import.enabled = false
+test.bulkdata.export.enabled = false
+# Commented out this is added back in during automation.
+# test.bulkdata.path = /liberty-runtime/wlp/usr/servers/fhir-server/output
diff --git a/fhir-server-test/src/test/resources/test.properties b/fhir-server-test/src/test/resources/test.properties
index 2fd84d02727..eb5267e0141 100644
--- a/fhir-server-test/src/test/resources/test.properties
+++ b/fhir-server-test/src/test/resources/test.properties
@@ -46,8 +46,16 @@ test.kafka.enabled = false
 test.db2.enabled = false
 test.performance.default = 1
 
+# Reindex
+test.reindex.enabled = false
+
 # Bulk Data
 test.bulkdata.import.enabled = false
 test.bulkdata.export.enabled = false
-# Commented out this is added back in during automation.
+
+# Azure is not possible to replicate in the pipeline.
+test.bulkdata.import.azure.enabled = false
+test.bulkdata.export.azure.enabled = false
+
+# Commented out - this is added back in during automation.
 # test.bulkdata.path = /liberty-runtime/wlp/usr/servers/fhir-server/output
diff --git a/fhir-server-test/src/test/resources/testdata/CodeSystem-test-updated.json b/fhir-server-test/src/test/resources/testdata/CodeSystem-test-updated.json
new file mode 100644
index 00000000000..b0d3b32e7f8
--- /dev/null
+++ b/fhir-server-test/src/test/resources/testdata/CodeSystem-test-updated.json
@@ -0,0 +1,211 @@
+{
+    "resourceType": "CodeSystem",
+    "id": "test",
+    "url": "http://ibm.com/fhir/CodeSystem/test",
+    "version": "1.0.0",
+    "status": "active",
+    "hierarchyMeaning": "is-a",
+    "content": "complete",
+    "property": [
+        {
+            "code": "booleanProperty",
+            "uri": "http://ibm.com/fhir/concept-properties#booleanProperty",
+            "type": "boolean"
+        },
+        {
+            "code": "codeProperty",
+            "uri": "http://ibm.com/fhir/concept-properties#codeProperty",
+            "type": "code"
+        },
+        {
+            "code": "dateTimeProperty",
+            "uri": "http://ibm.com/fhir/concept-properties#dateTimeProperty",
+            "type": "dateTime"
+        },
+        {
+            "code": "decimalProperty",
+            "uri": "http://ibm.com/fhir/concept-properties#decimalProperty",
+            "type": "decimal"
+        },
+        {
+            "code": "integerProperty",
+            "uri": "http://ibm.com/fhir/concept-properties#integerProperty",
+            "type": "integer"
+        },
+        {
+            "code": "stringProperty",
+            "uri": "http://ibm.com/fhir/concept-properties#stringProperty",
+            "type": "string"
+        }
+    ],
+    "concept": [
+        {
+            "code": "a",
+            "display": "Concept A",
+            "property": [
+                {
+                    "code": "stringProperty",
+                    "valueString": "stringValue"
+                }
+            ],
+            "concept": [
+                {
+                    "code": "g",
+                    "display": "Concept G"
+                },
+                {
+                    "code": "h",
+                    "display": "Concept H"
+                },
+                {
+                    "code": "i",
+                    "display": "Concept I",
+                    "concept": [
+                        {
+                            "code": "j",
+                            "display": "Concept J",
+                            "concept": [
+                                {
+                                    "code": "ZZ",
+                                    "display": "Concept ZZ",
+                                    "property": [
+                                        {
+                                            "code": "dateTimeProperty",
+                                            "valueDateTime": "2021-01-01T00:00:00.000Z"
+                                        }
+                                    ]
+                                }
+                            ]
+                        }
+                    ]
+                }
+            ]
+        },
+        {
+            "code": "b",
+            "display": "Concept B",
+            "concept": [
+                {
+                    "code": "l",
+                    "display": "Concept L",
+                    "concept": [
+                        {
+                            "code": "m",
+                            "display": "Concept M"
+                        },
+                        {
+                            "code": "n",
+                            "display": "Concept N",
+                            "property": [
+                                {
+                                    "code": "decimalProperty",
+                                    "valueDecimal": -101.01
+                                }
+                            ]
+                        }
+                    ]
+                }
+            ]
+        },
+        {
+            "code": "c",
+            "display": "Concept C",
+            "concept": [
+                {
+                    "code": "o",
+                    "display": "Concept O",
+                    "property": [
+                        {
+                            "code": "booleanProperty",
+                            "valueBoolean": true
+                        }
+                    ]
+                },
+                {
+                    "code": "p",
+                    "display": "Concept P"
+                }
+            ]
+        },
+        {
+            "code": "d",
+            "display": "Concept D",
+            "concept": [
+                {
+                    "code": "q",
+                    "display": "Concept Q",
+                    "concept": [
+                        {
+                            "code": "r",
+                            "display": "Concept R",
+                            "concept": [
+                                {
+                                    "code": "s",
+                                    "display": "Concept S",
+                                    "property": [
+                                        {
+                                            "code": "integerProperty",
+                                            "valueInteger": 5
+                                        }
+                                    ]
+                                }
+                            ]
+                        }
+                    ]
+                }
+            ]
+        },
+        {
+            "code": "e",
+            "display": "Concept E",
+            "concept": [
+                {
+                    "code": "t",
+                    "display": "Concept T",
+                    "concept": [
+                        {
+                            "code": "u",
+                            "display": "Concept U",
+                            "concept": [
+                                {
+                                    "code": "v",
+                                    "display": "Concept V"
+                                }
+                            ]
+                        }
+                    ]
+                },
+                {
+                    "code": "w",
+                    "display": "Concept W"
+                }
+            ]
+        },
+        {
+            "code": "f",
+            "display": "Concept F",
+            "concept": [
+                {
+                    "code": "x",
+                    "display": "Concept X"
+                },
+                {
+                    "code": "y",
+                    "display": "Concept Y",
+                    "property": [
+                        {
+                            "code": "codeProperty",
+                            "valueCode": "codeValue"
+                        }
+                    ],
+                    "concept": [
+                        {
+                            "code": "z",
+                            "display": "Concept Z"
+                        }
+                    ]
+                }
+            ]
+        }
+    ]
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/resources/testdata/ValueSet-extensional-updated.json b/fhir-server-test/src/test/resources/testdata/ValueSet-extensional-updated.json
new file mode 100644
index 00000000000..512d2cbfd91
--- /dev/null
+++ b/fhir-server-test/src/test/resources/testdata/ValueSet-extensional-updated.json
@@ -0,0 +1,66 @@
+{
+    "resourceType": "ValueSet",
+    "id": "179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5",
+    "url": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1114.7",
+    "version": "20200331",
+    "name": "2019 Novel Coronavirus COVID 19 Codeset",
+    "title": "2019 Novel Coronavirus COVID 19 Codeset",
+    "status": "active",
+    "compose": {
+        "include": [
+            {
+                "system": "http://snomed.info/sct",
+                "concept": [
+                    {
+                        "code": "260373001",
+                        "display": "Detected (qualifier value)"
+                    },
+                    {
+                        "code": "260415000",
+                        "display": "Not detected (qualifier value)"
+                    },
+                    {
+                        "code": "461911000124106",
+                        "display": "Swab specimen from oropharynx (specimen)"
+                    },
+                    {
+                        "code": "82334004",
+                        "display": "Indeterminate (qualifier value)"
+                    },
+                    {
+                        "code": "840533007",
+                        "display": "Severe acute respiratory syndrome coronavirus 2 (organism)"
+                    },
+                    {
+                        "code": "840534001",
+                        "display": "Severe acute respiratory syndrome coronavirus 2 vaccination (procedure)"
+                    },
+                    {
+                        "code": "840535000",
+                        "display": "Antibody to Severe acute respiratory syndrome coronavirus 2 (substance)"
+                    },
+                    {
+                        "code": "840536004",
+                        "display": "Antigen of Severe acute respiratory syndrome coronavirus 2 (substance)"
+                    },
+                    {
+                        "code": "840539006",
+                        "display": "Disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder)"
+                    },
+                    {
+                        "code": "840544004",
+                        "display": "Suspected disease caused by Severe acute respiratory coronavirus 2 (situation)"
+                    },
+                    {
+                        "code": "840546002",
+                        "display": "Exposure to Severe acute respiratory syndrome coronavirus 2 (event)"
+                    },
+                    {
+                        "code": "9999",
+                        "display": "Added to check the cache update"
+                    }
+                ]
+            }
+        ]
+    }
+}
diff --git a/fhir-server-test/src/test/resources/testdata/ValueSet-extensional.json b/fhir-server-test/src/test/resources/testdata/ValueSet-extensional.json
new file mode 100644
index 00000000000..46b41acc08a
--- /dev/null
+++ b/fhir-server-test/src/test/resources/testdata/ValueSet-extensional.json
@@ -0,0 +1,62 @@
+{
+    "resourceType": "ValueSet",
+    "id": "179814145dd-affc9873-c326-43c3-bf0f-7d7d695644b5",
+    "url": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1114.7",
+    "version": "20200331",
+    "name": "2019 Novel Coronavirus COVID 19 Codeset",
+    "title": "2019 Novel Coronavirus COVID 19 Codeset",
+    "status": "active",
+    "compose": {
+        "include": [
+            {
+                "system": "http://snomed.info/sct",
+                "concept": [
+                    {
+                        "code": "260373001",
+                        "display": "Detected (qualifier value)"
+                    },
+                    {
+                        "code": "260415000",
+                        "display": "Not detected (qualifier value)"
+                    },
+                    {
+                        "code": "461911000124106",
+                        "display": "Swab specimen from oropharynx (specimen)"
+                    },
+                    {
+                        "code": "82334004",
+                        "display": "Indeterminate (qualifier value)"
+                    },
+                    {
+                        "code": "840533007",
+                        "display": "Severe acute respiratory syndrome coronavirus 2 (organism)"
+                    },
+                    {
+                        "code": "840534001",
+                        "display": "Severe acute respiratory syndrome coronavirus 2 vaccination (procedure)"
+                    },
+                    {
+                        "code": "840535000",
+                        "display": "Antibody to Severe acute respiratory syndrome coronavirus 2 (substance)"
+                    },
+                    {
+                        "code": "840536004",
+                        "display": "Antigen of Severe acute respiratory syndrome coronavirus 2 (substance)"
+                    },
+                    {
+                        "code": "840539006",
+                        "display": "Disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder)"
+                    },
+                    {
+                        "code": "840544004",
+                        "display": "Suspected disease caused by Severe acute respiratory coronavirus 2 (situation)"
+                    },
+                    {
+                        "code": "840546002",
+                        "display": "Exposure to Severe acute respiratory syndrome coronavirus 2 (event)"
+                    }
+                ]
+            }
+        ]
+    }
+}
diff --git a/fhir-server-test/src/test/resources/testdata/ValueSet-intensional-updated.json b/fhir-server-test/src/test/resources/testdata/ValueSet-intensional-updated.json
new file mode 100644
index 00000000000..e40056529ac
--- /dev/null
+++ b/fhir-server-test/src/test/resources/testdata/ValueSet-intensional-updated.json
@@ -0,0 +1,33 @@
+{
+    "resourceType": "ValueSet",
+    "id": "test-intensional",
+    "url": "http://ibm.com/fhir/ValueSet/test-intensional",
+    "version": "1.0.0",
+    "name": "Test Intensional Value Set",
+    "title": "Test Intensional Value Set",
+    "status": "active",
+    "compose": {
+        "include": [
+            {
+                "system": "http://ibm.com/fhir/CodeSystem/test",
+                "filter": [
+	                {
+	                	"property": "concept",
+	                	"op": "descendent-of",
+	                	"value": "i"
+	                }
+	            ]
+            },
+            {
+                "system": "http://ibm.com/fhir/CodeSystem/test",
+                "filter": [
+                    {
+                    	"property": "concept",
+                    	"op": "in",
+                        "value": "a"
+                    }
+				]
+            }
+        ]
+    }
+}
diff --git a/fhir-server-test/src/test/resources/testdata/ValueSet-intensional.json b/fhir-server-test/src/test/resources/testdata/ValueSet-intensional.json
new file mode 100644
index 00000000000..57109fd3e99
--- /dev/null
+++ b/fhir-server-test/src/test/resources/testdata/ValueSet-intensional.json
@@ -0,0 +1,24 @@
+{
+    "resourceType": "ValueSet",
+    "id": "test-intensional",
+    "url": "http://ibm.com/fhir/ValueSet/test-intensional",
+    "version": "1.0.0",
+    "name": "Test Intensional Value Set",
+    "title": "Test Intensional Value Set",
+    "status": "active",
+    "compose": {
+        "include": [
+            {
+                "system": "http://ibm.com/fhir/CodeSystem/test",
+                "version":"1.0.0",
+                "filter": [
+	                {
+	                	"property": "concept",
+	                	"op": "descendent-of",
+	                	"value": "i"
+	                }
+	            ]
+            }
+        ]
+    }
+}
diff --git a/fhir-server-test/src/test/resources/testdata/import-operation/test-import.ndjson b/fhir-server-test/src/test/resources/testdata/import-operation/test-import.ndjson
index 218aff34667..4e2d507e799 100644
--- a/fhir-server-test/src/test/resources/testdata/import-operation/test-import.ndjson
+++ b/fhir-server-test/src/test/resources/testdata/import-operation/test-import.ndjson
@@ -1,4 +1,8 @@
 {"resourceType":"Patient","id":"72b0d93c-93d0-43d9-94a8-d5154ce07152","meta":{"versionId":"1","lastUpdated":"2020-04-17T00:09:36.910431Z"},"name":[{"family":"Doe","given":["import-1"]}],"telecom":[{"system":"phone","value":"555-1122","use":"home"}],"birthDate":"1970-01-01"}
 {"resourceType":"Patient","id":"72b0d93c-93d0-43d9-94a8-d5154ce07153","meta":{"versionId":"1","lastUpdated":"2020-04-17T00:09:36.910431Z"},"name":[{"family":"Doe","given":["import-2"]}],"telecom":[{"system":"phone","value":"555-1122","use":"home"}],"birthDate":"1970-01-01"}
 {"resourceType":"Patient","id":"72b0d93c-93d0-43d9-94a8-d5154ce07154","meta":{"versionId":"1","lastUpdated":"2020-04-17T00:09:36.910431Z"},"name":[{"family":"Doe","given":["import-3"]}],"telecom":[{"system":"phone","value":"555-1122","use":"home"}],"birthDate":"1970-01-01"}
-{"resourceType":"Patient","id":"1772b6bb75a-fd1b2296-6666-4ac1-8b06-f3651eebcc0a","meta":{"profile":["http:\/\/hl7.org\/fhir\/us\/core\/StructureDefinition\/us-core-patient"]},"text":{"status":"generated","div":"<div xmlns=\"http:\/\/www.w3.org\/1999\/xhtml\">Generated by <a href=\"https:\/\/github.com\/synthetichealth\/synthea\">Synthea<\/a>.Version identifier: master-branch-latest\n .   Person seed: 7504591771487461664  Population seed: 1604158140419<\/div>"},"extension":[{"url":"http:\/\/hl7.org\/fhir\/us\/core\/StructureDefinition\/us-core-race","extension":[{"url":"ombCategory","valueCoding":{"system":"urn:oid:2.16.840.1.113883.6.238","code":"2106-3","display":"White"}},{"url":"text","valueString":"White"}]},{"url":"http:\/\/hl7.org\/fhir\/us\/core\/StructureDefinition\/us-core-ethnicity","extension":[{"url":"ombCategory","valueCoding":{"system":"urn:oid:2.16.840.1.113883.6.238","code":"2186-5","display":"Non Hispanic or Latino"}},{"url":"text","valueString":"Non Hispanic or Latino"}]},{"url":"http:\/\/hl7.org\/fhir\/StructureDefinition\/patient-mothersMaidenName","valueString":"Librada521 Cassin499"},{"url":"http:\/\/hl7.org\/fhir\/us\/core\/StructureDefinition\/us-core-birthsex","valueCode":"M"},{"url":"http:\/\/hl7.org\/fhir\/StructureDefinition\/patient-birthPlace","valueAddress":{"city":"Lynn","state":"Massachusetts","country":"US"}},{"url":"http:\/\/synthetichealth.github.io\/synthea\/disability-adjusted-life-years","valueDecimal":2.039551033112163},{"url":"http:\/\/synthetichealth.github.io\/synthea\/quality-adjusted-life-years","valueDecimal":58.96044896688784}],"identifier":[{"system":"https:\/\/github.com\/synthetichealth\/synthea","value":"05f7fb9c-3358-e686-d1ff-a6de1aa2aaf7"},{"type":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v2-0203","code":"MR","display":"Medical Record Number"}],"text":"Medical Record Number"},"system":"http:\/\/hospital.smarthealthit.org","value":"05f7fb9c-3358-e686-d1ff-a6de1aa2aaf7"},{"type":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v2-0203","code":"SS","display":"Social Security Number"}],"text":"Social Security Number"},"system":"http:\/\/hl7.org\/fhir\/sid\/us-ssn","value":"999-32-8982"},{"type":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v2-0203","code":"DL","display":"Driver's License"}],"text":"Driver's License"},"system":"urn:oid:2.16.840.1.113883.4.3.25","value":"S99935913"},{"type":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v2-0203","code":"PPN","display":"Passport Number"}],"text":"Passport Number"},"system":"http:\/\/standardhealthrecord.org\/fhir\/StructureDefinition\/passportNumber","value":"X71919634X"}],"name":[{"use":"official","family":"Volkman526","given":["Abdul218"],"prefix":["Mr."]}],"telecom":[{"system":"phone","value":"555-341-1712","use":"home"}],"gender":"male","birthDate":"1958-08-31","address":[{"extension":[{"url":"http:\/\/hl7.org\/fhir\/StructureDefinition\/geolocation","extension":[{"url":"latitude","valueDecimal":42.06848443888001},{"url":"longitude","valueDecimal":-70.18801548971284}]}],"line":["405 Schmitt Knoll Unit 25"],"city":"Provincetown","state":"MA","country":"US"}],"maritalStatus":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v3-MaritalStatus","code":"M","display":"M"}],"text":"M"},"multipleBirthBoolean":false,"communication":[{"language":{"coding":[{"system":"urn:ietf:bcp:47","code":"en-US","display":"English"}],"text":"English"}}]}
\ No newline at end of file
+{"resourceType":"Patient","id":"1772b6bb75a-fd1b2296-6666-4ac1-8b06-f3651eebcc0a","meta":{"profile":["http:\/\/hl7.org\/fhir\/us\/core\/StructureDefinition\/us-core-patient"]},"text":{"status":"generated","div":"<div xmlns=\"http:\/\/www.w3.org\/1999\/xhtml\">Generated by <a href=\"https:\/\/github.com\/synthetichealth\/synthea\">Synthea<\/a>.Version identifier: master-branch-latest\n .   Person seed: 7504591771487461664  Population seed: 1604158140419<\/div>"},"extension":[{"url":"http:\/\/hl7.org\/fhir\/us\/core\/StructureDefinition\/us-core-race","extension":[{"url":"ombCategory","valueCoding":{"system":"urn:oid:2.16.840.1.113883.6.238","code":"2106-3","display":"White"}},{"url":"text","valueString":"White"}]},{"url":"http:\/\/hl7.org\/fhir\/us\/core\/StructureDefinition\/us-core-ethnicity","extension":[{"url":"ombCategory","valueCoding":{"system":"urn:oid:2.16.840.1.113883.6.238","code":"2186-5","display":"Non Hispanic or Latino"}},{"url":"text","valueString":"Non Hispanic or Latino"}]},{"url":"http:\/\/hl7.org\/fhir\/StructureDefinition\/patient-mothersMaidenName","valueString":"Librada521 Cassin499"},{"url":"http:\/\/hl7.org\/fhir\/us\/core\/StructureDefinition\/us-core-birthsex","valueCode":"M"},{"url":"http:\/\/hl7.org\/fhir\/StructureDefinition\/patient-birthPlace","valueAddress":{"city":"Lynn","state":"Massachusetts","country":"US"}},{"url":"http:\/\/synthetichealth.github.io\/synthea\/disability-adjusted-life-years","valueDecimal":2.039551033112163},{"url":"http:\/\/synthetichealth.github.io\/synthea\/quality-adjusted-life-years","valueDecimal":58.96044896688784}],"identifier":[{"system":"https:\/\/github.com\/synthetichealth\/synthea","value":"05f7fb9c-3358-e686-d1ff-a6de1aa2aaf7"},{"type":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v2-0203","code":"MR","display":"Medical Record Number"}],"text":"Medical Record Number"},"system":"http:\/\/hospital.smarthealthit.org","value":"05f7fb9c-3358-e686-d1ff-a6de1aa2aaf7"},{"type":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v2-0203","code":"SS","display":"Social Security Number"}],"text":"Social Security Number"},"system":"http:\/\/hl7.org\/fhir\/sid\/us-ssn","value":"999-32-8982"},{"type":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v2-0203","code":"DL","display":"Driver's License"}],"text":"Driver's License"},"system":"urn:oid:2.16.840.1.113883.4.3.25","value":"S99935913"},{"type":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v2-0203","code":"PPN","display":"Passport Number"}],"text":"Passport Number"},"system":"http:\/\/standardhealthrecord.org\/fhir\/StructureDefinition\/passportNumber","value":"X71919634X"}],"name":[{"use":"official","family":"Volkman526","given":["Abdul218"],"prefix":["Mr."]}],"telecom":[{"system":"phone","value":"555-341-1712","use":"home"}],"gender":"male","birthDate":"1958-08-31","address":[{"extension":[{"url":"http:\/\/hl7.org\/fhir\/StructureDefinition\/geolocation","extension":[{"url":"latitude","valueDecimal":42.06848443888001},{"url":"longitude","valueDecimal":-70.18801548971284}]}],"line":["405 Schmitt Knoll Unit 25"],"city":"Provincetown","state":"MA","country":"US"}],"maritalStatus":{"coding":[{"system":"http:\/\/terminology.hl7.org\/CodeSystem\/v3-MaritalStatus","code":"M","display":"M"}],"text":"M"},"multipleBirthBoolean":false,"communication":[{"language":{"coding":[{"system":"urn:ietf:bcp:47","code":"en-US","display":"English"}],"text":"English"}}]}
+{"resourceType":"Patient","id":"72b0d93c-93d0-43d9-94a8-d5154ce07152","meta":{"versionId":"1","lastUpdated":"2020-04-17T00:09:36.910431Z"},"name":[{"family":"Doe","given":["import-1"]}],"telecom":[{"system":"phone","value":"555-1122","use":"home"}],"birthDate":"1970-01-01"}
+{"resourceType":"Patient","id":"72b0d93c-93d0-43d9-94a8-d5154ce07152","meta":{"versionId":"1","lastUpdated":"2020-04-17T00:09:36.910431Z"},"name":[{"family":"Doe","given":["import-1"]}],"telecom":[{"system":"phone","value":"555-1122","use":"home"}],"birthDate":"1970-01-01"}
+{"resourceType":"Patient","id":"72b0d93c-93d0-43d9-94a8-d5154ce07152","meta":{"versionId":"1","lastUpdated":"2020-04-17T00:09:36.910431Z"},"name":[{"family":"Doe","given":["import-1"]}],"telecom":[{"system":"phone","value":"555-1122","use":"home"}],"birthDate":"1970-01-01"}
+{"resourceType":"Patient","id":"72b0d93c-93d0-43d9-94a8-d5154ce07152","meta":{"versionId":"1","lastUpdated":"2020-04-17T00:09:36.910431Z"},"name":[{"family":"Doe","given":["import-1"]}],"telecom":[{"system":"phone","value":"555-1122","use":"home"}],"birthDate":"1970-01-01"}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/resources/testdata/reindex-operation/extension-search-parameters-test1.json b/fhir-server-test/src/test/resources/testdata/reindex-operation/extension-search-parameters-test1.json
new file mode 100644
index 00000000000..be577551f5a
--- /dev/null
+++ b/fhir-server-test/src/test/resources/testdata/reindex-operation/extension-search-parameters-test1.json
@@ -0,0 +1,218 @@
+{
+    "resourceType": "Bundle",
+    "type": "collection",
+    "entry": [
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/Reindex-string",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "url": "test-code1",
+                "name": "test-code1",
+                "status": "draft",
+                "description": "test",
+                "code": "test-code1",
+                "base": [
+                    "Resource"
+                ],
+                "type": "string",
+                "expression": "Patient.extension.extension.where(url ='NAME1').value",
+                "target": [
+                    "Resource"
+                ]
+            }
+        },
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/Reindex-stringx",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "id": "reindex-string",
+                "url": "http://ibm.com/fhir/SearchParameter/Reindex-stringx",
+                "name": "reindex-string",
+                "status": "active",
+                "description": "test param",
+                "code": "reindex-string",
+                "base": [
+                    "Basic"
+                ],
+                "type": "string",
+                "expression": "Basic.extension.where(url='http://example.org/string').value",
+                "xpath": "f:Basic/f:extension[@url='http://example.org/string']/f:valueString",
+                "xpathUsage": "normal"
+            }
+        },
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/reindex-Quantity",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "id": "reindex-Quantity",
+                "url": "http://ibm.com/fhir/SearchParameter/reindex-Quantity",
+                "name": "Quantity",
+                "status": "active",
+                "description": "test param",
+                "code": "reindex-quantity",
+                "base": [
+                    "Basic"
+                ],
+                "type": "quantity",
+                "expression": "Basic.extension.where(url='http://example.org/Quantity').value",
+                "xpath": "f:Basic/f:extension[@url='http://example.org/Quantity']/f:valueQuantity",
+                "xpathUsage": "normal"
+            }
+        },
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/reindex-Reference",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "id": "reindex-Reference",
+                "url": "http://ibm.com/fhir/SearchParameter/reindex-Reference",
+                "name": "Reference",
+                "status": "active",
+                "description": "test param",
+                "code": "reindex-reference",
+                "base": [
+                    "Basic"
+                ],
+                "type": "reference",
+                "expression": "Basic.extension.where(url='http://example.org/Reference').value",
+                "xpath": "f:Basic/f:extension[@url='http://example.org/Reference']/f:valueReference",
+                "xpathUsage": "normal"
+            }
+        },
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/reindex-date",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "id": "reindex-date",
+                "url": "http://ibm.com/fhir/SearchParameter/reindex-date",
+                "name": "date",
+                "status": "active",
+                "description": "test param",
+                "code": "reindex-date",
+                "base": [
+                    "Basic"
+                ],
+                "type": "date",
+                "expression": "Basic.extension.where(url='http://example.org/date').value",
+                "xpath": "f:Basic/f:extension[@url='http://example.org/date']/f:valueDate",
+                "xpathUsage": "normal"
+            }
+        },
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/reindex-decimal",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "id": "reindex-decimal",
+                "url": "http://ibm.com/fhir/SearchParameter/reindex-decimal",
+                "name": "decimal",
+                "status": "active",
+                "description": "test param",
+                "code": "reindex-decimal",
+                "base": [
+                    "Basic"
+                ],
+                "type": "number",
+                "expression": "Basic.extension.where(url='http://example.org/decimal').value.as(Decimal)",
+                "xpath": "f:Basic/f:extension[@url='http://example.org/decimal']/f:valueDecimal",
+                "xpathUsage": "normal"
+            }
+        },
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/reindex-Quantity",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "id": "reindex-Quantity",
+                "url": "http://ibm.com/fhir/SearchParameter/reindex-Quantity",
+                "name": "Quantity",
+                "status": "active",
+                "description": "test param",
+                "code": "reindex-quantity",
+                "base": [
+                    "Basic"
+                ],
+                "type": "quantity",
+                "expression": "Basic.extension.where(url='http://example.org/Quantity').value",
+                "xpath": "f:Basic/f:extension[@url='http://example.org/Quantity']/f:valueQuantity",
+                "xpathUsage": "normal"
+            }
+        },
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/reindex-Coding",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "id": "reindex-Coding",
+                "url": "http://ibm.com/fhir/SearchParameter/reindex-Coding",
+                "name": "Coding",
+                "status": "active",
+                "description": "test param",
+                "code": "reindex-token",
+                "base": [
+                    "Basic"
+                ],
+                "type": "token",
+                "expression": "Basic.extension.where(url='http://example.org/Coding').value",
+                "xpath": "f:Basic/f:extension[@url='http://example.org/Coding']/f:valueCoding",
+                "xpathUsage": "normal"
+            }
+        },
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/reindex-code",
+            "resource": {
+              "resourceType": "SearchParameter",
+              "id": "reindex-code",
+              "url": "http://ibm.com/fhir/SearchParameter/reindex-code",
+              "name": "reindex-code",
+              "status": "active",
+              "description": "test param",
+              "code": "reindex-code",
+              "base": ["Basic"],
+              "type": "token",
+              "expression": "Basic.extension.where(url='http://example.org/code').value",
+              "xpath": "f:Basic/f:extension[@url='http://example.org/code']/f:valueCode",
+              "xpathUsage": "normal"
+            }
+          },
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/reindex-composite-code",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "id": "reindex-composite-code",
+                "url": "http://ibm.com/fhir/SearchParameter/reindex-composite-code",
+                "name": "composite-code",
+                "status": "active",
+                "description": "test param",
+                "code": "reindex-composite",
+                "base": [
+                    "Basic"
+                ],
+                "type": "composite",
+                "expression": "Basic.extension.where(url='http://example.org/composite').extension",
+                "component": [
+                    {
+                        "definition": "http://ibm.com/fhir/SearchParameter/reindex-code",
+                        "expression": "where(url='http://example.org/code').value"
+                    },
+                    {
+                        "definition": "http://ibm.com/fhir/SearchParameter/reindex-code",
+                        "expression": "where(url='http://example.org/code').value"
+                    }
+                ]
+            }
+        },{
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/reindex-uri",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "id": "reindex-uri",
+                "url": "http://ibm.com/fhir/SearchParameter/reindex-uri",
+                "name": "uri",
+                "status": "active",
+                "description": "test param",
+                "code": "reindex-uri",
+                "base": ["Basic"],
+                "type": "uri",
+                "expression": "Basic.extension.where(url='http://example.org/uri').value",
+                "xpath": "f:Basic/f:extension[@url='http://example.org/uri']/f:valueUri",
+                "xpathUsage": "normal"
+            }
+        }
+    ]
+}
\ No newline at end of file
diff --git a/fhir-server-test/src/test/resources/testdata/reindex-operation/extension-search-parameters-test2.json b/fhir-server-test/src/test/resources/testdata/reindex-operation/extension-search-parameters-test2.json
new file mode 100644
index 00000000000..5109b1715d4
--- /dev/null
+++ b/fhir-server-test/src/test/resources/testdata/reindex-operation/extension-search-parameters-test2.json
@@ -0,0 +1,25 @@
+{
+    "resourceType": "Bundle",
+    "type": "collection",
+    "entry": [
+        {
+            "fullUrl": "http://ibm.com/fhir/SearchParameter/Reindex-string",
+            "resource": {
+                "resourceType": "SearchParameter",
+                "url": "test-code1",
+                "name": "test-code1",
+                "status": "draft",
+                "description": "test",
+                "code": "test-code1",
+                "base": [
+                    "Resource"
+                ],
+                "type": "string",
+                "expression": "Patient.extension.extension.where(url ='NAME2').value",
+                "target": [
+                    "Resource"
+                ]
+            }
+        }
+    ]
+}
\ No newline at end of file
diff --git a/fhir-server-webapp/pom.xml b/fhir-server-webapp/pom.xml
index 429e174cbc9..d37e9d4c3ee 100644
--- a/fhir-server-webapp/pom.xml
+++ b/fhir-server-webapp/pom.xml
@@ -14,7 +14,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-server/liberty-config/config/default/fhir-server-config-db2.json b/fhir-server/liberty-config/config/default/fhir-server-config-db2.json
index 44299e117c1..f2073c54cc0 100644
--- a/fhir-server/liberty-config/config/default/fhir-server-config-db2.json
+++ b/fhir-server/liberty-config/config/default/fhir-server-config-db2.json
@@ -147,12 +147,11 @@
             "storageProviders": {
                 "default" : {
                     "type": "file",
-                    "_type": "ibm-cos|aws-s3|file|https",
+                    "_type": "ibm-cos|aws-s3|file|https|azure-blob",
                     "validBaseUrls": [],
                     "fileBase": "/output/bulkdata",
                     "enableParquet": false,
                     "disableBaseUrlValidation": true,
-                    "exportPublic": true,
                     "disableOperationOutcomes": true,
                     "duplicationCheck": false, 
                     "validateResources": false
@@ -170,12 +169,24 @@
                     },
                     "enableParquet": false,
                     "disableBaseUrlValidation": true,
-                    "exportPublic": true,
                     "disableOperationOutcomes": true,
                     "duplicationCheck": false, 
                     "validateResources": false, 
                     "create": false,
                     "presigned": true
+                },
+                "azure" : {
+                    "type": "azure-blob",
+                    "_type": "ibm-cos|aws-s3|file|https|azure-blob",
+                    "bucketName": "fhirbulkdata",
+                    "auth" : {
+                        "type": "connection",
+                        "connection": "DefaultEndpointsProtocol=https;AccountName=XYZ;AccountKey=XYZKEY;EndpointSuffix=core.windows.net"
+                    },
+                    "disableOperationOutcomes": true,
+                    "duplicationCheck": false, 
+                    "validateResources": false, 
+                    "create": false
                 }
             }
         },
diff --git a/fhir-server/liberty-config/config/default/fhir-server-config.json b/fhir-server/liberty-config/config/default/fhir-server-config.json
index e2b91810b13..e08fe80beeb 100644
--- a/fhir-server/liberty-config/config/default/fhir-server-config.json
+++ b/fhir-server/liberty-config/config/default/fhir-server-config.json
@@ -168,9 +168,9 @@
             "storageProviders": {
                 "default" : {
                     "type": "file",
-                    "_type": "ibm-cos|aws-s3|file|https",
+                    "_type": "ibm-cos|aws-s3|file|https|azure-blob",
                     "validBaseUrls": [],
-                    "fileBase": "/fhir-server/output",
+                    "fileBase": "/output/bulkdata",
                     "bucketName": "fhir-performance",
                     "location": "us",
                     "endpointInternal": "https://s3.us-east.cloud-object-storage.appdomain.cloud",
@@ -187,7 +187,6 @@
                     },
                     "enableParquet": false,
                     "disableBaseUrlValidation": true,
-                    "exportPublic": true,
                     "disableOperationOutcomes": true,
                     "duplicationCheck": false, 
                     "validateResources": false, 
diff --git a/fhir-server/liberty-config/configDropins/disabled/datasource-db2.xml b/fhir-server/liberty-config/configDropins/disabled/datasource-db2.xml
index ad9ae34e7f9..fa317fb413e 100644
--- a/fhir-server/liberty-config/configDropins/disabled/datasource-db2.xml
+++ b/fhir-server/liberty-config/configDropins/disabled/datasource-db2.xml
@@ -2,7 +2,7 @@
     <!-- ============================================================== -->
     <!-- TENANT: default; DSID: default; TYPE: read-write               -->
     <!-- ============================================================== -->
-    <dataSource id="fhirDefaultDefault" jndiName="jdbc/fhir_default_default" type="javax.sql.XADataSource" statementCacheSize="200" syncQueryTimeoutWithTransactionTimeout="true" validationTimeout="30s">
+    <dataSource id="fhirDefaultDefault" jndiName="jdbc/fhir_default_default" type="javax.sql.XADataSource" statementCacheSize="200" syncQueryTimeoutWithTransactionTimeout="true" validationTimeout="30s" isolationLevel="TRANSACTION_READ_COMMITTED">
         <jdbcDriver javax.sql.XADataSource="com.ibm.db2.jcc.DB2XADataSource" libraryRef="sharedLibDb2"/>
         <properties.db2.jcc
              serverName="db2"
diff --git a/fhir-server/pom.xml b/fhir-server/pom.xml
index 50756381827..a1d6dad0243 100644
--- a/fhir-server/pom.xml
+++ b/fhir-server/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/exception/FHIRRestServletRequestException.java b/fhir-server/src/main/java/com/ibm/fhir/server/exception/FHIRRestServletRequestException.java
new file mode 100644
index 00000000000..c670ace581a
--- /dev/null
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/exception/FHIRRestServletRequestException.java
@@ -0,0 +1,37 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.server.exception;
+
+import javax.servlet.http.HttpServletResponse;
+
+import com.ibm.fhir.exception.FHIROperationException;
+
+public class FHIRRestServletRequestException extends FHIROperationException {
+    private static final long serialVersionUID = 1L;
+    private int httpStatusCode = HttpServletResponse.SC_BAD_REQUEST;
+
+    public FHIRRestServletRequestException(String message) {
+        super(message);
+    }
+
+    public FHIRRestServletRequestException(String message, Throwable cause) {
+        super(message, cause);
+    }
+
+    public FHIRRestServletRequestException(String message, int httpStatusCode) {
+        this(message, httpStatusCode, null);
+    }
+
+    public FHIRRestServletRequestException(String message, int httpStatusCode, Throwable t) {
+        super(message, t);
+        this.httpStatusCode = httpStatusCode;
+    }
+
+    public int getHttpStatusCode() {
+        return httpStatusCode;
+    }
+}
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/filter/rest/FHIRRestServletFilter.java b/fhir-server/src/main/java/com/ibm/fhir/server/filter/rest/FHIRRestServletFilter.java
index 193eba869ef..1692ed62ee1 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/filter/rest/FHIRRestServletFilter.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/filter/rest/FHIRRestServletFilter.java
@@ -23,6 +23,7 @@
 import javax.servlet.http.HttpFilter;
 import javax.servlet.http.HttpServletRequest;
 import javax.servlet.http.HttpServletResponse;
+import javax.ws.rs.core.HttpHeaders;
 import javax.ws.rs.core.MediaType;
 import javax.ws.rs.core.UriBuilder;
 
@@ -32,6 +33,7 @@
 import com.ibm.fhir.config.FHIRConfiguration;
 import com.ibm.fhir.config.FHIRRequestContext;
 import com.ibm.fhir.config.PropertyGroup;
+import com.ibm.fhir.core.FHIRMediaType;
 import com.ibm.fhir.core.HTTPHandlingPreference;
 import com.ibm.fhir.core.HTTPReturnPreference;
 import com.ibm.fhir.exception.FHIRException;
@@ -41,6 +43,7 @@
 import com.ibm.fhir.model.type.code.IssueSeverity;
 import com.ibm.fhir.model.type.code.IssueType;
 import com.ibm.fhir.model.util.FHIRUtil;
+import com.ibm.fhir.server.exception.FHIRRestServletRequestException;
 
 /**
  * This class is a servlet filter which is registered with the REST API's servlet. The main purpose of the class is to
@@ -115,6 +118,8 @@ public void doFilter(HttpServletRequest request, HttpServletResponse response, F
         String encodedRequestDescription = Encode.forHtml(requestDescription.toString());
         log.info("Received request: " + encodedRequestDescription);
 
+        int statusOnException = HttpServletResponse.SC_BAD_REQUEST;
+
         try {
             // Checks for Valid Tenant Configuration
             checkValidTenantConfiguration(tenantId);
@@ -138,6 +143,14 @@ public void doFilter(HttpServletRequest request, HttpServletResponse response, F
             Map<String, List<String>> requestHeaders = extractRequestHeaders(request);
             context.setHttpHeaders(requestHeaders);
 
+            // Check the FHIR version parameter.
+            try {
+                checkFhirVersionParameter(requestHeaders);
+            } catch (FHIRRestServletRequestException e) {
+                statusOnException = e.getHttpStatusCode();
+                throw e;
+            }
+
             // Pass the request through to the next filter in the chain.
             chain.doFilter(request, response);
         } catch (Exception e) {
@@ -145,9 +158,9 @@ public void doFilter(HttpServletRequest request, HttpServletResponse response, F
 
             OperationOutcome outcome = FHIRUtil.buildOperationOutcome(e, IssueType.INVALID, IssueSeverity.FATAL, false);
 
-            response.setStatus(HttpServletResponse.SC_BAD_REQUEST);
+            response.setStatus(statusOnException);
 
-            Format format = chooseResponseFormat(request.getHeader("Accept"));
+            Format format = chooseResponseFormat(request.getHeader(HttpHeaders.ACCEPT));
             switch (format) {
             case XML:
                 response.setContentType(com.ibm.fhir.core.FHIRMediaType.APPLICATION_FHIR_XML);
@@ -261,6 +274,45 @@ private HTTPReturnPreference computeReturnPref(ServletRequest request, HTTPHandl
         return returnPref;
     }
 
+    /**
+     * Check that FHIR version parameters in the HTTP headers are valid.
+     * @param requestHeaders the headers
+     * @throws FHIRRestServletRequestException
+     */
+    void checkFhirVersionParameter(Map<String, List<String>> requestHeaders) throws FHIRRestServletRequestException {
+        Map<String, Integer> headerStatusMap = new LinkedHashMap<>();
+        // 415 Unsupported Media Type is the appropriate response when the client posts a format that is not supported to the server.
+        headerStatusMap.put(HttpHeaders.CONTENT_TYPE, HttpServletResponse.SC_UNSUPPORTED_MEDIA_TYPE);
+        // 406 Not Acceptable is the appropriate response when the Accept header requests a format that the server does not support.
+        headerStatusMap.put(HttpHeaders.ACCEPT, HttpServletResponse.SC_NOT_ACCEPTABLE);
+
+        for (String headerName : headerStatusMap.keySet()) {
+            String fhirVersion = null;
+            for (String headerValue : requestHeaders.getOrDefault(headerName, Collections.emptyList())) {
+                for (String headerValueElement : headerValue.split(",")) {
+                    for (Map.Entry<String, String> parameter : MediaType.valueOf(headerValueElement).getParameters().entrySet()) {
+                        if (FHIRMediaType.FHIR_VERSION_PARAMETER.equalsIgnoreCase(parameter.getKey())) {
+                            String curFhirVersion = parameter.getValue();
+                            if (curFhirVersion != null && !FHIRMediaType.SUPPORTED_FHIR_VERSIONS.contains(curFhirVersion)) {
+                                throw new FHIRRestServletRequestException("Invalid '" + FHIRMediaType.FHIR_VERSION_PARAMETER
+                                    + "' parameter value in '" + headerName + "' header; the following FHIR versions are supported: "
+                                        + FHIRMediaType.SUPPORTED_FHIR_VERSIONS, headerStatusMap.get(headerName));
+                            }
+                            // If Content-Type header, check for multiple different FHIR versions
+                            if (headerName.equals(HttpHeaders.CONTENT_TYPE)) {
+                                if (fhirVersion != null && !fhirVersion.equals(curFhirVersion)) {
+                                    throw new FHIRRestServletRequestException("Multiple different '" + FHIRMediaType.FHIR_VERSION_PARAMETER
+                                        + "' parameter values in '" + headerName + "' header", headerStatusMap.get(headerName));
+                                }
+                                fhirVersion = curFhirVersion;
+                            }
+                        }
+                    }
+                }
+            }
+        }
+    }
+
     private Format chooseResponseFormat(String acceptableContentTypes) {
         if (acceptableContentTypes.contains(com.ibm.fhir.core.FHIRMediaType.APPLICATION_FHIR_JSON) ||
                 acceptableContentTypes.contains(MediaType.APPLICATION_JSON)) {
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/listener/FHIRServletContextListener.java b/fhir-server/src/main/java/com/ibm/fhir/server/listener/FHIRServletContextListener.java
index 9dc06b39d85..546efe8ff3b 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/listener/FHIRServletContextListener.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/listener/FHIRServletContextListener.java
@@ -64,6 +64,7 @@
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider;
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration;
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration.BasicAuth;
+import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration.Header;
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration.Supports;
 import com.ibm.fhir.term.remote.provider.RemoteTermServiceProvider.Configuration.TrustStore;
 import com.ibm.fhir.term.service.FHIRTermService;
@@ -330,6 +331,17 @@ private void configureTermServiceCapabilities(PropertyGroup fhirConfig) throws E
                                 .build());
                         }
 
+                        Object[] headersArray = remoteTermServiceProviderPropertyGroup.getArrayProperty("headers");
+                        if (headersArray != null) {
+                            for (Object headerObject : headersArray) {
+                                PropertyGroup headerPropertyGroup = (PropertyGroup) headerObject;
+                                builder.headers(Header.builder()
+                                    .name(headerPropertyGroup.getStringProperty("name"))
+                                    .value(headerPropertyGroup.getStringProperty("value"))
+                                    .build());
+                            }
+                        }
+
                         builder.httpTimeout(remoteTermServiceProviderPropertyGroup.getIntProperty("httpTimeout", Configuration.DEFAULT_HTTP_TIMEOUT));
 
                         Object[] supportsArray = remoteTermServiceProviderPropertyGroup.getArrayProperty("supports");
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/operation/FHIROperationRegistry.java b/fhir-server/src/main/java/com/ibm/fhir/server/operation/FHIROperationRegistry.java
index e3c71f91f6b..d36af9ed119 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/operation/FHIROperationRegistry.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/operation/FHIROperationRegistry.java
@@ -42,23 +42,34 @@ private FHIROperationRegistry() {
         // https://docs.oracle.com/javase/8/docs/api/java/util/ServiceLoader.html#iterator--
         Iterator<FHIROperation> iterator = operations.iterator();
         while (iterator.hasNext()) {
-            String operationName = "unknown name";
+            String operationCode = "unknown code";
             try {
                 FHIROperation operation = iterator.next();
-                log.fine("Found FHIROperation implementation class: " + operation.getClass().getName());
-                operationName = operation.getName();
+                log.fine(() -> "Found FHIROperation implementation class: " + operation.getClass().getName());
+                // This is actually the code.
+                operationCode = operation.getName();
                 if (!isValid(operation)) {
-                    log.severe("Operation $" + operationName + " has failed validation and will be skipped.");
+                    log.severe("Operation $" + operationCode + " has failed validation and will be skipped.");
                     continue;
                 }
+
+                // Some OperationDefinitions use System, Type and Instance, so we want to set this independently.
+                boolean isSet = false;
+                if (Boolean.TRUE.equals(operation.getDefinition().getSystem())) {
+                    if (operationMap.putIfAbsent(operationCode, operation) != null) {
+                        throw new IllegalStateException("Found duplicated operation code: " + operationCode);
+                    }
+                    isSet = true;
+                }
+
                 List<ResourceType> operationResourceTypes = operation.getDefinition().getResource();
-                if (operationResourceTypes == null || operationResourceTypes.isEmpty() || Boolean.TRUE.equals(operation.getDefinition().getSystem())) {
-                    if (operationMap.putIfAbsent(operation.getName(), operation) != null) {
-                        throw new IllegalStateException("Found duplicated operation name: " + operation.getName());
+                if (operationResourceTypes == null || operationResourceTypes.isEmpty()) {
+                    if (!isSet && operationMap.putIfAbsent(operationCode, operation) != null) {
+                        throw new IllegalStateException("Found duplicated operation code: " + operationCode);
                     }
                 } else {
                     // First, check if there is already an operation defined for all resource types.
-                    String tmpKey = operation.getName() + ":" + "Resource";
+                    String tmpKey = operationCode + ":" + "Resource";
                     if (operationMap.containsKey(tmpKey)) {
                         throw new IllegalStateException("There is already operation defined for all resource types: "
                             + operation.getName() + "; Conflict Operations: " + operation.getDefinition().getName()
@@ -66,7 +77,7 @@ private FHIROperationRegistry() {
                     }
                     // Then check if there is already operation defined for the required resource types.
                     for (ResourceType operationResourceType : operationResourceTypes) {
-                        tmpKey = operation.getName() + ":" + operationResourceType.getValue();
+                        tmpKey = operationCode + ":" + operationResourceType.getValue();
                         if (operationMap.putIfAbsent(tmpKey, operation) != null) {
                             throw new IllegalStateException("Found duplicated operation name plus resource type: "
                                 + operation.getName() + "-" + operationResourceType.getValue()
@@ -76,7 +87,7 @@ private FHIROperationRegistry() {
                     }
                 }
             } catch (ServiceConfigurationError | FHIRValidationException e) {
-                log.log(Level.SEVERE, "Unable to validate operation $" + operationName + ". This operation will be skipped.", e);
+                log.log(Level.SEVERE, "Unable to validate operation $" + operationCode + ". This operation will be skipped.", e);
             }
         }
 
@@ -121,13 +132,13 @@ public static FHIROperationRegistry getInstance() {
         return INSTANCE;
     }
 
-    public FHIROperation getOperation(String name) throws FHIROperationException {
-        FHIROperation operation = operationMap.get(name);
+    public FHIROperation getOperation(String code) throws FHIROperationException {
+        FHIROperation operation = operationMap.get(code);
         if (operation == null) {
             // Check if there is an operation defined for all resource types.
-            operation = operationMap.get(name.split(":")[0] + ":" + "Resource");
+            operation = operationMap.get(code.split(":")[0] + ":" + "Resource");
             if (operation == null) {
-                String msg = "Operation with name: '" + name + "' was not found";
+                String msg = "Operation with code: '" + code + "' was not found";
                 throw new FHIROperationException(msg)
                     .withIssue(FHIRUtil.buildOperationOutcomeIssue(IssueSeverity.FATAL, IssueType.NOT_SUPPORTED, msg));
             }
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/operation/spi/AbstractOperation.java b/fhir-server/src/main/java/com/ibm/fhir/server/operation/spi/AbstractOperation.java
index fdff32bc6f0..7296a4ec0dd 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/operation/spi/AbstractOperation.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/operation/spi/AbstractOperation.java
@@ -14,6 +14,7 @@
 
 import org.owasp.encoder.Encode;
 
+import com.ibm.fhir.core.FHIRConstants;
 import com.ibm.fhir.exception.FHIROperationException;
 import com.ibm.fhir.model.resource.OperationDefinition;
 import com.ibm.fhir.model.resource.OperationOutcome;
@@ -29,7 +30,6 @@
 import com.ibm.fhir.model.type.code.ResourceType;
 import com.ibm.fhir.model.util.FHIRUtil;
 import com.ibm.fhir.model.util.ModelSupport;
-import com.ibm.fhir.server.util.FHIRRestHelper;
 
 public abstract class AbstractOperation implements FHIROperation {
     protected final OperationDefinition definition;
@@ -186,7 +186,7 @@ private FHIROperationException buildUnsupportedResourceTypeException(String reso
                 .severity(IssueSeverity.FATAL)
                 .code(IssueType.NOT_SUPPORTED.toBuilder()
                         .extension(Extension.builder()
-                            .url(FHIRRestHelper.EXTENSION_URL +  "/not-supported-detail")
+                            .url(FHIRConstants.EXT_BASE + "not-supported-detail")
                             .value(Code.of("resource"))
                             .build())
                         .build())
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/resources/Capabilities.java b/fhir-server/src/main/java/com/ibm/fhir/server/resources/Capabilities.java
index 656b56fc3ce..102f54d73be 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/resources/Capabilities.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/resources/Capabilities.java
@@ -13,6 +13,7 @@
 import static com.ibm.fhir.config.FHIRConfiguration.PROPERTY_SECURITY_OAUTH_REG_URL;
 import static com.ibm.fhir.config.FHIRConfiguration.PROPERTY_SECURITY_OAUTH_REVOKE_URL;
 import static com.ibm.fhir.config.FHIRConfiguration.PROPERTY_SECURITY_OAUTH_TOKEN_URL;
+import static com.ibm.fhir.core.FHIRConstants.EXT_BASE;
 import static com.ibm.fhir.model.type.String.string;
 import static com.ibm.fhir.server.util.IssueTypeToHttpStatusMapper.issueListToStatus;
 
@@ -110,7 +111,6 @@ public class Capabilities extends FHIRResource {
     private static final String FHIR_SERVER_NAME = "IBM FHIR Server";
     private static final String FHIR_COPYRIGHT = "(C) Copyright IBM Corporation 2016, 2021";
     private static final String FHIR_PUBLISHER = "IBM Corporation";
-    private static final String EXTENSION_URL = "http://ibm.com/fhir/extension";
     private static final String BASE_CAPABILITY_URL = "http://hl7.org/fhir/CapabilityStatement/base";
     private static final String BASE_2_CAPABILITY_URL = "http://hl7.org/fhir/CapabilityStatement/base2";
     private static final List<String> ALL_INTERACTIONS = Arrays.asList("create", "read", "vread", "update", "patch", "delete", "history", "search");
@@ -194,6 +194,24 @@ private Resource computeCapabilityStatement(String mode) {
     private TerminologyCapabilities buildTerminologyCapabilities() {
         FHIRBuildIdentifier buildInfo = new FHIRBuildIdentifier();
         String buildDescription = FHIR_SERVER_NAME + " version " + buildInfo.getBuildVersion() + " build id " + buildInfo.getBuildId() + "";
+
+        /*
+         * The following checks to see if there is a Terminology Service URL that we want to inline into the Terminology Capabilities Statement
+         * else the minimal implementation.description.
+         */
+        String customTerminologyImpl = FHIRConfigHelper.getStringProperty(FHIRConfiguration.PROPERTY_TERM_SERVICE_CAPABILITIES_URL, null);
+        TerminologyCapabilities.Implementation impl;
+        if (customTerminologyImpl != null) {
+            impl = TerminologyCapabilities.Implementation.builder()
+                    .description(string(buildDescription))
+                    .url(com.ibm.fhir.model.type.Url.of(customTerminologyImpl))
+                    .build();
+        } else {
+            impl = TerminologyCapabilities.Implementation.builder()
+                    .description(string(buildDescription))
+                    .build();
+        }
+
         return TerminologyCapabilities.builder()
             .status(PublicationStatus.ACTIVE)
             .experimental(com.ibm.fhir.model.type.Boolean.TRUE)
@@ -209,6 +227,7 @@ private TerminologyCapabilities buildTerminologyCapabilities() {
                 .version(string(buildInfo.getBuildVersion()))
                 .id(buildInfo.getBuildId())
                 .build())
+            .implementation(impl)
             .codeSystem(buildCodeSystem())
             .expansion(Expansion.builder()
                 .hierarchical(com.ibm.fhir.model.type.Boolean.FALSE)
@@ -483,6 +502,23 @@ private CapabilityStatement buildCapabilityStatement() throws Exception {
         format.add(Code.of(FHIRMediaType.APPLICATION_XML));
         format.add(Code.of(FHIRMediaType.APPLICATION_FHIR_XML));
 
+        /*
+         * The following checks to see if there is a IBM FHIR Server Service URL that we want to inline into the Capabilities Statement
+         * else the minimal implementation.description.
+         */
+        String customImpl = FHIRConfigHelper.getStringProperty(FHIRConfiguration.PROPERTY_CAPABILITIES_URL, null);
+        CapabilityStatement.Implementation impl;
+        if (customImpl != null) {
+            impl = CapabilityStatement.Implementation.builder()
+                    .description(string(buildDescription))
+                    .url(com.ibm.fhir.model.type.Url.of(customImpl))
+                    .build();
+        } else {
+            impl = CapabilityStatement.Implementation.builder()
+                    .description(string(buildDescription))
+                    .build();
+        }
+
         // Finally, create the CapabilityStatement resource itself.
         CapabilityStatement conformance = CapabilityStatement.builder()
                 .status(PublicationStatus.ACTIVE)
@@ -505,6 +541,7 @@ private CapabilityStatement buildCapabilityStatement() throws Exception {
                           .build())
                 .rest(rest)
                 .instantiates(buildInstantiates())
+                .implementation(impl)
                 .build();
 
         try {
@@ -688,25 +725,25 @@ private CapabilityStatement addExtensionElements(CapabilityStatement capabilityS
         throws Exception {
         List<Extension> extentions = new ArrayList<>();
         Extension extension = Extension.builder()
-                .url(EXTENSION_URL + "/defaultTenantId")
+                .url(EXT_BASE + "defaultTenantId")
                 .value(string(fhirConfig.getStringProperty(FHIRConfiguration.PROPERTY_DEFAULT_TENANT_ID, FHIRConfiguration.DEFAULT_TENANT_ID)))
                 .build();
         extentions.add(extension);
 
         extension = Extension.builder()
-                .url(EXTENSION_URL + "/websocketNotificationsEnabled")
+                .url(EXT_BASE + "websocketNotificationsEnabled")
                 .value(com.ibm.fhir.model.type.Boolean.of(fhirConfig.getBooleanProperty(FHIRConfiguration.PROPERTY_WEBSOCKET_ENABLED, Boolean.FALSE)))
                 .build();
         extentions.add(extension);
 
         extension = Extension.builder()
-                .url(EXTENSION_URL + "/kafkaNotificationsEnabled")
+                .url(EXT_BASE + "kafkaNotificationsEnabled")
                 .value(com.ibm.fhir.model.type.Boolean.of(fhirConfig.getBooleanProperty(FHIRConfiguration.PROPERTY_KAFKA_ENABLED, Boolean.FALSE)))
                 .build();
         extentions.add(extension);
 
         extension = Extension.builder()
-                .url(EXTENSION_URL + "/natsNotificationsEnabled")
+                .url(EXT_BASE + "natsNotificationsEnabled")
                 .value(com.ibm.fhir.model.type.Boolean.of(fhirConfig.getBooleanProperty(FHIRConfiguration.PROPERTY_NATS_ENABLED, Boolean.FALSE)))
                 .build();
         extentions.add(extension);
@@ -717,7 +754,7 @@ private CapabilityStatement addExtensionElements(CapabilityStatement capabilityS
         }
 
         extension = Extension.builder()
-                .url(EXTENSION_URL + "/notificationResourceTypes")
+                .url(EXT_BASE + "notificationResourceTypes")
                 .value(string(notificationResourceTypes))
                 .build();
         extentions.add(extension);
@@ -733,13 +770,13 @@ private CapabilityStatement addExtensionElements(CapabilityStatement capabilityS
         }
 
         extension = Extension.builder()
-                .url(EXTENSION_URL + "/auditLogServiceName")
+                .url(EXT_BASE + "auditLogServiceName")
                 .value(string(auditLogServiceName))
                 .build();
         extentions.add(extension);
 
         extension = Extension.builder()
-                .url(EXTENSION_URL + "/persistenceType")
+                .url(EXT_BASE + "persistenceType")
                 .value(string(getPersistenceImpl().getClass().getSimpleName()))
                 .build();
         extentions.add(extension);
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/resources/Patch.java b/fhir-server/src/main/java/com/ibm/fhir/server/resources/Patch.java
index d96c7eac68f..df95af3e594 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/resources/Patch.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/resources/Patch.java
@@ -14,9 +14,9 @@
 
 import javax.annotation.security.RolesAllowed;
 import javax.enterprise.context.RequestScoped;
-import javax.json.JsonArray;
-import javax.json.JsonPatch;
-import javax.json.JsonValue;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonPatch;
+import jakarta.json.JsonValue;
 import javax.ws.rs.Consumes;
 import javax.ws.rs.HeaderParam;
 import javax.ws.rs.Path;
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/resources/WellKnown.java b/fhir-server/src/main/java/com/ibm/fhir/server/resources/WellKnown.java
index 43fa07c7416..7ec706a881e 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/resources/WellKnown.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/resources/WellKnown.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -23,9 +23,9 @@
 import java.util.logging.Level;
 import java.util.logging.Logger;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
 import javax.ws.rs.GET;
 import javax.ws.rs.Path;
 import javax.ws.rs.Produces;
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/util/FHIRRestHelper.java b/fhir-server/src/main/java/com/ibm/fhir/server/util/FHIRRestHelper.java
index a3789cae2cd..cb098f7d873 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/util/FHIRRestHelper.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/util/FHIRRestHelper.java
@@ -6,6 +6,7 @@
 
 package com.ibm.fhir.server.util;
 
+import static com.ibm.fhir.core.FHIRConstants.EXT_BASE;
 import static com.ibm.fhir.model.type.String.string;
 import static com.ibm.fhir.model.util.ModelSupport.getResourceType;
 import static javax.servlet.http.HttpServletResponse.SC_ACCEPTED;
@@ -133,7 +134,6 @@ public class FHIRRestHelper implements FHIRResourceHelpers {
     private static final Logger log =
             java.util.logging.Logger.getLogger(FHIRRestHelper.class.getName());
 
-    public static final String EXTENSION_URL = "http://ibm.com/fhir/extension";
     private static final String LOCAL_REF_PREFIX = "urn:";
     private static final com.ibm.fhir.model.type.String SC_BAD_REQUEST_STRING = string(Integer.toString(SC_BAD_REQUEST));
     private static final com.ibm.fhir.model.type.String SC_GONE_STRING = string(Integer.toString(SC_GONE));
@@ -1281,7 +1281,7 @@ private Map<Integer, Entry> validateBundle(Bundle bundle) throws Exception {
                         + "the configured persistence layer does not support transactions.";
                 IssueType extendedIssueType = IssueType.NOT_SUPPORTED.toBuilder()
                         .extension(Extension.builder()
-                            .url(EXTENSION_URL +  "/not-supported-detail")
+                            .url(EXT_BASE +  "not-supported-detail")
                             .value(Code.of("interaction"))
                             .build())
                         .build();
@@ -1419,7 +1419,7 @@ private void methodValidation(HTTPVerb method, Resource resource) throws FHIRPer
                         + method.getValue();
                 IssueType extendedIssueType = IssueType.NOT_SUPPORTED.toBuilder()
                         .extension(Extension.builder()
-                            .url(EXTENSION_URL +  "/not-supported-detail")
+                            .url(EXT_BASE +  "not-supported-detail")
                             .value(Code.of("interaction"))
                             .build())
                         .build();
@@ -1489,7 +1489,7 @@ private void performVersionAwareUpdateCheck(Resource currentResource, String ifM
                         + "' does not match current latest version of resource: " + currentVersion;
                 IssueType extendedIssueType = IssueType.CONFLICT.toBuilder()
                         .extension(Extension.builder()
-                            .url(EXTENSION_URL + "/http-failed-precondition")
+                            .url(EXT_BASE + "http-failed-precondition")
                             .value(string("If-Match"))
                             .build())
                         .build();
@@ -1504,7 +1504,7 @@ private FHIROperationException buildUnsupportedResourceTypeException(String reso
                 .severity(IssueSeverity.FATAL)
                 .code(IssueType.NOT_SUPPORTED.toBuilder()
                         .extension(Extension.builder()
-                            .url(EXTENSION_URL +  "/not-supported-detail")
+                            .url(EXT_BASE +  "not-supported-detail")
                             .value(Code.of("resource"))
                             .build())
                         .build())
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/util/IssueTypeToHttpStatusMapper.java b/fhir-server/src/main/java/com/ibm/fhir/server/util/IssueTypeToHttpStatusMapper.java
index 1cb4f781aee..acbdd38f5fd 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/util/IssueTypeToHttpStatusMapper.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/util/IssueTypeToHttpStatusMapper.java
@@ -6,6 +6,8 @@
 
 package com.ibm.fhir.server.util;
 
+import static com.ibm.fhir.core.FHIRConstants.EXT_BASE;
+
 import java.util.List;
 
 import javax.ws.rs.core.Response;
@@ -20,18 +22,18 @@ public class IssueTypeToHttpStatusMapper {
     /**
      * Custom extension used by the IBM FHIR Server for marking which precondition has failed (if any)
      */
-    private static final String EXTENSION_URL_HTTP_FAILED_PRECONDITION = "http://ibm.com/fhir/extension/http-failed-precondition";
+    private static final String EXTENSION_URL_HTTP_FAILED_PRECONDITION = EXT_BASE + "http-failed-precondition";
 
     /**
      * Custom extension used by the IBM FHIR Server for marking what it was that wasn't supported:
      * resource | interaction
      */
-    private static final String EXTENSION_URL_NOT_SUPPORTED_DETAIL = "http://ibm.com/fhir/extension/not-supported-detail";
+    private static final String EXTENSION_URL_NOT_SUPPORTED_DETAIL = EXT_BASE + "not-supported-detail";
 
     /**
      * Custom extension used by the IBM FHIR Server for marking which code was not found
      */
-    private static final String EXTENSION_URL_NOT_FOUND_DETAIL = "http://ibm.com/fhir/extension/not-found-detail";
+    private static final String EXTENSION_URL_NOT_FOUND_DETAIL = EXT_BASE + "not-found-detail";
 
     /**
      * @return an HTTP response status based on the first issue contained within the OperationOutcome with a code;
diff --git a/fhir-server/src/main/java/com/ibm/fhir/server/util/RestAuditLogger.java b/fhir-server/src/main/java/com/ibm/fhir/server/util/RestAuditLogger.java
index 6bd5eba124c..b57e0523b43 100644
--- a/fhir-server/src/main/java/com/ibm/fhir/server/util/RestAuditLogger.java
+++ b/fhir-server/src/main/java/com/ibm/fhir/server/util/RestAuditLogger.java
@@ -8,8 +8,11 @@
 
 import java.security.Principal;
 import java.util.ArrayList;
+import java.util.Arrays;
 import java.util.Date;
+import java.util.HashSet;
 import java.util.List;
+import java.util.Set;
 import java.util.logging.Level;
 import java.util.logging.Logger;
 
@@ -359,6 +362,8 @@ public static void logBundle(HttpServletRequest request, Bundle requestBundle, B
             long readCount = 0;
             long createCount = 0;
             long updateCount = 0;
+            long deleteCount = 0;
+            long executeCount = 0;
             HTTPVerb requestMethod;
 
             populateAuditLogEntry(entry, request, null, startTime, endTime, responseStatus);
@@ -368,29 +373,50 @@ public static void logBundle(HttpServletRequest request, Bundle requestBundle, B
                 for (Entry bundleEntry : requestBundle.getEntry()) {
                     if (bundleEntry.getRequest() != null && bundleEntry.getRequest().getMethod() != null) {
                         requestMethod = bundleEntry.getRequest().getMethod();
+                        boolean operation =  bundleEntry.getRequest().getUrl().getValue().contains("$")
+                                                || bundleEntry.getRequest().getUrl().getValue().contains("/%24");
                         switch (HTTPVerb.Value.from(requestMethod.getValue())) {
                         case GET:
-                            readCount++;
+                            if (operation) {
+                                executeCount++;
+                            } else {
+                                readCount++;
+                            }
                             break;
                         case POST:
-                            createCount++;
+                            if (operation) {
+                                executeCount++;
+                            } else {
+                                createCount++;
+                            }
                             break;
                         case PUT:
                             updateCount++;
                             break;
+                        case DELETE:
+                            if (operation) {
+                                executeCount++;
+                            } else {
+                                deleteCount++;
+                            }
+                            break;
                         default:
                             break;
                         }
                     }
                 }
             }
-            entry.getContext().setBatch(Batch.builder().resourcesCreated(createCount).resourcesRead(readCount).resourcesUpdated(updateCount).build());
+            entry.getContext()
+                .setBatch(Batch.builder()
+                    .resourcesCreated(createCount)
+                    .resourcesRead(readCount)
+                    .resourcesUpdated(updateCount)
+                    .resourcesDeleted(deleteCount)
+                    .resourcesExecuted(executeCount)
+                    .build());
             entry.setDescription("FHIR Bundle request");
 
-            // Team discussion results in a recommendation of 'E'
-            // New logic should ensure consistency, all R, all U, all D, all C
-            // when mixed default to E
-            entry.getContext().setAction("E");
+            entry.getContext().setAction(selectActionForBundle(createCount, readCount, updateCount, deleteCount, executeCount));
 
             if (log.isLoggable(Level.FINE)) {
                 log.fine("createCount=[" + createCount + "]updateCount=[" + updateCount + "] readCount=[" + readCount + "]");
@@ -400,6 +426,47 @@ public static void logBundle(HttpServletRequest request, Bundle requestBundle, B
         log.exiting(CLASSNAME, METHODNAME);
     }
 
+    /**
+     * logic to determine the action type.
+     * @param createCount
+     * @param readCount
+     * @param updateCount
+     * @param deleteCount
+     * @param executeCount
+     * @return
+     */
+    private static String selectActionForBundle(long createCount, long readCount, long updateCount, long deleteCount, long executeCount) {
+        Set<String> actions = new HashSet<>(Arrays.asList("C", "R", "U", "D"));
+        // logic ensures consistency, all R, all U, all D, all C
+        // when mixed default to E
+        String action = "E";
+
+        // If the bundle is all creates, set "C".
+        if (createCount == 0) {
+            actions.remove("C");
+        }
+        // If the bundle is all reads, set "R".
+        if (readCount == 0) {
+            actions.remove("R");
+        }
+
+        // If the bundles is all updates, set "U".
+        if (updateCount == 0) {
+            actions.remove("U");
+        }
+
+        // If the bundle is all deletes, set "D".
+        if (deleteCount == 0) {
+            actions.remove("D");
+        }
+
+        // Check and determine.
+        if (actions.size() == 1) {
+            action = actions.iterator().next();
+        }
+        return action;
+    }
+
     /**
      * Builds an audit log entry for a 'search' REST service invocation.
      *
@@ -576,7 +643,6 @@ protected static AuditLogEntry populateAuditLogEntry(AuditLogEntry entry, HttpSe
         final String METHODNAME = "populateAuditLogEntry";
         log.entering(CLASSNAME, METHODNAME);
 
-        StringBuilder requestUrl;
         String patientIdExtUrl;
         List<String> userList = new ArrayList<>();
 
@@ -598,10 +664,13 @@ protected static AuditLogEntry populateAuditLogEntry(AuditLogEntry entry, HttpSe
         entry.setLocation(new StringBuilder().append(request.getRemoteAddr()).append("/").append(request.getRemoteHost()).toString());
         entry.setContext(new Context());
 
-        // Uses the FHIRRestServletFilter to pass the OriginalRequestUri to the backend.
-        requestUrl = new StringBuilder(FHIRRequestContext.get().getOriginalRequestUri());
-
-        entry.getContext().setApiParameters(ApiParameters.builder().request(requestUrl.toString()).status(responseStatus.getStatusCode()).build());
+        // Per Issue 2473, the audit log is what changed on the server.
+        entry.getContext()
+            .setApiParameters(
+                ApiParameters.builder()
+                    .request(request.getRequestURI())
+                    .status(responseStatus.getStatusCode())
+                    .build());
         entry.getContext().setStartTime(FHIRUtilities.formatTimestamp(startTime));
         entry.getContext().setEndTime(FHIRUtilities.formatTimestamp(endTime));
         if (resource != null) {
diff --git a/fhir-server/src/test/java/com/ibm/fhir/server/filter/rest/FHIRRestServletFilterTest.java b/fhir-server/src/test/java/com/ibm/fhir/server/filter/rest/FHIRRestServletFilterTest.java
new file mode 100644
index 00000000000..e0b5b1d9219
--- /dev/null
+++ b/fhir-server/src/test/java/com/ibm/fhir/server/filter/rest/FHIRRestServletFilterTest.java
@@ -0,0 +1,79 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+package com.ibm.fhir.server.filter.rest;
+
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.fail;
+
+import java.util.Collections;
+import java.util.HashMap;
+import java.util.List;
+import java.util.Map;
+
+import javax.servlet.http.HttpServletResponse;
+import javax.ws.rs.core.HttpHeaders;
+
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.server.exception.FHIRRestServletRequestException;
+
+public class FHIRRestServletFilterTest {
+
+    @Test
+    void testCheckFhirVersionParameter_valid() throws Exception {
+        Map<String, List<String>> requestHeaders = new HashMap<>();
+        requestHeaders.put(HttpHeaders.CONTENT_TYPE, Collections.singletonList("application/fhir+json;fhirVersion=4.0.1"));
+        requestHeaders.put(HttpHeaders.ACCEPT, Collections.singletonList("application/fhir+json;fhirVersion=4.0.1"));
+
+        FHIRRestServletFilter servletFilter = new FHIRRestServletFilter();
+        servletFilter.checkFhirVersionParameter(requestHeaders);
+    }
+
+    @Test
+    void testCheckFhirVersionParameter_contentType_invalidFhirVersion() throws Exception {
+        Map<String, List<String>> requestHeaders = new HashMap<>();
+        requestHeaders.put(HttpHeaders.CONTENT_TYPE, Collections.singletonList("application/fhir+json;fhirVersion=3.0.1"));
+        requestHeaders.put(HttpHeaders.ACCEPT, Collections.singletonList("application/fhir+json;fhirVersion=4.0.1"));
+
+        FHIRRestServletFilter servletFilter = new FHIRRestServletFilter();
+        try {
+            servletFilter.checkFhirVersionParameter(requestHeaders);
+            fail();
+        } catch (FHIRRestServletRequestException e) {
+            assertEquals(e.getHttpStatusCode(), HttpServletResponse.SC_UNSUPPORTED_MEDIA_TYPE);
+        }
+    }
+
+    @Test
+    void testCheckFhirVersionParameter_contentType_multipleFhirVersions() throws Exception {
+        Map<String, List<String>> requestHeaders = new HashMap<>();
+        requestHeaders.put(HttpHeaders.CONTENT_TYPE, Collections.singletonList("application/fhir+json;fhirVersion=3.0.1"));
+        requestHeaders.put(HttpHeaders.ACCEPT, Collections.singletonList("application/fhir+json;fhirVersion=4.0.1"));
+
+        FHIRRestServletFilter servletFilter = new FHIRRestServletFilter();
+        try {
+            servletFilter.checkFhirVersionParameter(requestHeaders);
+            fail();
+        } catch (FHIRRestServletRequestException e) {
+            assertEquals(e.getHttpStatusCode(), HttpServletResponse.SC_UNSUPPORTED_MEDIA_TYPE);
+        }
+    }
+
+    @Test
+    void testCheckFhirVersionParameter_accept_invalidFhirVersion() throws Exception {
+        Map<String, List<String>> requestHeaders = new HashMap<>();
+        requestHeaders.put(HttpHeaders.CONTENT_TYPE, Collections.singletonList("application/fhir+json;fhirVersion=4.0.1"));
+        requestHeaders.put(HttpHeaders.ACCEPT, Collections.singletonList("application/fhir+json;fhirVersion=3.0.1"));
+
+        FHIRRestServletFilter servletFilter = new FHIRRestServletFilter();
+        try {
+            servletFilter.checkFhirVersionParameter(requestHeaders);
+            fail();
+        } catch (FHIRRestServletRequestException e) {
+            assertEquals(e.getHttpStatusCode(), HttpServletResponse.SC_NOT_ACCEPTABLE);
+        }
+    }
+}
diff --git a/fhir-server/src/test/java/com/ibm/fhir/server/test/ServerResolveFunctionTest.java b/fhir-server/src/test/java/com/ibm/fhir/server/test/ServerResolveFunctionTest.java
index 971d1841d05..09f4ca219c1 100644
--- a/fhir-server/src/test/java/com/ibm/fhir/server/test/ServerResolveFunctionTest.java
+++ b/fhir-server/src/test/java/com/ibm/fhir/server/test/ServerResolveFunctionTest.java
@@ -40,11 +40,9 @@
 import com.ibm.fhir.model.type.Meta;
 import com.ibm.fhir.model.type.Reference;
 import com.ibm.fhir.model.type.code.ObservationStatus;
-import com.ibm.fhir.path.FHIRPathBooleanValue;
 import com.ibm.fhir.path.FHIRPathNode;
 import com.ibm.fhir.path.evaluator.FHIRPathEvaluator;
 import com.ibm.fhir.path.evaluator.FHIRPathEvaluator.EvaluationContext;
-import com.ibm.fhir.path.function.ResolveFunction;
 import com.ibm.fhir.path.function.registry.FHIRPathFunctionRegistry;
 import com.ibm.fhir.persistence.FHIRPersistence;
 import com.ibm.fhir.persistence.FHIRPersistenceTransaction;
@@ -161,7 +159,7 @@ public void testServerResolveFunction() throws Exception {
         FHIRPathEvaluator evaluator = FHIRPathEvaluator.evaluator();
         EvaluationContext evaluationContext = new EvaluationContext(observation);
 
-        evaluationContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.TRUE);
+        evaluationContext.setResolveRelativeReferences(true);
         Collection<FHIRPathNode> nodes = evaluator.evaluate(evaluationContext, "subject.resolve() is Patient");
         assertEquals(nodes, SINGLETON_TRUE);
 
@@ -177,14 +175,14 @@ public void testServerResolveFunction() throws Exception {
         nodes = evaluator.evaluate(evaluationContext, "subject.resolve().deceased = false");
         assertEquals(nodes, SINGLETON_TRUE);
 
-        evaluationContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.FALSE);
+        evaluationContext.setResolveRelativeReferences(false);
         nodes = evaluator.evaluate(evaluationContext, "subject.resolve() is Patient");
         assertEquals(nodes, SINGLETON_TRUE);
 
         nodes = evaluator.evaluate(evaluationContext, "subject.resolve().id = '12345'");
         assertEquals(nodes, empty());
 
-        evaluationContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.TRUE);
+        evaluationContext.setResolveRelativeReferences(true);
         nodes = evaluator.evaluate(evaluationContext, "subject.resolve().managingOrganization.resolve() is Organization");
         assertEquals(nodes, SINGLETON_TRUE);
 
@@ -202,7 +200,7 @@ public void testServerResolveFunction() throws Exception {
                     .build())
                 .build();
         evaluationContext = new EvaluationContext(observation);
-        evaluationContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.TRUE);
+        evaluationContext.setResolveRelativeReferences(true);
         nodes = evaluator.evaluate(evaluationContext, "subject.resolve() is Patient");
         assertEquals(nodes, SINGLETON_TRUE);
 
@@ -217,7 +215,7 @@ public void testServerResolveFunction() throws Exception {
                     .build())
                 .build();
         evaluationContext = new EvaluationContext(observation);
-        evaluationContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.TRUE);
+        evaluationContext.setResolveRelativeReferences(true);
         nodes = evaluator.evaluate(evaluationContext, "subject.resolve() is Patient");
         assertEquals(nodes, SINGLETON_TRUE);
 
@@ -232,7 +230,7 @@ public void testServerResolveFunction() throws Exception {
                     .build())
                 .build();
         evaluationContext = new EvaluationContext(observation);
-        evaluationContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.TRUE);
+        evaluationContext.setResolveRelativeReferences(true);
         nodes = evaluator.evaluate(evaluationContext, "subject.resolve() is Patient");
         assertEquals(nodes, SINGLETON_TRUE);
 
@@ -247,7 +245,7 @@ public void testServerResolveFunction() throws Exception {
                     .build())
                 .build();
         evaluationContext = new EvaluationContext(observation);
-        evaluationContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.TRUE);
+        evaluationContext.setResolveRelativeReferences(true);
         nodes = evaluator.evaluate(evaluationContext, "subject.resolve() is Patient");
         assertEquals(nodes, SINGLETON_TRUE);
 
diff --git a/fhir-server/src/test/java/com/ibm/fhir/server/test/WellKnownTest.java b/fhir-server/src/test/java/com/ibm/fhir/server/test/WellKnownTest.java
index 37c49b566ac..551cb009d1e 100644
--- a/fhir-server/src/test/java/com/ibm/fhir/server/test/WellKnownTest.java
+++ b/fhir-server/src/test/java/com/ibm/fhir/server/test/WellKnownTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2020
+ * (C) Copyright IBM Corp. 2020, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -9,7 +9,7 @@
 import static org.testng.Assert.assertNull;
 import static org.testng.Assert.assertTrue;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 import javax.ws.rs.core.Response;
 
 import org.testng.annotations.AfterClass;
diff --git a/fhir-server/src/test/java/com/ibm/fhir/server/util/IssueTypeToHttpStatusMapperTest.java b/fhir-server/src/test/java/com/ibm/fhir/server/util/IssueTypeToHttpStatusMapperTest.java
index 812167daab0..f4a46344350 100644
--- a/fhir-server/src/test/java/com/ibm/fhir/server/util/IssueTypeToHttpStatusMapperTest.java
+++ b/fhir-server/src/test/java/com/ibm/fhir/server/util/IssueTypeToHttpStatusMapperTest.java
@@ -1,3 +1,9 @@
+/*
+ * (C) Copyright IBM Corp. 2020, 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
 package com.ibm.fhir.server.util;
 
 import static org.testng.Assert.assertEquals;
@@ -8,6 +14,7 @@
 
 import org.testng.annotations.Test;
 
+import com.ibm.fhir.core.FHIRConstants;
 import com.ibm.fhir.model.resource.OperationOutcome;
 import com.ibm.fhir.model.type.Code;
 import com.ibm.fhir.model.type.CodeableConcept;
@@ -24,12 +31,12 @@ public void testExtensionCodeNotFound__bad_request() {
 
         IssueType issueType = IssueType.NOT_FOUND.toBuilder()
                 .extension(Extension.builder()
-                        .url(FHIRRestHelper.EXTENSION_URL + "/not-found-detail")
+                        .url(FHIRConstants.EXT_BASE + "not-found-detail")
                         .value(Code.of("code")).build()).build();
 
         OperationOutcome.Issue issue = OperationOutcome.Issue.builder().severity(IssueSeverity.ERROR).code(issueType)
                 .details(CodeableConcept.builder().coding(coding).build()).build();
-        
+
         System.out.println(issue.toString());
 
         Response.Status status = IssueTypeToHttpStatusMapper.issueListToStatus(Arrays.asList(issue));
diff --git a/fhir-smart/pom.xml b/fhir-smart/pom.xml
index d9221d48660..9794376286b 100644
--- a/fhir-smart/pom.xml
+++ b/fhir-smart/pom.xml
@@ -8,7 +8,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-smart/src/main/java/com/ibm/fhir/smart/AuthzPolicyEnforcementPersistenceInterceptor.java b/fhir-smart/src/main/java/com/ibm/fhir/smart/AuthzPolicyEnforcementPersistenceInterceptor.java
index 55c97d021ef..dd75c603049 100644
--- a/fhir-smart/src/main/java/com/ibm/fhir/smart/AuthzPolicyEnforcementPersistenceInterceptor.java
+++ b/fhir-smart/src/main/java/com/ibm/fhir/smart/AuthzPolicyEnforcementPersistenceInterceptor.java
@@ -8,9 +8,11 @@
 
 import java.util.Arrays;
 import java.util.Collection;
+import java.util.HashSet;
 import java.util.List;
 import java.util.Map;
 import java.util.Objects;
+import java.util.Set;
 import java.util.logging.Level;
 import java.util.logging.Logger;
 import java.util.stream.Collectors;
@@ -24,6 +26,7 @@
 import com.ibm.fhir.model.resource.Provenance;
 import com.ibm.fhir.model.resource.Resource;
 import com.ibm.fhir.model.resource.SearchParameter;
+import com.ibm.fhir.model.type.Canonical;
 import com.ibm.fhir.model.type.Reference;
 import com.ibm.fhir.model.type.code.CompartmentType;
 import com.ibm.fhir.model.type.code.IssueType;
@@ -38,6 +41,8 @@
 import com.ibm.fhir.persistence.context.FHIRPersistenceContext;
 import com.ibm.fhir.persistence.context.FHIRPersistenceContextFactory;
 import com.ibm.fhir.persistence.exception.FHIRPersistenceException;
+import com.ibm.fhir.persistence.exception.FHIRPersistenceResourceDeletedException;
+import com.ibm.fhir.persistence.exception.FHIRPersistenceResourceNotFoundException;
 import com.ibm.fhir.persistence.interceptor.FHIRPersistenceEvent;
 import com.ibm.fhir.persistence.interceptor.FHIRPersistenceInterceptor;
 import com.ibm.fhir.persistence.interceptor.FHIRPersistenceInterceptorException;
@@ -52,6 +57,9 @@
 import com.ibm.fhir.smart.Scope.Permission;
 
 public class AuthzPolicyEnforcementPersistenceInterceptor implements FHIRPersistenceInterceptor {
+    private static final String DAVINCI_DRUG_FORMULARY_COVERAGE_PLAN =
+            "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-CoveragePlan";
+
     private static final Logger log = Logger.getLogger(AuthzPolicyEnforcementPersistenceInterceptor.class.getName());
 
     private static final String BEARER_TOKEN_PREFIX = "Bearer";
@@ -77,7 +85,7 @@ public void beforeHistory(FHIRPersistenceEvent event) throws FHIRPersistenceInte
     private void enforceDirectPatientAccess(FHIRPersistenceEvent event) throws FHIRPersistenceInterceptorException {
         if (PATIENT.equals(event.getFhirResourceType())) {
             DecodedJWT jwt = JWT.decode(getAccessToken());
-            List<String> patientIdFromToken = getPatientIdFromToken(jwt);
+            Set<String> patientIdFromToken = getPatientIdFromToken(jwt);
             if (!patientIdFromToken.contains(event.getFhirResourceId())) {
                 String msg = "Interaction with 'Patient/" + event.getFhirResourceId() +
                         "' is not permitted under patient context '" + patientIdFromToken + "'.";
@@ -97,7 +105,7 @@ public void beforeSearch(FHIRPersistenceEvent event) throws FHIRPersistenceInter
         FHIRSearchContext searchContext = event.getSearchContextImpl();
         if (searchContext != null) {
             DecodedJWT jwt = JWT.decode(getAccessToken());
-            List<String> patientIdFromToken = getPatientIdFromToken(jwt);
+            Set<String> patientIdFromToken = getPatientIdFromToken(jwt);
 
             // Determine if compartment search
             String compartment = null;
@@ -114,26 +122,42 @@ public void beforeSearch(FHIRPersistenceEvent event) throws FHIRPersistenceInter
 
             if (compartment != null) {
                 // Compartment search - validate patient access
-                if (!"Patient".equals(compartment)) {
-                    String msg = "Compartment search with compartment '" + compartment + "' is not permitted.";
-                    throw new FHIRPersistenceInterceptorException(msg).withIssue(FHIRUtil.buildOperationOutcomeIssue(msg, IssueType.FORBIDDEN));
-                }
-                if (!patientIdFromToken.contains(compartmentId)) {
-                    String msg = "Interaction with 'Patient/" + compartmentId + "' is not permitted under patient context '" + patientIdFromToken + "'.";
+                switch(compartment) {
+                case "Patient":
+                    if (!patientIdFromToken.contains(compartmentId)) {
+                        String msg = "Interaction with 'Patient/" + compartmentId + "' is not permitted for patient context " + patientIdFromToken;
+                        throw new FHIRPersistenceInterceptorException(msg).withIssue(FHIRUtil.buildOperationOutcomeIssue(msg, IssueType.FORBIDDEN));
+                    }
+                    break;
+                case "Encounter":
+                    Resource r = executeRead(event.getPersistenceImpl(), ModelSupport.getResourceType(compartment), compartmentId);
+                    if (!isInCompartment(r, CompartmentType.PATIENT, patientIdFromToken)) {
+                        String msg = "Interaction with 'Encounter/" + compartmentId + "' is not permitted for patient context " + patientIdFromToken;
+                        throw new FHIRPersistenceInterceptorException(msg).withIssue(FHIRUtil.buildOperationOutcomeIssue(msg, IssueType.FORBIDDEN));
+                    }
+                    break;
+                case "Device":
+                case "Practitioner":
+                case "RelatedPerson":
+                    String msg = "Compartment search for compartment type '" + compartment + "' is not permitted.";
                     throw new FHIRPersistenceInterceptorException(msg).withIssue(FHIRUtil.buildOperationOutcomeIssue(msg, IssueType.FORBIDDEN));
+                default:
+                    // If the operator has extended the server with custom compartment definitions, they will need to protect those separately
                 }
-                try {
-                    if (!CompartmentUtil.getCompartmentResourceTypes(PATIENT).contains(event.getFhirResourceType())) {
-                        String msg = "Resource type '" + event.getFhirResourceType() + "' is not valid for Patient compartment search.";
-                        throw new FHIRPersistenceInterceptorException(msg).withIssue(FHIRUtil.buildOperationOutcomeIssue(msg, IssueType.INVALID));
-                    }
-                } catch (FHIRSearchException e) {
-                    log.log(Level.WARNING, "Unexpected exception while getting compartment resource types", e);
+
+                if (log.isLoggable(Level.FINE)) {
+                    log.fine("Performing compartment search for compartment '" + compartment + "/" + compartmentId + "'.");
                 }
             } else {
-                // Not compartment search - validate and convert to Patient compartment search if resource type is member of Patient compartment
+                // Not compartment search - validate and convert to Patient compartment search if the resource type can be in the Patient compartment
                 try {
                     if (CompartmentUtil.getCompartmentResourceTypes(PATIENT).contains(event.getFhirResourceType())) {
+                        // Special case for the List resource because we want to enable searches for Formulary Coverage Plan lists
+                        if ("List".equals(event.getFhirResourceType())) {
+                            // In this case, we will rely on the afterSearch logic to prevent unauthorized access to patient-scoped Lists
+                            return;
+                        }
+
                         // Build the Patient compartment inclusion criteria search parameter
                         QueryParameter inclusionCriteria = SearchUtil.buildInclusionCriteria(PATIENT, patientIdFromToken, event.getFhirResourceType());
 
@@ -163,7 +187,7 @@ public void beforeDelete(FHIRPersistenceEvent event) throws FHIRPersistenceInter
     @Override
     public void beforeUpdate(FHIRPersistenceEvent event) throws FHIRPersistenceInterceptorException {
         DecodedJWT jwt = JWT.decode(getAccessToken());
-        List<String> patientIdFromToken = getPatientIdFromToken(jwt);
+        Set<String> patientIdFromToken = getPatientIdFromToken(jwt);
         List<Scope> scopesFromToken = getScopesFromToken(jwt);
 
         // First, check READ permission on the existing resource to ensure we don't write over something that
@@ -176,7 +200,7 @@ public void beforeUpdate(FHIRPersistenceEvent event) throws FHIRPersistenceInter
     public void afterRead(FHIRPersistenceEvent event) throws FHIRPersistenceInterceptorException {
         DecodedJWT jwt = JWT.decode(getAccessToken());
         Resource resource = event.getFhirResource();
-        List<String> patientIdFromToken = getPatientIdFromToken(jwt);
+        Set<String> patientIdFromToken = getPatientIdFromToken(jwt);
         List<Scope> scopesFromToken = getScopesFromToken(jwt);
 
         enforceDirectProvenanceAccess(event, resource, patientIdFromToken, scopesFromToken);
@@ -187,7 +211,7 @@ public void afterRead(FHIRPersistenceEvent event) throws FHIRPersistenceIntercep
     public void afterVread(FHIRPersistenceEvent event) throws FHIRPersistenceInterceptorException {
         DecodedJWT jwt = JWT.decode(getAccessToken());
         Resource resource = event.getFhirResource();
-        List<String> patientIdFromToken = getPatientIdFromToken(jwt);
+        Set<String> patientIdFromToken = getPatientIdFromToken(jwt);
         List<Scope> scopesFromToken = getScopesFromToken(jwt);
 
         enforceDirectProvenanceAccess(event, resource, patientIdFromToken, scopesFromToken);
@@ -197,7 +221,7 @@ public void afterVread(FHIRPersistenceEvent event) throws FHIRPersistenceInterce
     @Override
     public void afterHistory(FHIRPersistenceEvent event) throws FHIRPersistenceInterceptorException {
         DecodedJWT jwt = JWT.decode(getAccessToken());
-        List<String> patientIdFromToken = getPatientIdFromToken(jwt);
+        Set<String> patientIdFromToken = getPatientIdFromToken(jwt);
         List<Scope> scopesFromToken = getScopesFromToken(jwt);
 
         if (event.getFhirResource() instanceof Bundle) {
@@ -215,7 +239,7 @@ public void afterHistory(FHIRPersistenceEvent event) throws FHIRPersistenceInter
         }
     }
 
-    private void enforceDirectProvenanceAccess(FHIRPersistenceEvent event, Resource resource, List<String> patientIdFromToken, List<Scope> scopesFromToken)
+    private void enforceDirectProvenanceAccess(FHIRPersistenceEvent event, Resource resource, Set<String> patientIdFromToken, List<Scope> scopesFromToken)
             throws FHIRPersistenceInterceptorException {
         if (resource instanceof Provenance) {
             if (!isAllowed(((Provenance) resource).getTarget(), event.getPersistenceImpl(), patientIdFromToken, Permission.READ, scopesFromToken)) {
@@ -242,7 +266,7 @@ private void enforceDirectProvenanceAccess(FHIRPersistenceEvent event, Resource
      * @throws IllegalStateException if the baseUrl cannot be computed from the request context
      * @throws FHIRPersistenceInterceptorException if the interaction is not permitted
      */
-    private boolean isAllowed(List<Reference> references, FHIRPersistence persistence, List<String> contextIds, Permission requiredPermission, List<Scope> approvedScopes) {
+    private boolean isAllowed(List<Reference> references, FHIRPersistence persistence, Set<String> contextIds, Permission requiredPermission, List<Scope> approvedScopes) {
         boolean allow = false;
 
         String baseUrl;
@@ -259,7 +283,7 @@ private boolean isAllowed(List<Reference> references, FHIRPersistence persistenc
                 try {
                     SingleResourceResult<? extends Resource> result = executeRead(persistence, referenceValue, resourceType);
 
-                    if (result.isSuccess() && checkCompartment(result.getResource(), CompartmentType.PATIENT, contextIds)) {
+                    if (result.isSuccess() && isInCompartment(result.getResource(), CompartmentType.PATIENT, contextIds)) {
                         allow = true;
                         break;
                     }
@@ -290,10 +314,32 @@ private SingleResourceResult<? extends Resource> executeRead(FHIRPersistence per
                 persistence.vread(freshContext, resourceType, referenceValue.getValue(), referenceValue.getVersion().toString());
     }
 
+    private Resource executeRead(FHIRPersistence persistence, Class<? extends Resource> resourceType, String resourceId)
+            throws FHIRPersistenceInterceptorException {
+        try {
+            FHIRPersistenceContext freshContext = FHIRPersistenceContextFactory.createPersistenceContext(null);
+            SingleResourceResult<? extends Resource> result = persistence.read(freshContext, resourceType, resourceId);
+            if (!result.isSuccess()) {
+                String msg = "Unexpected error while reading resource " + resourceType.getSimpleName() + "/" + resourceId;
+                throw new FHIRPersistenceInterceptorException(msg).withIssue(result.getOutcome().getIssue());
+            }
+            return result.getResource();
+        } catch (FHIRPersistenceInterceptorException e) {
+            throw e;
+        } catch (FHIRPersistenceResourceNotFoundException | FHIRPersistenceResourceDeletedException e) {
+            String msg = "The resource '" + resourceType.getSimpleName() + "/" + resourceId + "' does not exist.";
+            throw new FHIRPersistenceInterceptorException(msg).withIssue(FHIRUtil.buildOperationOutcomeIssue(msg, IssueType.FORBIDDEN));
+        } catch (FHIRPersistenceException e) {
+            String msg = "Unexpected error while reading resource " + resourceType.getSimpleName() + "/" + resourceId;
+            log.log(Level.WARNING, msg, e);
+            throw new FHIRPersistenceInterceptorException(msg);
+        }
+    }
+
     @Override
     public void afterSearch(FHIRPersistenceEvent event) throws FHIRPersistenceInterceptorException {
         DecodedJWT jwt = JWT.decode(getAccessToken());
-        List<String> patientIdFromToken = getPatientIdFromToken(jwt);
+        Set<String> patientIdFromToken = getPatientIdFromToken(jwt);
         List<Scope> scopesFromToken = getScopesFromToken(jwt);
 
         if (event.getFhirResource() instanceof Bundle) {
@@ -317,7 +363,7 @@ public void afterSearch(FHIRPersistenceEvent event) throws FHIRPersistenceInterc
      * @param approvedScopes a list of SMART scopes associated with the request
      * @throws FHIRPersistenceInterceptorException if the interaction is not permitted
      */
-    private void enforce(Resource resource, List<String> contextIds, Permission requiredPermission, List<Scope> approvedScopes)
+    private void enforce(Resource resource, Set<String> contextIds, Permission requiredPermission, List<Scope> approvedScopes)
             throws FHIRPersistenceInterceptorException {
         if (!isAllowed(resource, contextIds, requiredPermission, approvedScopes)) {
             if (log.isLoggable(Level.FINE)) {
@@ -339,7 +385,7 @@ private void enforce(Resource resource, List<String> contextIds, Permission requ
      * @param approvedScopes a list of SMART scopes associated with the request
      * @throws FHIRPersistenceInterceptorException if the interaction is not permitted
      */
-    private boolean isAllowed(Resource resource, List<String> contextIds, Permission requiredPermission, List<Scope> approvedScopes)
+    private boolean isAllowed(Resource resource, Set<String> contextIds, Permission requiredPermission, List<Scope> approvedScopes)
             throws FHIRPersistenceInterceptorException {
         Objects.requireNonNull(resource, "resource");
         Objects.requireNonNull(contextIds, "contextIds");
@@ -372,10 +418,25 @@ private boolean isAllowed(Resource resource, List<String> contextIds, Permission
                         "' is granted via scope " + approvedScopeMap.get(ContextType.PATIENT));
                 }
                 return true;
+            } else if (resource instanceof com.ibm.fhir.model.resource.List) {
+                // List is another special-case:  a Patient-compartment resource type that
+                // we may want to grant access to when it is not scoped to any particular patient (e.g. for
+                // <a href="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition-usdf-CoveragePlan.html">Drug Formulary</a>).
+
+                // TODO: consider double-checking that the Patient compartment inclusion criteria for List have no
+                // patient references.  The inclusion criteria are "subject" and "source".
+                if (resource.getMeta() != null &&
+                        resource.getMeta().getProfile().contains(Canonical.of(DAVINCI_DRUG_FORMULARY_COVERAGE_PLAN))) {
+                    if (log.isLoggable(Level.FINE)) {
+                        log.fine(requiredPermission.value() + " permission for 'List/" + resource.getId() +
+                            "' is granted via scope " + approvedScopeMap.get(ContextType.PATIENT));
+                    }
+                    return true;
+                }
             }
 
             // Else, see if the target resource belongs to the Patient compartment of the in-context patient
-            return checkCompartment(resource, CompartmentType.PATIENT, contextIds);
+            return isInCompartment(resource, CompartmentType.PATIENT, contextIds);
         }
 
         if (approvedScopeMap.containsKey(ContextType.USER)) {
@@ -394,7 +455,7 @@ private boolean isAllowed(Resource resource, List<String> contextIds, Permission
      * @return true if the resource is in one of the compartment defined by the compartmentType and the contextIds
      *          or if the resource type is not applicable for the given compartmentType
      */
-    private boolean checkCompartment(Resource resource, CompartmentType compartmentType, List<String> contextIds) {
+    private boolean isInCompartment(Resource resource, CompartmentType compartmentType, Set<String> contextIds) {
         String resourceType = resource.getClass().getSimpleName();
         String compartment = compartmentType.getValue();
 
@@ -527,7 +588,7 @@ private List<Scope> getScopesFromToken(DecodedJWT jwt) throws FHIRPersistenceInt
                 .collect(Collectors.toList());
     }
 
-    private List<String> getPatientIdFromToken(DecodedJWT jwt) throws FHIRPersistenceInterceptorException {
+    private Set<String> getPatientIdFromToken(DecodedJWT jwt) throws FHIRPersistenceInterceptorException {
         Claim claim = jwt.getClaim("patient_id");
         if (claim.isNull()) {
             String msg = "Authorization token is missing 'patient_id' claim";
@@ -537,12 +598,12 @@ private List<String> getPatientIdFromToken(DecodedJWT jwt) throws FHIRPersistenc
 
         String patientId = claim.asString();
         if (patientId == null) {
-            return claim.asList(String.class);
+            return new HashSet<>(claim.asList(String.class));
         }
 
         return Stream.of(patientId.split(" "))
                 .map(String::trim)
                 .filter(s -> !s.isEmpty())
-                .collect(Collectors.toList());
+                .collect(Collectors.toSet());
     }
 }
diff --git a/fhir-smart/src/test/java/com/ibm/fhir/smart/test/AuthzPolicyEnforcementTest.java b/fhir-smart/src/test/java/com/ibm/fhir/smart/test/AuthzPolicyEnforcementTest.java
index 96c8826cef7..75b93e94c36 100644
--- a/fhir-smart/src/test/java/com/ibm/fhir/smart/test/AuthzPolicyEnforcementTest.java
+++ b/fhir-smart/src/test/java/com/ibm/fhir/smart/test/AuthzPolicyEnforcementTest.java
@@ -97,6 +97,7 @@ public void setup() throws Exception {
         observation = observation.toBuilder()
                 .id(OBSERVATION_ID)
                 .subject(Reference.builder().reference(string("Patient/" + PATIENT_ID)).build())
+                .encounter(Reference.builder().reference(string("Encounter/" + MockPersistenceImpl.ENCOUNTER_ID_GOOD)).build())
                 .build();
 
         observationProvenance = provenanceBase.toBuilder()
@@ -291,9 +292,9 @@ public void testBeforeSearch() throws FHIRPersistenceInterceptorException {
             fail("Patient interaction was not allowed but should have been");
         }
 
-        // Invalid compartment search: not a Patient compartment
+        // Invalid compartment search: wrong Patient compartment
         try {
-            queryParameterValue.setValueString("Encounter/" + PATIENT_ID);
+            queryParameterValue.setValueString("Patient/bogus");
             properties.put(FHIRPersistenceEvent.PROPNAME_RESOURCE_TYPE, "Observation");
             properties.put(FHIRPersistenceEvent.PROPNAME_SEARCH_CONTEXT_IMPL, searchContext);
             FHIRPersistenceEvent event = new FHIRPersistenceEvent(observation, properties);
@@ -303,12 +304,23 @@ public void testBeforeSearch() throws FHIRPersistenceInterceptorException {
             // success
             assertEquals(1, e.getIssues().size());
             assertEquals(IssueType.FORBIDDEN, e.getIssues().get(0).getCode());
-            assertEquals("Compartment search with compartment 'Encounter' is not permitted.", e.getIssues().get(0).getDetails().getText().getValue());
+            assertEquals("Interaction with 'Patient/bogus' is not permitted for patient context [" + PATIENT_ID + "]", e.getIssues().get(0).getDetails().getText().getValue());
         }
 
-        // Invalid compartment search: wrong Patient compartment
+        // Valid compartment search: Encounter in Patient compartment
         try {
-            queryParameterValue.setValueString("Patient/bogus");
+            queryParameterValue.setValueString("Encounter/" + MockPersistenceImpl.ENCOUNTER_ID_GOOD);
+            properties.put(FHIRPersistenceEvent.PROPNAME_RESOURCE_TYPE, "Observation");
+            properties.put(FHIRPersistenceEvent.PROPNAME_SEARCH_CONTEXT_IMPL, searchContext);
+            FHIRPersistenceEvent event = new FHIRPersistenceEvent(observation, properties);
+            interceptor.beforeSearch(event);
+        } catch (FHIRPersistenceInterceptorException e) {
+            fail("Patient interaction was not allowed but should have been");
+        }
+
+        // Invalid compartment search: Encounter not in Patient compartment
+        try {
+            queryParameterValue.setValueString("Encounter/" + MockPersistenceImpl.ENCOUNTER_ID_BAD);
             properties.put(FHIRPersistenceEvent.PROPNAME_RESOURCE_TYPE, "Observation");
             properties.put(FHIRPersistenceEvent.PROPNAME_SEARCH_CONTEXT_IMPL, searchContext);
             FHIRPersistenceEvent event = new FHIRPersistenceEvent(observation, properties);
@@ -316,24 +328,74 @@ public void testBeforeSearch() throws FHIRPersistenceInterceptorException {
             fail("Patient interaction was allowed but should not be");
         } catch (FHIRPersistenceInterceptorException e) {
             // success
-            assertEquals(1, e.getIssues().size());
-            assertEquals(IssueType.FORBIDDEN, e.getIssues().get(0).getCode());
-            assertEquals("Interaction with 'Patient/bogus' is not permitted under patient context '[" + PATIENT_ID + "]'.", e.getIssues().get(0).getDetails().getText().getValue());
+            assertEquals(e.getIssues().size(), 1);
+            assertEquals(e.getIssues().get(0).getCode(), IssueType.FORBIDDEN);
+            assertEquals(e.getIssues().get(0).getDetails().getText().getValue(),
+                "Interaction with 'Encounter/" + MockPersistenceImpl.ENCOUNTER_ID_BAD + "' is not permitted for patient context [" + PATIENT_ID + "]");
         }
 
-        // Invalid compartment search: resource type not in Patient compartment
+        // Invalid compartment search: Encounter compartment resource does not exist
         try {
-            queryParameterValue.setValueString("Patient/" + PATIENT_ID);
-            properties.put(FHIRPersistenceEvent.PROPNAME_RESOURCE_TYPE, "Practitioner");
+            queryParameterValue.setValueString("Encounter/bogus");
+            properties.put(FHIRPersistenceEvent.PROPNAME_RESOURCE_TYPE, "Observation");
             properties.put(FHIRPersistenceEvent.PROPNAME_SEARCH_CONTEXT_IMPL, searchContext);
-            FHIRPersistenceEvent event = new FHIRPersistenceEvent(practitioner, properties);
+            FHIRPersistenceEvent event = new FHIRPersistenceEvent(observation, properties);
             interceptor.beforeSearch(event);
             fail("Patient interaction was allowed but should not be");
         } catch (FHIRPersistenceInterceptorException e) {
             // success
-            assertEquals(1, e.getIssues().size());
-            assertEquals(IssueType.INVALID, e.getIssues().get(0).getCode());
-            assertEquals("Resource type 'Practitioner' is not valid for Patient compartment search.", e.getIssues().get(0).getDetails().getText().getValue());
+            assertEquals(e.getIssues().size(), 1);
+            assertEquals(e.getIssues().get(0).getCode(), IssueType.FORBIDDEN);
+            assertEquals(e.getIssues().get(0).getDetails().getText().getValue(),
+                "The resource 'Encounter/bogus' does not exist.");
+        }
+
+        // Invalid compartment search: Device compartment
+        try {
+            queryParameterValue.setValueString("Device/" + PATIENT_ID);
+            properties.put(FHIRPersistenceEvent.PROPNAME_RESOURCE_TYPE, "Observation");
+            properties.put(FHIRPersistenceEvent.PROPNAME_SEARCH_CONTEXT_IMPL, searchContext);
+            FHIRPersistenceEvent event = new FHIRPersistenceEvent(observation, properties);
+            interceptor.beforeSearch(event);
+            fail("Patient interaction was allowed but should not be");
+        } catch (FHIRPersistenceInterceptorException e) {
+            // success
+            assertEquals(e.getIssues().size(), 1);
+            assertEquals(e.getIssues().get(0).getCode(), IssueType.FORBIDDEN);
+            assertEquals(e.getIssues().get(0).getDetails().getText().getValue(),
+                "Compartment search for compartment type 'Device' is not permitted.");
+        }
+
+        // Invalid compartment search: Practitioner compartment
+        try {
+            queryParameterValue.setValueString("Practitioner/" + PATIENT_ID);
+            properties.put(FHIRPersistenceEvent.PROPNAME_RESOURCE_TYPE, "Observation");
+            properties.put(FHIRPersistenceEvent.PROPNAME_SEARCH_CONTEXT_IMPL, searchContext);
+            FHIRPersistenceEvent event = new FHIRPersistenceEvent(observation, properties);
+            interceptor.beforeSearch(event);
+            fail("Patient interaction was allowed but should not be");
+        } catch (FHIRPersistenceInterceptorException e) {
+            // success
+            assertEquals(e.getIssues().size(), 1);
+            assertEquals(e.getIssues().get(0).getCode(), IssueType.FORBIDDEN);
+            assertEquals(e.getIssues().get(0).getDetails().getText().getValue(),
+                "Compartment search for compartment type 'Practitioner' is not permitted.");
+        }
+
+        // Invalid compartment search: RelatedPerson compartment
+        try {
+            queryParameterValue.setValueString("RelatedPerson/" + PATIENT_ID);
+            properties.put(FHIRPersistenceEvent.PROPNAME_RESOURCE_TYPE, "Observation");
+            properties.put(FHIRPersistenceEvent.PROPNAME_SEARCH_CONTEXT_IMPL, searchContext);
+            FHIRPersistenceEvent event = new FHIRPersistenceEvent(observation, properties);
+            interceptor.beforeSearch(event);
+            fail("Patient interaction was allowed but should not be");
+        } catch (FHIRPersistenceInterceptorException e) {
+            // success
+            assertEquals(e.getIssues().size(), 1);
+            assertEquals(e.getIssues().get(0).getCode(), IssueType.FORBIDDEN);
+            assertEquals(e.getIssues().get(0).getDetails().getText().getValue(),
+                "Compartment search for compartment type 'RelatedPerson' is not permitted.");
         }
 
         // Valid non-compartment search: converted to Patient compartment search
diff --git a/fhir-smart/src/test/java/com/ibm/fhir/smart/test/MockPersistenceImpl.java b/fhir-smart/src/test/java/com/ibm/fhir/smart/test/MockPersistenceImpl.java
index 2574e04da5f..e8ef8fcaeff 100644
--- a/fhir-smart/src/test/java/com/ibm/fhir/smart/test/MockPersistenceImpl.java
+++ b/fhir-smart/src/test/java/com/ibm/fhir/smart/test/MockPersistenceImpl.java
@@ -6,14 +6,20 @@
 
 package com.ibm.fhir.smart.test;
 
+import static com.ibm.fhir.model.type.String.string;
+
 import java.time.Instant;
 import java.util.List;
 import java.util.function.Function;
 
+import com.ibm.fhir.model.resource.Encounter;
 import com.ibm.fhir.model.resource.Observation;
 import com.ibm.fhir.model.resource.OperationOutcome;
 import com.ibm.fhir.model.resource.Patient;
 import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.test.TestUtil;
+import com.ibm.fhir.model.type.Reference;
+import com.ibm.fhir.model.type.code.ResourceType;
 import com.ibm.fhir.persistence.FHIRPersistence;
 import com.ibm.fhir.persistence.FHIRPersistenceTransaction;
 import com.ibm.fhir.persistence.MultiResourceResult;
@@ -23,18 +29,33 @@
 import com.ibm.fhir.persistence.context.FHIRPersistenceContext;
 import com.ibm.fhir.persistence.exception.FHIRPersistenceException;
 import com.ibm.fhir.persistence.exception.FHIRPersistenceResourceDeletedException;
+import com.ibm.fhir.persistence.exception.FHIRPersistenceResourceNotFoundException;
 
 /**
  * Mock implementation of FHIRPersistence for use during testing.
  *
  */
 public class MockPersistenceImpl implements FHIRPersistence {
+    static final String ENCOUNTER_ID_GOOD = "good";
+    static final String ENCOUNTER_ID_BAD = "bad";
+
     Patient patient = null;
     Observation observation = null;
+    Encounter encounter_in_patient_compartment = null;
+    Encounter encounter_not_in_patient_compartment = null;
 
-    public MockPersistenceImpl(Patient patient, Observation observation) {
+    public MockPersistenceImpl(Patient patient, Observation observation) throws Exception {
         this.patient = patient;
         this.observation = observation;
+
+
+        encounter_not_in_patient_compartment = TestUtil.getMinimalResource(ResourceType.ENCOUNTER);
+        encounter_in_patient_compartment = encounter_not_in_patient_compartment.toBuilder()
+                .id(ENCOUNTER_ID_GOOD)
+                .subject(Reference.builder()
+                    .reference(string("Patient/" + patient.getId()))
+                    .build())
+                .build();
     }
 
     @Override
@@ -60,6 +81,22 @@ public <T extends Resource> SingleResourceResult<T> read(FHIRPersistenceContext
                     .build();
         }
 
+        if (resourceType == Encounter.class) {
+            if (ENCOUNTER_ID_GOOD.equals(logicalId)) {
+                return new SingleResourceResult.Builder<T>()
+                        .success(true)
+                        .resource((T)encounter_in_patient_compartment)
+                        .build();
+            } else if (ENCOUNTER_ID_BAD.equals(logicalId)){
+                return new SingleResourceResult.Builder<T>()
+                        .success(true)
+                        .resource((T)encounter_not_in_patient_compartment)
+                        .build();
+            } else {
+                throw new FHIRPersistenceResourceNotFoundException("Not found");
+            }
+        }
+
         return null;
     }
 
diff --git a/fhir-swagger-generator/pom.xml b/fhir-swagger-generator/pom.xml
index f868356f8ad..cc2bff57b80 100644
--- a/fhir-swagger-generator/pom.xml
+++ b/fhir-swagger-generator/pom.xml
@@ -4,7 +4,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-swagger-generator/src/main/java/com/ibm/fhir/openapi/generator/FHIROpenApiGenerator.java b/fhir-swagger-generator/src/main/java/com/ibm/fhir/openapi/generator/FHIROpenApiGenerator.java
index ec6cf5325ea..1276ac6485f 100644
--- a/fhir-swagger-generator/src/main/java/com/ibm/fhir/openapi/generator/FHIROpenApiGenerator.java
+++ b/fhir-swagger-generator/src/main/java/com/ibm/fhir/openapi/generator/FHIROpenApiGenerator.java
@@ -29,17 +29,17 @@
 import java.util.Set;
 import java.util.stream.Collectors;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonArrayBuilder;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
-import javax.json.JsonReader;
-import javax.json.JsonStructure;
-import javax.json.JsonWriter;
-import javax.json.JsonWriterFactory;
-import javax.json.stream.JsonGenerator;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonArrayBuilder;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonStructure;
+import jakarta.json.JsonWriter;
+import jakarta.json.JsonWriterFactory;
+import jakarta.json.stream.JsonGenerator;
 
 import com.ibm.fhir.core.FHIRMediaType;
 import com.ibm.fhir.examples.ExamplesUtil;
diff --git a/fhir-swagger-generator/src/main/java/com/ibm/fhir/swagger/generator/APIConnectAdapter.java b/fhir-swagger-generator/src/main/java/com/ibm/fhir/swagger/generator/APIConnectAdapter.java
index 1b02d61b2f1..8de7c542bbe 100644
--- a/fhir-swagger-generator/src/main/java/com/ibm/fhir/swagger/generator/APIConnectAdapter.java
+++ b/fhir-swagger-generator/src/main/java/com/ibm/fhir/swagger/generator/APIConnectAdapter.java
@@ -1,15 +1,15 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
 
 package com.ibm.fhir.swagger.generator;
 
-import javax.json.Json;
-import javax.json.JsonArrayBuilder;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObjectBuilder;
+import jakarta.json.Json;
+import jakarta.json.JsonArrayBuilder;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObjectBuilder;
 
 /**
  *
diff --git a/fhir-swagger-generator/src/main/java/com/ibm/fhir/swagger/generator/FHIRSwaggerGenerator.java b/fhir-swagger-generator/src/main/java/com/ibm/fhir/swagger/generator/FHIRSwaggerGenerator.java
index 26a04d9cbee..85c3b845cbf 100644
--- a/fhir-swagger-generator/src/main/java/com/ibm/fhir/swagger/generator/FHIRSwaggerGenerator.java
+++ b/fhir-swagger-generator/src/main/java/com/ibm/fhir/swagger/generator/FHIRSwaggerGenerator.java
@@ -23,16 +23,16 @@
 import java.util.Map;
 import java.util.Set;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonArrayBuilder;
-import javax.json.JsonBuilderFactory;
-import javax.json.JsonObject;
-import javax.json.JsonObjectBuilder;
-import javax.json.JsonStructure;
-import javax.json.JsonWriter;
-import javax.json.JsonWriterFactory;
-import javax.json.stream.JsonGenerator;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonArrayBuilder;
+import jakarta.json.JsonBuilderFactory;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonObjectBuilder;
+import jakarta.json.JsonStructure;
+import jakarta.json.JsonWriter;
+import jakarta.json.JsonWriterFactory;
+import jakarta.json.stream.JsonGenerator;
 
 import com.ibm.fhir.core.FHIRMediaType;
 import com.ibm.fhir.model.annotation.Required;
diff --git a/fhir-term-graph/pom.xml b/fhir-term-graph/pom.xml
index 768f774baa3..4bf9ad4a78a 100644
--- a/fhir-term-graph/pom.xml
+++ b/fhir-term-graph/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-term-graph</artifactId>
diff --git a/fhir-term-remote/pom.xml b/fhir-term-remote/pom.xml
index 7d5189b6965..a2259c8a357 100644
--- a/fhir-term-remote/pom.xml
+++ b/fhir-term-remote/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
     
diff --git a/fhir-term-remote/src/main/java/com/ibm/fhir/term/remote/provider/RemoteTermServiceProvider.java b/fhir-term-remote/src/main/java/com/ibm/fhir/term/remote/provider/RemoteTermServiceProvider.java
index c106030c0d9..ca97ee9cc89 100644
--- a/fhir-term-remote/src/main/java/com/ibm/fhir/term/remote/provider/RemoteTermServiceProvider.java
+++ b/fhir-term-remote/src/main/java/com/ibm/fhir/term/remote/provider/RemoteTermServiceProvider.java
@@ -36,8 +36,8 @@
 import java.util.logging.Level;
 import java.util.logging.Logger;
 
-import javax.json.JsonObject;
-import javax.json.JsonValue;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonValue;
 import javax.net.ssl.HostnameVerifier;
 import javax.net.ssl.SSLSession;
 import javax.ws.rs.ProcessingException;
@@ -48,6 +48,8 @@
 import javax.ws.rs.client.ClientRequestFilter;
 import javax.ws.rs.client.Entity;
 import javax.ws.rs.client.WebTarget;
+import javax.ws.rs.core.MultivaluedHashMap;
+import javax.ws.rs.core.MultivaluedMap;
 import javax.ws.rs.core.Response;
 import javax.ws.rs.core.Response.Status;
 
@@ -96,11 +98,13 @@ public class RemoteTermServiceProvider extends AbstractTermServiceProvider {
 
     private final Configuration configuration;
     private final String base;
+    private final MultivaluedMap<String, Object> headersMap;
     private Client client;
 
     public RemoteTermServiceProvider(Configuration configuration) {
         this.configuration = Objects.requireNonNull(configuration, "configuration");
         this.base = configuration.getBase();
+        headersMap = buildHeadersMap(configuration.getHeaders());
         try {
             log.info("Creating client...");
 
@@ -185,11 +189,13 @@ public Concept getConcept(CodeSystem codeSystem, Code code) {
                     .queryParam("version", codeSystem.getVersion().getValue())
                     .queryParam("code", code.getValue())
                     .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .headers(headersMap)
                     .get() :
                 target.path(CODE_SYSTEM_LOOKUP)
                     .queryParam("system", codeSystem.getUrl().getValue())
                     .queryParam("code", code.getValue())
                     .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .headers(headersMap)
                     .get();
 
             log(GET, uri(CODE_SYSTEM_LOOKUP), response.getStatus(), elapsed(start));
@@ -240,6 +246,7 @@ public <R> Set<R> getConcepts(CodeSystem codeSystem, List<Filter> filters, Funct
 
             response = target.path(VALUE_SET_EXPAND)
                 .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                .headers(headersMap)
                 .post(Entity.entity(parameters, FHIRMediaType.APPLICATION_FHIR_JSON));
 
             log(POST, uri(VALUE_SET_EXPAND), response.getStatus(), elapsed(start));
@@ -294,11 +301,13 @@ public boolean hasConcept(CodeSystem codeSystem, Code code) {
                     .queryParam("version", codeSystem.getVersion().getValue())
                     .queryParam("code", code.getValue())
                     .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .headers(headersMap)
                     .get() :
                 target.path(CODE_SYSTEM_VALIDATE_CODE)
                     .queryParam("url", codeSystem.getUrl().getValue())
                     .queryParam("code", code.getValue())
                     .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .headers(headersMap)
                     .get();
 
             log(GET, uri(CODE_SYSTEM_VALIDATE_CODE), response.getStatus(), elapsed(start));
@@ -359,12 +368,14 @@ public boolean subsumes(CodeSystem codeSystem, Code codeA, Code codeB) {
                     .queryParam("codeA", codeA.getValue())
                     .queryParam("codeB", codeB.getValue())
                     .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .headers(headersMap)
                     .get() :
                 target.path(CODE_SYSTEM_SUBSUMES)
                     .queryParam("system", codeSystem.getUrl().getValue())
                     .queryParam("codeA", codeA.getValue())
                     .queryParam("codeB", codeB.getValue())
                     .request(FHIRMediaType.APPLICATION_FHIR_JSON)
+                    .headers(headersMap)
                     .get();
 
             log(GET, uri(CODE_SYSTEM_SUBSUMES), response.getStatus(), elapsed(start));
@@ -386,6 +397,14 @@ public boolean subsumes(CodeSystem codeSystem, Code codeA, Code codeB) {
         }
     }
 
+    private MultivaluedMap<String, Object> buildHeadersMap(List<Configuration.Header> headers) {
+        MultivaluedMap<String, Object> headersMap = new MultivaluedHashMap<>();
+        for (Configuration.Header header : headers) {
+            headersMap.putSingle(header.getName(), header.getValue());
+        }
+        return headersMap;
+    }
+
     private double elapsed(long start) {
         return (System.currentTimeMillis() - start) / 1000.0;
     }
@@ -594,6 +613,7 @@ public static class Configuration {
         private final TrustStore trustStore;
         private final boolean hostnameVerificationEnabled;
         private final BasicAuth basicAuth;
+        private final List<Header> headers;
         private final int httpTimeout;
         private final List<Supports> supports;
 
@@ -602,6 +622,7 @@ private Configuration(Builder builder) {
             trustStore = builder.trustStore;
             hostnameVerificationEnabled = builder.hostnameVerificationEnabled;
             basicAuth = builder.basicAuth;
+            headers = Collections.unmodifiableList(builder.headers);
             httpTimeout = builder.httpTimeout;
             supports = Collections.unmodifiableList(builder.supports);
         }
@@ -622,6 +643,10 @@ public BasicAuth getBasicAuth() {
             return basicAuth;
         }
 
+        public List<Header> getHeaders() {
+            return headers;
+        }
+
         public int getHttpTimeout() {
             return httpTimeout;
         }
@@ -646,13 +671,14 @@ public boolean equals(Object obj) {
                     Objects.equals(trustStore, other.trustStore) &&
                     Objects.equals(hostnameVerificationEnabled, other.hostnameVerificationEnabled) &&
                     Objects.equals(basicAuth, other.basicAuth) &&
+                    Objects.equals(headers, other.headers) &&
                     Objects.equals(httpTimeout, other.httpTimeout) &&
                     Objects.equals(supports, other.supports);
         }
 
         @Override
         public int hashCode() {
-            return Objects.hash(base, trustStore, hostnameVerificationEnabled, basicAuth, httpTimeout, supports);
+            return Objects.hash(base, trustStore, hostnameVerificationEnabled, basicAuth, headers, httpTimeout, supports);
         }
 
         public Builder toBuilder() {
@@ -668,6 +694,7 @@ public static class Builder {
             private TrustStore trustStore;
             private boolean hostnameVerificationEnabled = DEFAULT_HOSTNAME_VERIFICATION_ENABLED;
             private BasicAuth basicAuth;
+            private List<Header> headers = new ArrayList<>();
             private int httpTimeout = DEFAULT_HTTP_TIMEOUT;
             private List<Supports> supports = new ArrayList<>();
 
@@ -693,6 +720,18 @@ public Builder basicAuth(BasicAuth basicAuth) {
                 return this;
             }
 
+            public Builder headers(Header... headers) {
+                for (Header value : headers) {
+                    this.headers.add(value);
+                }
+                return this;
+            }
+
+            public Builder headers(Collection<Header> headers) {
+                this.headers = new ArrayList<>(headers);
+                return this;
+            }
+
             public Builder httpTimeout(int httpTimeout) {
                 this.httpTimeout = httpTimeout;
                 return this;
@@ -719,6 +758,7 @@ protected Builder from(Configuration configuration) {
                 trustStore = configuration.trustStore;
                 hostnameVerificationEnabled = configuration.hostnameVerificationEnabled;
                 basicAuth = configuration.basicAuth;
+                headers.addAll(configuration.headers);
                 httpTimeout = configuration.httpTimeout;
                 supports.addAll(configuration.supports);
                 return this;
@@ -895,6 +935,83 @@ protected Builder from(BasicAuth basicAuth) {
             }
         }
 
+        /**
+         * A class that represents the HTTP header(s) supported by a remote term service provider
+         */
+        public static class Header {
+            private final String name;
+            private final Object value;
+
+            public Header(Builder builder) {
+                name = Objects.requireNonNull(builder.name, "name");
+                value = Objects.requireNonNull(builder.value, "value");
+            }
+
+            public String getName() {
+                return name;
+            }
+
+            public Object getValue() {
+                return value;
+            }
+
+            @Override
+            public boolean equals(Object obj) {
+                if (this == obj) {
+                    return true;
+                }
+                if (obj == null) {
+                    return false;
+                }
+                if (getClass() != obj.getClass()) {
+                    return false;
+                }
+                Header other = (Header) obj;
+                return Objects.equals(name, other.name) &&
+                        Objects.equals(value, other.value);
+            }
+
+            @Override
+            public int hashCode() {
+                return Objects.hash(name, value);
+            }
+
+            public Builder toBuilder() {
+                return new Builder().from(this);
+            }
+
+            public static Builder builder() {
+                return new Builder();
+            }
+
+            public static class Builder {
+                private String name;
+                private Object value;
+
+                private Builder() { }
+
+                public Builder name(String name) {
+                    this.name = name;
+                    return this;
+                }
+
+                public Builder value(Object value) {
+                    this.value = value;
+                    return this;
+                }
+
+                public Header build() {
+                    return new Header(this);
+                }
+
+                protected Builder from(Header header) {
+                    name = header.name;
+                    value = header.value;
+                    return this;
+                }
+            }
+        }
+
         /**
          * A class that represents the code system(s) supported by a remote term service provider
          */
diff --git a/fhir-term/pom.xml b/fhir-term/pom.xml
index 238e4617add..a1cda0f73f8 100644
--- a/fhir-term/pom.xml
+++ b/fhir-term/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-term</artifactId>
diff --git a/fhir-term/src/main/java/com/ibm/fhir/term/util/ValueSetSupport.java b/fhir-term/src/main/java/com/ibm/fhir/term/util/ValueSetSupport.java
index e2934dbbc78..6c4b93d0195 100644
--- a/fhir-term/src/main/java/com/ibm/fhir/term/util/ValueSetSupport.java
+++ b/fhir-term/src/main/java/com/ibm/fhir/term/util/ValueSetSupport.java
@@ -92,11 +92,34 @@ public static Map<java.lang.String, Set<java.lang.String>> getCodeSetMap(ValueSe
         if (valueSet.getUrl() == null || valueSet.getVersion() == null || FHIRTermConfig.isCachingDisabled()) {
             return computeCodeSetMap(valueSet);
         }
-        java.lang.String url = valueSet.getUrl().getValue() + "|" + valueSet.getVersion().getValue();
+        java.lang.String url = cacheKey(valueSet);
         Map<java.lang.String, Map<java.lang.String, Set<java.lang.String>>> cacheAsMap = CacheManager.getCacheAsMap(CODE_SET_MAP_CACHE_NAME, CODE_SET_MAP_CACHE_CONFIG);
         return cacheAsMap.computeIfAbsent(url, k -> computeCodeSetMap(valueSet));
     }
 
+    /**
+     * Clear the code set map cache for the given value set.
+     *
+     * @param valueSet
+     *     the value set
+     */
+    public static void clearCache(ValueSet valueSet) {
+        CacheManager.invalidate(CODE_SET_MAP_CACHE_NAME, cacheKey(valueSet));
+    }
+
+    /**
+     * Compute the code set map cache key for the given value set.
+     * 
+     * @param valueSet
+     *     the value set
+     * 
+     * @return 
+     *     computed cache key
+     */
+    private static java.lang.String cacheKey(ValueSet valueSet) {
+        return valueSet.getUrl().getValue() + "|" + valueSet.getVersion().getValue();
+    }
+
     /**
      * Get a list containing {@link ValueSet.Expansion.Contains} instances where all structural
      * hierarchies have been flattened.
diff --git a/fhir-tools/pom.xml b/fhir-tools/pom.xml
index 178aadf890d..a11c077362e 100644
--- a/fhir-tools/pom.xml
+++ b/fhir-tools/pom.xml
@@ -5,7 +5,7 @@
     <modelVersion>4.0.0</modelVersion>
 
     <groupId>com.ibm.fhir</groupId>
-    <version>4.8.0-SNAPSHOT</version>
+    <version>4.9.0-SNAPSHOT</version>
     <artifactId>fhir-tools</artifactId>
 
     <packaging>maven-plugin</packaging>
@@ -208,17 +208,10 @@
     </build>
 
     <dependencies>
-        <!-- javax.json API -->
-        <dependency>
-            <groupId>jakarta.json</groupId>
-            <artifactId>jakarta.json-api</artifactId>
-            <version>1.1.5</version>
-        </dependency>
-        <!-- javax.json implementation -->
         <dependency>
             <groupId>org.glassfish</groupId>
             <artifactId>jakarta.json</artifactId>
-            <version>1.1.5</version>
+            <version>2.0.1</version>
         </dependency>
         <dependency>
             <groupId>org.skyscreamer</groupId>
diff --git a/fhir-tools/src/main/java/com/ibm/fhir/model/plugin/generator/impl/R4ModelGeneratorImpl.java b/fhir-tools/src/main/java/com/ibm/fhir/model/plugin/generator/impl/R4ModelGeneratorImpl.java
index 5cbf68ebd90..5965f0fbd6f 100644
--- a/fhir-tools/src/main/java/com/ibm/fhir/model/plugin/generator/impl/R4ModelGeneratorImpl.java
+++ b/fhir-tools/src/main/java/com/ibm/fhir/model/plugin/generator/impl/R4ModelGeneratorImpl.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -9,7 +9,7 @@
 import java.io.File;
 import java.util.Map;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 
 import org.apache.maven.plugin.logging.Log;
 import org.apache.maven.project.MavenProject;
diff --git a/fhir-tools/src/main/java/com/ibm/fhir/model/plugin/generator/impl/R4TargetModelGeneratorImpl.java b/fhir-tools/src/main/java/com/ibm/fhir/model/plugin/generator/impl/R4TargetModelGeneratorImpl.java
index 14842676020..fc4c077f63d 100644
--- a/fhir-tools/src/main/java/com/ibm/fhir/model/plugin/generator/impl/R4TargetModelGeneratorImpl.java
+++ b/fhir-tools/src/main/java/com/ibm/fhir/model/plugin/generator/impl/R4TargetModelGeneratorImpl.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -9,7 +9,7 @@
 import java.io.File;
 import java.util.Map;
 
-import javax.json.JsonObject;
+import jakarta.json.JsonObject;
 
 import org.apache.maven.plugin.logging.Log;
 import org.apache.maven.project.MavenProject;
diff --git a/fhir-tools/src/main/java/com/ibm/fhir/tools/CodeGenerator.java b/fhir-tools/src/main/java/com/ibm/fhir/tools/CodeGenerator.java
index da3a5990286..107f2c40dda 100644
--- a/fhir-tools/src/main/java/com/ibm/fhir/tools/CodeGenerator.java
+++ b/fhir-tools/src/main/java/com/ibm/fhir/tools/CodeGenerator.java
@@ -35,14 +35,15 @@
 import java.util.StringJoiner;
 import java.util.stream.Collectors;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonString;
-import javax.json.JsonValue;
 import javax.lang.model.SourceVersion;
 
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonString;
+import jakarta.json.JsonValue;
+
 public class CodeGenerator {
     private final Map<String, JsonObject> structureDefinitionMap;
     private final Map<String, JsonObject> codeSystemMap;
@@ -723,12 +724,25 @@ private void generateBuilderClass(JsonObject structureDefinition, String classNa
             cb.javadocThrows("IllegalStateException", "if the current state cannot be built into a valid "
                     + className + " per the base specification");
             cb.javadocEnd();
+
+            String varName = camelCase(className);
+            if (SourceVersion.isKeyword(varName)) {
+                varName = "_" + varName;
+            }
+
             cb.override();
             cb.method(mods("public"), className, "build")
-                ._return(_new(className, args("this")))
+                .decl(className, varName, _new(className, args("this")))
+                ._if("validating")
+                    .invoke("validate", args(varName))
+                ._end()
+                ._return(varName)
             .end();
         }
 
+        cb.newLine();
+        generateValidateMethod(structureDefinition, path, className, visibility, cb, nested);
+
         String paramName = camelCase(className);
         if (SourceVersion.isKeyword(paramName)) {
             paramName = "_" + paramName;
@@ -739,7 +753,7 @@ private void generateBuilderClass(JsonObject structureDefinition, String classNa
         // Call super.from unless we are at the topMost resources in the model hierarchy
         if (!(isAbstract(structureDefinition) &&
                 ("Resource".equals(className) || "Element".equals(className)))) {
-            cb.invoke("super.from", args(paramName));
+            cb.invoke("super", "from", args(paramName));
         }
         for (JsonObject elementDefinition : declaredElementDefinitions) {
             String fieldName = getFieldName(elementDefinition, path);
@@ -759,6 +773,177 @@ private void generateBuilderClass(JsonObject structureDefinition, String classNa
         cb._end();
     }
 
+    private void generateValidateMethod(JsonObject structureDefinition, String path, String className, String visibility, CodeBuilder cb, boolean nested) {
+        String paramName = camelCase(className);
+        if (SourceVersion.isKeyword(paramName)) {
+            paramName = "_" + paramName;
+        }
+
+        cb.method(mods("protected"), "void", "validate", params(param(className, paramName)));
+
+        if (!(isAbstract(structureDefinition) &&
+                ("Resource".equals(className) || "Element".equals(className)))) {
+            cb.invoke("super", "validate", args(paramName));
+        }
+
+        List<JsonObject> elementDefinitions = getElementDefinitions(structureDefinition, path);
+
+        for (JsonObject elementDefinition : elementDefinitions) {
+            String basePath = elementDefinition.getJsonObject("base").getString("path");
+            if (elementDefinition.getString("path").equals(basePath)) {
+                String elementName = getElementName(elementDefinition, path);
+                String fieldName = getFieldName(elementName);
+
+                if (isRequired(elementDefinition)) {
+                    if (isRepeating(elementDefinition)) {
+                        cb.invoke("ValidationSupport", "checkNonEmptyList", args(paramName + "." + fieldName, quote(elementName), getFieldType(structureDefinition, elementDefinition, false) + ".class"));
+                    } else {
+                        if (isChoiceElement(elementDefinition)) {
+                            String types = getChoiceTypeNames(elementDefinition).stream().map(s -> s + ".class").collect(Collectors.joining(", "));
+                            cb.invoke("ValidationSupport", "requireChoiceElement", args(paramName + "." + fieldName, quote(elementName), types));
+                        } else {
+                            cb.invoke("ValidationSupport", "requireNonNull", args(paramName + "." + fieldName, quote(elementName)));
+                        }
+                    }
+                } else {
+                    if (isRepeating(elementDefinition)) {
+                        cb.invoke("ValidationSupport", "checkList", args(paramName + "." + fieldName, quote(elementName), getFieldType(structureDefinition, elementDefinition, false) + ".class"));
+                    } else if (isChoiceElement(elementDefinition)) {
+                        String types = getChoiceTypeNames(elementDefinition).stream().map(s -> s + ".class").collect(Collectors.joining(", "));
+                        cb.invoke("ValidationSupport", "choiceElement", args(paramName + "." + fieldName, quote(elementName), types));
+                    }
+                }
+            }
+        }
+
+        if (isUnsignedInt(structureDefinition) || isPositiveInt(structureDefinition)) {
+            cb.invoke("ValidationSupport", "checkValue", args(paramName + ".value", "MIN_VALUE"));
+        }
+
+        if (isString(structureDefinition)) {
+            cb.invoke("ValidationSupport", "checkString", args(paramName + ".value"));
+        }
+        if (isUri(structureDefinition)) {
+            cb.invoke("ValidationSupport", "checkUri", args(paramName + ".value"));
+        }
+
+        if (isCode(structureDefinition)) {
+            cb.invoke("ValidationSupport", "checkCode", args(paramName + ".value"));
+        } else if (isId(structureDefinition)){
+            cb.invoke("ValidationSupport", "checkId", args(paramName + ".value"));
+        } else if (isStringSubtype(structureDefinition)) {
+            if (!STRING_PATTERN.equals(getPattern(structureDefinition))) {
+                cb.invoke("ValidationSupport", "checkValue", args(paramName + ".value", "PATTERN"));
+            }
+        }
+
+        if (isUriSubtype(structureDefinition)) {
+            if (!URI_PATTERN.equals(getPattern(structureDefinition))) {
+                cb.invoke("ValidationSupport", "checkValue", args(paramName + ".value", "PATTERN"));
+            }
+        }
+
+        if (isDate(structureDefinition)) {
+            cb.invoke("ValidationSupport", "checkValueType", args(paramName + ".value", "LocalDate.class", "YearMonth.class", "Year.class"));
+        }
+
+        if (isDateTime(structureDefinition)) {
+            cb.invoke("ValidationSupport", "checkValueType", args(paramName + ".value", "ZonedDateTime.class", "LocalDate.class", "YearMonth.class", "Year.class"));
+        }
+
+        for (JsonObject elementDefinition : getElementDefinitions(structureDefinition, path)) {
+            if (isProhibited(elementDefinition)) {
+                String elementName = getElementName(elementDefinition, path);
+                String fieldName = getFieldName(elementName);
+                cb.invoke("ValidationSupport", "prohibited", args(paramName + "." + fieldName, quote(elementName)));
+            }
+        }
+
+        if ("Resource".equals(className) && !nested) {
+            cb.invoke("ValidationSupport", "checkId", args(paramName + ".id"));
+        }
+
+        if ("Element".equals(className) && !nested) {
+            cb.invoke("ValidationSupport", "checkString", args(paramName + ".id"));
+        }
+
+        if ("Extension".equals(className) && !nested) {
+            cb.invoke("ValidationSupport", "checkUri", args(paramName + ".url"));
+        }
+
+        // Handle code/coding/codeableconcept/quantity/string/uri fields with required or maxValueSet binding
+        for (JsonObject elementDefinition : elementDefinitions) {
+            String basePath = elementDefinition.getJsonObject("base").getString("path");
+            if (elementDefinition.getString("path").equals(basePath)) {
+                String elementName = getElementName(elementDefinition, path);
+                String fieldName = getFieldName(elementName);
+                String fieldType = getFieldType(structureDefinition, elementDefinition, false);
+                if ("Code".equals(fieldType) || "Coding".equals(fieldType) || "CodeableConcept".equals(fieldType) ||
+                        "Quantity".equals(fieldType) || "String".equals(fieldType) || "Uri".equals(fieldType)) {
+                    JsonObject binding = getBinding(elementDefinition);
+                    if (binding != null && binding.containsKey("valueSet") && binding.containsKey("strength")) {
+                        String valueSet = binding.getString("valueSet").split("\\|")[0];
+                        if ("required".equals(binding.getString("strength"))) {
+                            // required binding, check if it should be validated
+                            String system = getSystem(valueSet);
+                            List<JsonObject> concepts = getConcepts(valueSet);
+                            if ((!concepts.isEmpty() && !"Code".equals(fieldType)) || isSyntaxValidatedValueSet(valueSet)) {
+                                if (concepts.isEmpty()) {
+                                    cb.invoke("ValidationSupport", "checkValueSetBinding", args(paramName + "." + fieldName, quote(elementName), quote(valueSet), quote(system)));
+                                } else {
+                                    cb.invoke("ValidationSupport", "checkValueSetBinding", args(paramName + "." + fieldName, quote(elementName), quote(valueSet), quote(system),
+                                        concepts.stream().map(concept -> quote(concept.getString("code"))).collect(Collectors.joining(", "))));
+                                }
+                            }
+                        } else if (getMaxValueSet(binding) != null) {
+                            // not a required binding, check maxValueSet binding
+                            valueSet = getMaxValueSet(binding).split("\\|")[0];
+                            String system = getSystem(valueSet);
+                            List<JsonObject> concepts = getConcepts(valueSet);
+                            if (!concepts.isEmpty() || isSyntaxValidatedValueSet(valueSet)) {
+                                if (concepts.isEmpty()) {
+                                    cb.invoke("ValidationSupport", "checkValueSetBinding", args(paramName + "." + fieldName, quote(elementName), quote(valueSet), quote(system)));
+                                } else {
+                                    cb.invoke("ValidationSupport", "checkValueSetBinding", args(paramName + "." + fieldName, quote(elementName), quote(valueSet), quote(system),
+                                        concepts.stream().map(concept -> quote(concept.getString("code"))).collect(Collectors.joining(", "))));
+                                }
+                            }
+                        }
+                    }
+                }
+            }
+        }
+
+        for (JsonObject elementDefinition : elementDefinitions) {
+            String elementName = getElementName(elementDefinition, path);
+            String fieldName = getFieldName(elementName);
+            if (isReferenceElement(structureDefinition, elementDefinition) ||
+                    (isRepeating(elementDefinition) && "List<Reference>".equals(getFieldType(structureDefinition, elementDefinition))) ||
+                    (isChoiceElement(elementDefinition) && getChoiceTypeNames(elementDefinition).contains("Reference"))) {
+                List<String> referenceTypes = getReferenceTypes(elementDefinition);
+                if (!referenceTypes.isEmpty()) {
+                    cb.invoke("ValidationSupport", "checkReferenceType", args(paramName + "." + fieldName, quote(elementName), referenceTypes.stream().map(type -> quote(type)).collect(Collectors.joining(", "))));
+                }
+            }
+        }
+
+        if ((!isResource(structureDefinition) &&
+                !isAbstract(structureDefinition) &&
+                !isStringSubtype(structureDefinition) &&
+                !isUriSubtype(structureDefinition) &&
+                !isQuantitySubtype(structureDefinition) &&
+                !isXhtml(structureDefinition)) ||
+                nested) {
+            cb.invoke("ValidationSupport", "requireValueOrChildren", args(paramName));
+        }
+
+        if (isXhtml(structureDefinition)) {
+            cb.invoke("ValidationSupport", "checkXHTMLContent", args(paramName + ".value"));
+        }
+
+        cb.end();
+    }
+
     /**
      * @param className The name of the class currently being generated
      * @param elementDefinition
@@ -1105,177 +1290,9 @@ private void generateClass(JsonObject structureDefinition, List<String> paths, C
                 cb.field(mods("protected", "volatile"), "int", "hashCode").newLine();
             }
 
-            cb.constructor(mods(visibility), className, args("Builder builder"));
-            if ((!"Resource".equals(className) && !"Element".equals(className)) || nested) {
-                cb._super(args("builder"));
-            }
+            generateConstructor(structureDefinition, path, className, visibility, cb, nested);
 
-            for (JsonObject elementDefinition : elementDefinitions) {
-                String basePath = elementDefinition.getJsonObject("base").getString("path");
-                if (elementDefinition.getString("path").equals(basePath)) {
-                    String elementName = getElementName(elementDefinition, path);
-                    String fieldName = getFieldName(elementName);
-
-                    if (isRequired(elementDefinition)) {
-                        if (isRepeating(elementDefinition)) {
-                            cb.assign(fieldName, "Collections.unmodifiableList(ValidationSupport.checkNonEmptyList(builder." + fieldName + ", " + quote(elementName) + ", " +
-                                    getFieldType(structureDefinition, elementDefinition, false) + ".class))");
-                        } else {
-                            if (isChoiceElement(elementDefinition)) {
-                                String types = getChoiceTypeNames(elementDefinition).stream().map(s -> s + ".class").collect(Collectors.joining(", "));
-                                cb.assign(fieldName, "ValidationSupport.requireChoiceElement(builder." + fieldName + ", " + quote(elementName) + ", " + types + ")");
-                            } else {
-                                cb.assign(fieldName, "ValidationSupport.requireNonNull(builder." + fieldName + ", " + quote(elementName) + ")");
-                            }
-                        }
-                    } else {
-                        if (isRepeating(elementDefinition)) {
-                            cb.assign(fieldName, "Collections.unmodifiableList(ValidationSupport.checkList(builder." + fieldName + ", " + quote(elementName) + ", " +
-                                    getFieldType(structureDefinition, elementDefinition, false) + ".class))");
-                        } else {
-                            if (isChoiceElement(elementDefinition)) {
-                                String types = getChoiceTypeNames(elementDefinition).stream().map(s -> s + ".class").collect(Collectors.joining(", "));
-                                cb.assign(fieldName, "ValidationSupport.choiceElement(builder." + fieldName + ", " + quote(elementName) + ", " + types + ")");
-                            } else {
-                                // Instant, DateTime, and Time values require special handling
-                                if ((isInstant(structureDefinition) || isDateTime(structureDefinition) || isTime(structureDefinition))
-                                        && "value".equals(fieldName)) {
-                                    cb.assign(fieldName, "ModelSupport.truncateTime(builder.value, ChronoUnit.MICROS)");
-                                } else {
-                                    cb.assign(fieldName, "builder." + fieldName);
-                                }
-                            }
-                        }
-                    }
-                }
-            }
-
-            if (isUnsignedInt(structureDefinition) || isPositiveInt(structureDefinition)) {
-                cb.invoke("ValidationSupport", "checkValue", args("value", "MIN_VALUE"));
-            }
-
-            if (isString(structureDefinition)) {
-                cb.invoke("ValidationSupport", "checkString", args("value"));
-            }
-            if (isUri(structureDefinition)) {
-                cb.invoke("ValidationSupport", "checkUri", args("value"));
-            }
-
-            if (isCode(structureDefinition)) {
-                cb.invoke("ValidationSupport", "checkCode", args("value"));
-            } else if (isId(structureDefinition)){
-                cb.invoke("ValidationSupport", "checkId", args("value"));
-            } else if (isStringSubtype(structureDefinition)) {
-                if (!STRING_PATTERN.equals(getPattern(structureDefinition))) {
-                    cb.invoke("ValidationSupport", "checkValue", args("value", "PATTERN"));
-                }
-            }
-
-            if (isUriSubtype(structureDefinition)) {
-                if (!URI_PATTERN.equals(getPattern(structureDefinition))) {
-                    cb.invoke("ValidationSupport", "checkValue", args("value", "PATTERN"));
-                }
-            }
-
-            if (isDate(structureDefinition)) {
-                cb.invoke("ValidationSupport", "checkValueType", args("value", "LocalDate.class", "YearMonth.class", "Year.class"));
-            }
-
-            if (isDateTime(structureDefinition)) {
-                cb.invoke("ValidationSupport", "checkValueType", args("value", "ZonedDateTime.class", "LocalDate.class", "YearMonth.class", "Year.class"));
-            }
-
-            for (JsonObject elementDefinition : getElementDefinitions(structureDefinition, path)) {
-                if (isProhibited(elementDefinition)) {
-                    String elementName = getElementName(elementDefinition, path);
-                    String fieldName = getFieldName(elementName);
-                    cb.invoke("ValidationSupport", "prohibited", args(fieldName, quote(elementName)));
-                }
-            }
-
-            if ("Resource".equals(className) && !nested) {
-                cb.invoke("ValidationSupport", "checkId", args("id"));
-            }
-
-            if ("Element".equals(className) && !nested) {
-                cb.invoke("ValidationSupport", "checkString", args("id"));
-            }
-
-            if ("Extension".equals(className) && !nested) {
-                cb.invoke("ValidationSupport", "checkUri", args("url"));
-            }
-
-            // Handle code/coding/codeableconcept/quantity/string/uri fields with required or maxValueSet binding
-            for (JsonObject elementDefinition : elementDefinitions) {
-                String basePath = elementDefinition.getJsonObject("base").getString("path");
-                if (elementDefinition.getString("path").equals(basePath)) {
-                    String elementName = getElementName(elementDefinition, path);
-                    String fieldName = getFieldName(elementName);
-                    String fieldType = getFieldType(structureDefinition, elementDefinition, false);
-                    if ("Code".equals(fieldType) || "Coding".equals(fieldType) || "CodeableConcept".equals(fieldType) ||
-                            "Quantity".equals(fieldType) || "String".equals(fieldType) || "Uri".equals(fieldType)) {
-                        JsonObject binding = getBinding(elementDefinition);
-                        if (binding != null && binding.containsKey("valueSet") && binding.containsKey("strength")) {
-                            String valueSet = binding.getString("valueSet").split("\\|")[0];
-                            if ("required".equals(binding.getString("strength"))) {
-                                // required binding, check if it should be validated
-                                String system = getSystem(valueSet);
-                                List<JsonObject> concepts = getConcepts(valueSet);
-                                if ((!concepts.isEmpty() && !"Code".equals(fieldType)) || isSyntaxValidatedValueSet(valueSet)) {
-                                    if (concepts.isEmpty()) {
-                                        cb.invoke("ValidationSupport", "checkValueSetBinding", args(fieldName, quote(elementName), quote(valueSet), quote(system)));
-                                    } else {
-                                        cb.invoke("ValidationSupport", "checkValueSetBinding", args(fieldName, quote(elementName), quote(valueSet), quote(system),
-                                            concepts.stream().map(concept -> quote(concept.getString("code"))).collect(Collectors.joining(", "))));
-                                    }
-                                }
-                            } else if (getMaxValueSet(binding) != null) {
-                                // not a required binding, check maxValueSet binding
-                                valueSet = getMaxValueSet(binding).split("\\|")[0];
-                                String system = getSystem(valueSet);
-                                List<JsonObject> concepts = getConcepts(valueSet);
-                                if (!concepts.isEmpty() || isSyntaxValidatedValueSet(valueSet)) {
-                                    if (concepts.isEmpty()) {
-                                        cb.invoke("ValidationSupport", "checkValueSetBinding", args(fieldName, quote(elementName), quote(valueSet), quote(system)));
-                                    } else {
-                                        cb.invoke("ValidationSupport", "checkValueSetBinding", args(fieldName, quote(elementName), quote(valueSet), quote(system),
-                                            concepts.stream().map(concept -> quote(concept.getString("code"))).collect(Collectors.joining(", "))));
-                                    }
-                                }
-                            }
-                        }
-                    }
-                }
-            }
-
-            for (JsonObject elementDefinition : elementDefinitions) {
-                String elementName = getElementName(elementDefinition, path);
-                String fieldName = getFieldName(elementName);
-                if (isReferenceElement(structureDefinition, elementDefinition) ||
-                        (isRepeating(elementDefinition) && "List<Reference>".equals(getFieldType(structureDefinition, elementDefinition))) ||
-                        (isChoiceElement(elementDefinition) && getChoiceTypeNames(elementDefinition).contains("Reference"))) {
-                    List<String> referenceTypes = getReferenceTypes(elementDefinition);
-                    if (!referenceTypes.isEmpty()) {
-                        cb.invoke("ValidationSupport", "checkReferenceType", args(fieldName, quote(elementName), referenceTypes.stream().map(type -> quote(type)).collect(Collectors.joining(", "))));
-                    }
-                }
-            }
-
-            if ((!isResource(structureDefinition) &&
-                    !isAbstract(structureDefinition) &&
-                    !isStringSubtype(structureDefinition) &&
-                    !isUriSubtype(structureDefinition) &&
-                    !isQuantitySubtype(structureDefinition) &&
-                    !isXhtml(structureDefinition)) ||
-                    nested) {
-                cb.invoke("ValidationSupport", "requireValueOrChildren", args("this"));
-            }
-
-            if (isXhtml(structureDefinition)) {
-                cb.invoke("ValidationSupport", "checkXHTMLContent", args("value"));
-            }
-
-            cb.end().newLine();
+            cb.newLine();
 
             for (JsonObject elementDefinition : elementDefinitions) {
                 String basePath = elementDefinition.getJsonObject("base").getString("path");
@@ -1346,6 +1363,40 @@ private void generateClass(JsonObject structureDefinition, List<String> paths, C
         }
     }
 
+    private void generateConstructor(JsonObject structureDefinition, String path, String className, String visibility, CodeBuilder cb, boolean nested) {
+        cb.constructor(mods(visibility), className, args("Builder builder"));
+        if ((!"Resource".equals(className) && !"Element".equals(className)) || nested) {
+            cb._super(args("builder"));
+        }
+
+        List<JsonObject> elementDefinitions = getElementDefinitions(structureDefinition, path);
+        if (isProfiledType(className)) {
+            elementDefinitions = Collections.emptyList();
+        }
+
+        for (JsonObject elementDefinition : elementDefinitions) {
+            String basePath = elementDefinition.getJsonObject("base").getString("path");
+            if (elementDefinition.getString("path").equals(basePath)) {
+                String elementName = getElementName(elementDefinition, path);
+                String fieldName = getFieldName(elementName);
+
+                if (isRepeating(elementDefinition)) {
+                    cb.assign(fieldName, "Collections.unmodifiableList(builder." + fieldName + ")");
+                } else {
+                    // Instant, DateTime, and Time values require special handling
+                    if ((isInstant(structureDefinition) || isDateTime(structureDefinition) || isTime(structureDefinition))
+                            && "value".equals(fieldName)) {
+                        cb.assign(fieldName, "ModelSupport.truncateTime(builder.value, ChronoUnit.MICROS)");
+                    } else {
+                        cb.assign(fieldName, "builder." + fieldName);
+                    }
+                }
+            }
+        }
+
+        cb.end();
+    }
+
     /**
      * Determines whether or not the value set is validated by syntax.
      * @param valueSet the value set
@@ -2703,6 +2754,8 @@ private void generateXMLParseMethod(String generatedClassName, JsonObject struct
             cb.assign(generatedClassName + ".Builder builder", generatedClassName + ".builder()");
         }
 
+        cb.invoke("builder", "setValidating", args("validating"));
+
         if (typeClassNames.contains(generatedClassName) || generatedClassName.contains(".")) {
             cb.assign("java.lang.String id", "reader.getAttributeValue(null, \"id\")")
             ._if("id != null")
@@ -2802,7 +2855,11 @@ private void generateXMLParseMethod(String generatedClassName, JsonObject struct
         }
 
         cb._default()
-            ._throw(_new("IllegalArgumentException", args("\"Unrecognized element: '\" + localName + \"'\"")));
+            ._if("!ignoringUnrecognizedElements")
+                ._throw(_new("IllegalArgumentException", args("\"Unrecognized element: '\" + localName + \"'\"")))
+            ._end()
+            .invoke("reader", "nextTag", args())
+            ._break();
 
         cb._end();
 
@@ -2877,19 +2934,25 @@ private void generateJsonParser(String basePath) {
         cb._import("java.io.Reader");
         cb._import("java.nio.charset.StandardCharsets");
         cb._import("java.util.Collection");
+        cb._import("java.util.Collections");
         cb._import("java.util.Stack");
         cb._import("java.util.StringJoiner");
         cb.newLine();
 
         cb._import("javax.annotation.Generated");
-        cb._import("javax.json.Json");
-        cb._import("javax.json.JsonArray");
-        cb._import("javax.json.JsonNumber");
-        cb._import("javax.json.JsonObject");
-        cb._import("javax.json.JsonReader");
-        cb._import("javax.json.JsonReaderFactory");
-        cb._import("javax.json.JsonString");
-        cb._import("javax.json.JsonValue");
+        cb.newLine();
+
+        cb._import("org.glassfish.json.api.JsonConfig");
+        cb.newLine();
+
+        cb._import("jakarta.json.Json");
+        cb._import("jakarta.json.JsonArray");
+        cb._import("jakarta.json.JsonNumber");
+        cb._import("jakarta.json.JsonObject");
+        cb._import("jakarta.json.JsonReader");
+        cb._import("jakarta.json.JsonReaderFactory");
+        cb._import("jakarta.json.JsonString");
+        cb._import("jakarta.json.JsonValue");
         cb.newLine();
 
         cb._import("com.ibm.fhir.model.parser.exception.FHIRParserException");
@@ -2900,8 +2963,6 @@ private void generateJsonParser(String basePath) {
         cb._import("com.ibm.fhir.model.type.Integer");
         cb._import("com.ibm.fhir.model.type.String");
         cb._import("com.ibm.fhir.model.util.ElementFilter");
-        cb.newLine();
-
         cb._import("net.jcip.annotations.NotThreadSafe");
         cb.newLine();
 
@@ -2909,7 +2970,7 @@ private void generateJsonParser(String basePath) {
         cb.annotation("Generated", quote("com.ibm.fhir.tools.CodeGenerator"));
         cb._class(mods("public"), "FHIRJsonParser", "FHIRAbstractParser");
         cb.field(mods("public", "static"), "boolean", "DEBUG", "false");
-        cb.field(mods("private", "static", "final"), "JsonReaderFactory", "JSON_READER_FACTORY", "Json.createReaderFactory(null)");
+        cb.field(mods("private", "static", "final"), "JsonReaderFactory", "JSON_READER_FACTORY", "Json.createReaderFactory(Collections.singletonMap(JsonConfig.REJECT_DUPLICATE_KEYS, true))");
         cb.newLine();
 
         cb.field(mods("private", "final"), "Stack<java.lang.String>", "stack", _new("Stack<>"));
@@ -2987,15 +3048,6 @@ private void generateJsonParser(String basePath) {
         .end();
         cb.newLine();
 
-        cb.override();
-        cb.method(mods("public"), "boolean", "isPropertySupported", params("java.lang.String name"))
-            ._if("FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS.equals(name)")
-                ._return("true")
-            ._end()
-            ._return("false")
-        .end();
-        cb.newLine();
-
         cb.method(mods("private"), "Resource", "parseResource", params("java.lang.String elementName", "JsonObject jsonObject", "int elementIndex"));
         cb._if("jsonObject == null");
         cb._return("null");
@@ -3188,7 +3240,7 @@ private void generateParseMethod(String generatedClassName, JsonObject structure
                 ._return("null")
             ._end();
             cb.invoke("stackPush", args("elementName", "elementIndex"));
-            cb._if("getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false")
+            cb._if("!ignoringUnrecognizedElements")
                 .invoke("checkForUnrecognizedElements", args(generatedClassName + ".class", "jsonObject"))
             ._end();
         }
@@ -3197,6 +3249,8 @@ private void generateParseMethod(String generatedClassName, JsonObject structure
             cb.assign(generatedClassName + ".Builder builder", generatedClassName + ".builder()");
         }
 
+        cb.invoke("builder", "setValidating", args("validating"));
+
         String superClass = superClassMap.get(generatedClassName);
         if (superClass != null) {
             cb.invoke("parse" + superClass, args("builder", "jsonObject"));
@@ -3273,9 +3327,11 @@ private void generatePrimitiveTypeParseMethod(String generatedClassName, JsonObj
             cb.assign(generatedClassName + ".Builder builder", generatedClassName + ".builder()");
         }
 
+        cb.invoke("builder", "setValidating", args("validating"));
+
         cb._if("_jsonValue != null && _jsonValue.getValueType() == JsonValue.ValueType.OBJECT")
             .assign("JsonObject jsonObject", "(JsonObject) _jsonValue")
-            ._if("getPropertyOrDefault(FHIRParser.PROPERTY_IGNORE_UNRECOGNIZED_ELEMENTS, java.lang.Boolean.FALSE, java.lang.Boolean.class) == false")
+            ._if("!ignoringUnrecognizedElements")
                 .invoke("checkForUnrecognizedElements", args("Element.class", "jsonObject"))
             ._end()
             .invoke("parseElement", args("builder", "jsonObject"))
@@ -3367,7 +3423,7 @@ private void generateCodeSubtypeClasses(JsonObject structureDefinition, String b
         }
     }
 
-    public void generateCodeSubtypeClass(String bindingName, String valueSet, String basePath) {
+    private void generateCodeSubtypeClass(String bindingName, String valueSet, String basePath) {
         CodeBuilder cb = new CodeBuilder();
         String packageName = "com.ibm.fhir.model.type.code";
         cb.lines(HEADER).newLine();
@@ -3510,11 +3566,7 @@ public void generateCodeSubtypeClass(String bindingName, String valueSet, String
         cb.end().newLine();
 
         cb.method(mods("public"), "Builder", "toBuilder")
-            .assign("Builder builder", "new Builder()")
-            .invoke("builder", "id", args("id"))
-            .invoke("builder", "extension", args("extension"))
-            .invoke("builder", "value", args("value"))
-            ._return("builder")
+            ._return(_new("Builder") + ".from(this)")
         .end().newLine();
 
         cb.method(mods("public", "static"), "Builder", "builder")
@@ -3566,9 +3618,32 @@ public void generateCodeSubtypeClass(String bindingName, String valueSet, String
             ._return("(value != null) ? (Builder) super.value(value.value()) : this")
         .end().newLine();
 
+        String varName = camelCase(bindingName);
+        if (SourceVersion.isKeyword(varName)) {
+            varName = "_" + varName;
+        }
+
         cb.override();
         cb.method(mods("public"), bindingName, "build")
-            ._return(_new(bindingName, args("this")))
+            .decl(bindingName, varName, _new(bindingName, args("this")))
+            ._if("validating")
+                .invoke("validate", args(varName))
+            ._end()
+            ._return(varName)
+        .end().newLine();
+
+        String paramName = camelCase(bindingName);
+        if (SourceVersion.isKeyword(paramName)) {
+            paramName = "_" + paramName;
+        }
+
+        cb.method(mods("protected"), "void", "validate", params(param(bindingName, paramName)))
+            .invoke("super", "validate", args(paramName))
+        .end().newLine();
+
+        cb.method(mods("protected"), "Builder", "from", params(param(bindingName, paramName)))
+            .invoke("super", "from", args(paramName))
+            ._return("this")
         .end();
 
         cb._end().newLine();
@@ -4087,7 +4162,7 @@ private String getFieldType(JsonObject structureDefinition, JsonObject elementDe
      *
      * @return
      */
-    public String getFieldTypeForJavaDocLink(JsonObject structureDefinition, JsonObject elementDefinition, String fieldType) {
+    private String getFieldTypeForJavaDocLink(JsonObject structureDefinition, JsonObject elementDefinition, String fieldType) {
         String path = elementDefinition.getString("path");
 
         if (isPrimitiveType(structureDefinition) && path.endsWith("value")) {
diff --git a/fhir-tools/src/test/resources/modelplugin/pom.xml b/fhir-tools/src/test/resources/modelplugin/pom.xml
index b1f88942f87..7b76db0cff5 100644
--- a/fhir-tools/src/test/resources/modelplugin/pom.xml
+++ b/fhir-tools/src/test/resources/modelplugin/pom.xml
@@ -6,7 +6,7 @@
 	<parent>
 		<groupId>com.ibm.fhir</groupId>
 		<artifactId>fhir-parent</artifactId>
-		<version>4.8.0-SNAPSHOT</version>
+		<version>4.9.0-SNAPSHOT</version>
 		<relativePath>../fhir-parent</relativePath>
 	</parent>
 
diff --git a/fhir-validation/pom.xml b/fhir-validation/pom.xml
index 3edc3b04a5b..d93db6d673a 100644
--- a/fhir-validation/pom.xml
+++ b/fhir-validation/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../fhir-parent</relativePath>
     </parent>
 
diff --git a/fhir-validation/src/main/java/com/ibm/fhir/validation/FHIRValidator.java b/fhir-validation/src/main/java/com/ibm/fhir/validation/FHIRValidator.java
index ccb58462954..78da4144350 100644
--- a/fhir-validation/src/main/java/com/ibm/fhir/validation/FHIRValidator.java
+++ b/fhir-validation/src/main/java/com/ibm/fhir/validation/FHIRValidator.java
@@ -35,19 +35,26 @@
 import com.ibm.fhir.model.type.code.IssueSeverity;
 import com.ibm.fhir.model.type.code.IssueType;
 import com.ibm.fhir.model.util.ModelSupport;
-import com.ibm.fhir.path.FHIRPathBooleanValue;
 import com.ibm.fhir.path.FHIRPathElementNode;
 import com.ibm.fhir.path.FHIRPathNode;
 import com.ibm.fhir.path.FHIRPathResourceNode;
 import com.ibm.fhir.path.FHIRPathTree;
 import com.ibm.fhir.path.evaluator.FHIRPathEvaluator;
 import com.ibm.fhir.path.evaluator.FHIRPathEvaluator.EvaluationContext;
-import com.ibm.fhir.path.function.ResolveFunction;
 import com.ibm.fhir.path.visitor.FHIRPathDefaultNodeVisitor;
 import com.ibm.fhir.profile.ProfileSupport;
 import com.ibm.fhir.registry.FHIRRegistry;
 import com.ibm.fhir.validation.exception.FHIRValidationException;
 
+import net.jcip.annotations.NotThreadSafe;
+
+/**
+ * A validator that uses conformance resources from the {@link com.ibm.fhir.registry.FHIRRegistry}
+ * to validate resource instances against the base specification and, optionally, extended profiles.
+ *
+ * The static factory method {@link #validator()} is threadsafe, but the created instances are not.
+ */
+@NotThreadSafe
 public class FHIRValidator {
     private static final Logger log = Logger.getLogger(FHIRValidator.class.getName());
 
@@ -170,7 +177,7 @@ public List<Issue> validate(EvaluationContext evaluationContext, boolean include
             throw new IllegalArgumentException("Root must be resource node");
         }
         try {
-            evaluationContext.setExternalConstant(ResolveFunction.RESOLVE_RELATIVE_REFERENCES, FHIRPathBooleanValue.TRUE);
+            evaluationContext.setResolveRelativeReferences(true);
             List<Issue> issues = new ArrayList<>();
             validateProfileReferences(evaluationContext.getTree().getRoot().asResourceNode(), Arrays.asList(profiles), false, issues);
             issues.addAll(visitor.validate(evaluationContext, includeResourceAssertedProfiles, profiles));
diff --git a/fhir-validation/src/test/java/com/ibm/fhir/validation/test/ConformsToLoopTest.java b/fhir-validation/src/test/java/com/ibm/fhir/validation/test/ConformsToLoopTest.java
new file mode 100644
index 00000000000..3fa8a737cb3
--- /dev/null
+++ b/fhir-validation/src/test/java/com/ibm/fhir/validation/test/ConformsToLoopTest.java
@@ -0,0 +1,166 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.validation.test;
+
+import static com.ibm.fhir.model.type.String.string;
+import static com.ibm.fhir.validation.util.FHIRValidationUtil.countErrors;
+import static com.ibm.fhir.validation.util.FHIRValidationUtil.hasErrors;
+import static org.testng.Assert.assertEquals;
+import static org.testng.Assert.assertFalse;
+import static org.testng.Assert.assertTrue;
+
+import java.util.ArrayList;
+import java.util.List;
+import java.util.logging.ConsoleHandler;
+import java.util.logging.Handler;
+import java.util.logging.Level;
+import java.util.logging.Logger;
+
+import org.testng.annotations.BeforeClass;
+import org.testng.annotations.Test;
+
+import com.ibm.fhir.model.resource.OperationOutcome.Issue;
+import com.ibm.fhir.model.resource.Organization;
+import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.resource.StructureDefinition;
+import com.ibm.fhir.model.type.Canonical;
+import com.ibm.fhir.model.type.ElementDefinition;
+import com.ibm.fhir.model.type.ElementDefinition.Constraint;
+import com.ibm.fhir.model.type.Id;
+import com.ibm.fhir.model.type.Meta;
+import com.ibm.fhir.model.type.Reference;
+import com.ibm.fhir.model.type.Uri;
+import com.ibm.fhir.model.type.code.ConstraintSeverity;
+import com.ibm.fhir.model.type.code.TypeDerivationRule;
+import com.ibm.fhir.path.function.ConformsToFunction;
+import com.ibm.fhir.registry.FHIRRegistry;
+import com.ibm.fhir.registry.resource.FHIRRegistryResource;
+import com.ibm.fhir.registry.util.FHIRRegistryResourceProviderAdapter;
+import com.ibm.fhir.validation.FHIRValidator;
+
+public class ConformsToLoopTest {
+    @BeforeClass
+    public void beforeClass() throws Exception {
+        configureLogging();
+
+        StructureDefinition structureDefinition = FHIRRegistry.getInstance().getResource("http://hl7.org/fhir/StructureDefinition/Organization", StructureDefinition.class);
+
+        List<ElementDefinition> element = new ArrayList<>(structureDefinition.getSnapshot().getElement());
+        element.set(indexOf(structureDefinition, "Organization"), addConstraints(getElementDefinition(structureDefinition, "Organization"),
+            Constraint.builder()
+                .key(Id.of("test-1"))
+                .severity(ConstraintSeverity.ERROR)
+                .human(string("The organization SHALL conform to the TestOrganization profile"))
+                .expression(string("conformsTo('http://ibm.com/fhir/StructureDefinition/TestOrganization')"))
+                .source(Canonical.of("http://ibm.com/fhir/StructureDefinition/TestOrganization"))
+                .build(),
+            Constraint.builder()
+                .key(Id.of("test-2"))
+                .severity(ConstraintSeverity.ERROR)
+                .human(string("The organization name length SHALL be greater than 9 characters"))
+                .expression(string("name.length() > 9"))
+                .source(Canonical.of("http://ibm.com/fhir/StructureDefinition/TestOrganization"))
+                .build()));
+        element.set(indexOf(structureDefinition, "Organization.partOf"), addConstraints(getElementDefinition(structureDefinition, "Organization.partOf"), Constraint.builder()
+            .key(Id.of("test-3"))
+            .human(string("The partOf reference SHALL resolve to an organization that conforms the TestOrganization profile"))
+            .expression(string("resolve().conformsTo('http://ibm.com/fhir/StructureDefinition/TestOrganization')"))
+            .source(Canonical.of("http://ibm.com/fhir/StructureDefinition/TestOrganization"))
+            .severity(ConstraintSeverity.ERROR)
+            .build()));
+
+        StructureDefinition profile = structureDefinition.toBuilder()
+            .url(Uri.of("http://ibm.com/fhir/StructureDefinition/TestOrganization"))
+            .baseDefinition(Canonical.of("http://hl7.org/fhir/StructureDefinition/Organization"))
+            .derivation(TypeDerivationRule.CONSTRAINT)
+            .snapshot(structureDefinition.getSnapshot().toBuilder()
+                .element(element)
+                .build())
+            .build();
+
+        FHIRRegistry.getInstance().addProvider(new FHIRRegistryResourceProviderAdapter() {
+            @Override
+            public FHIRRegistryResource getRegistryResource(Class<? extends Resource> resourceType, String url, String version) {
+                if ("http://ibm.com/fhir/StructureDefinition/TestOrganization".equals(url)) {
+                    return FHIRRegistryResource.from(profile);
+                }
+                return null;
+            }
+        });
+    }
+
+    @Test
+    public void testConformsToLoop1() throws Exception {
+        Organization organization = Organization.builder()
+            .name(string("Test Organization"))
+            .contained(Organization.builder()
+                .meta(Meta.builder()
+                    .profile(Canonical.of("http://ibm.com/fhir/StructureDefinition/TestOrganization"))
+                    .build())
+                .name(string("Child Test Organization"))
+                .partOf(Reference.builder()
+                    .reference(string("#"))
+                    .build())
+                .build())
+            .build();
+        List<Issue> issues = FHIRValidator.validator().validate(organization, true, "http://ibm.com/fhir/StructureDefinition/TestOrganization");
+        assertFalse(hasErrors(issues));
+    }
+
+    @Test
+    public void testConformsToLoop2() throws Exception {
+        Organization organization = Organization.builder()
+            .name(string("Test Organization"))
+            .contained(Organization.builder()
+                .meta(Meta.builder()
+                    .profile(Canonical.of("http://ibm.com/fhir/StructureDefinition/TestOrganization"))
+                    .build())
+                .name(string("invalid"))
+                .partOf(Reference.builder()
+                    .reference(string("#"))
+                    .build())
+                .build())
+            .build();
+        List<Issue> issues = FHIRValidator.validator().validate(organization, true, "http://ibm.com/fhir/StructureDefinition/TestOrganization");
+        assertTrue(hasErrors(issues));
+        assertEquals(countErrors(issues), 1);
+    }
+
+    private ElementDefinition addConstraints(ElementDefinition elementDefinition, Constraint... constraints) {
+        return elementDefinition.toBuilder()
+            .constraint(elementDefinition.getConstraint())
+            .constraint(constraints)
+            .build();
+    }
+
+    private void configureLogging() {
+        Logger logger = Logger.getLogger(ConformsToFunction.class.getName());
+        logger.setLevel(Level.FINEST);
+        Handler handler = new ConsoleHandler();
+        handler.setLevel(Level.FINEST);
+        logger.addHandler(handler);
+    }
+
+    private ElementDefinition getElementDefinition(StructureDefinition structureDefinition, String path) {
+        for (ElementDefinition elementDefinition : structureDefinition.getSnapshot().getElement()) {
+            if (elementDefinition.getPath().getValue().equals(path)) {
+                return elementDefinition;
+            }
+        }
+        return null;
+    }
+
+    private int indexOf(StructureDefinition structureDefinition, String path) {
+        for (int i = 0; i < structureDefinition.getSnapshot().getElement().size(); i++) {
+            ElementDefinition elementDefinition = structureDefinition.getSnapshot().getElement().get(i);
+            if (elementDefinition.getPath().getValue().equals(path)) {
+                return i;
+            }
+        }
+        return -1;
+    }
+}
diff --git a/notification/fhir-notification-kafka/pom.xml b/notification/fhir-notification-kafka/pom.xml
index a1ff1b45779..80a107e3c22 100644
--- a/notification/fhir-notification-kafka/pom.xml
+++ b/notification/fhir-notification-kafka/pom.xml
@@ -4,7 +4,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
 
diff --git a/notification/fhir-notification-kafka/src/main/java/com/ibm/fhir/notifications/kafka/impl/FHIRNotificationKafkaPublisher.java b/notification/fhir-notification-kafka/src/main/java/com/ibm/fhir/notifications/kafka/impl/FHIRNotificationKafkaPublisher.java
index 7fb142258bd..05b29f1e517 100644
--- a/notification/fhir-notification-kafka/src/main/java/com/ibm/fhir/notifications/kafka/impl/FHIRNotificationKafkaPublisher.java
+++ b/notification/fhir-notification-kafka/src/main/java/com/ibm/fhir/notifications/kafka/impl/FHIRNotificationKafkaPublisher.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2016, 2020
+ * (C) Copyright IBM Corp. 2016, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -17,6 +17,8 @@
 import org.apache.kafka.clients.producer.ProducerRecord;
 import org.apache.kafka.clients.producer.RecordMetadata;
 
+import com.ibm.fhir.config.FHIRConfigHelper;
+import com.ibm.fhir.config.FHIRConfiguration;
 import com.ibm.fhir.notification.FHIRNotificationEvent;
 import com.ibm.fhir.notification.FHIRNotificationService;
 import com.ibm.fhir.notification.FHIRNotificationSubscriber;
@@ -27,7 +29,7 @@
  * This class implements the FHIR server notification service via a Kafka topic.
  */
 public class FHIRNotificationKafkaPublisher implements FHIRNotificationSubscriber {
-    private static final Logger log = Logger.getLogger(FHIRNotificationKafkaPublisher.class.getName());
+    private static final Logger LOG = Logger.getLogger(FHIRNotificationKafkaPublisher.class.getName());
 
     private static FHIRNotificationService service = FHIRNotificationService.getInstance();
 
@@ -41,11 +43,11 @@ protected FHIRNotificationKafkaPublisher() {
     }
 
     public FHIRNotificationKafkaPublisher(String topicName, Properties kafkaProps) {
-        log.entering(this.getClass().getName(), "ctor");
+        LOG.entering(this.getClass().getName(), "ctor");
         try {
             init(topicName, kafkaProps);
         } finally {
-            log.exiting(this.getClass().getName(), "ctor");
+            LOG.exiting(this.getClass().getName(), "ctor");
         }
     }
 
@@ -53,13 +55,13 @@ public FHIRNotificationKafkaPublisher(String topicName, Properties kafkaProps) {
      * Performs any required initialization to allow us to publish events to the topic.
      */
     private void init(String topicName, Properties kafkaProps) {
-        log.entering(this.getClass().getName(), "init");
+        LOG.entering(this.getClass().getName(), "init");
         try {
             this.topicName = topicName;
             this.kafkaProps = kafkaProps;
-            if (log.isLoggable(Level.FINER)) {
-                log.finer("Kafka publisher is configured with the following properties:\n" + this.kafkaProps.toString());
-                log.finer("Topic name: " + this.topicName);
+            if (LOG.isLoggable(Level.FINER)) {
+                LOG.finer("Kafka publisher is configured with the following properties:\n" + this.kafkaProps.toString());
+                LOG.finer("Topic name: " + this.topicName);
             }
 
             // We'll hard-code some properties to ensure they are set correctly.
@@ -79,13 +81,13 @@ private void init(String topicName, Properties kafkaProps) {
             // Register this Kafka implementation as a "subscriber" with our Notification Service.
             // This means that our "notify" method will be called when the server publishes an event.
             service.subscribe(this);
-            log.info("Initialized Kafka publisher for topic '" + topicName + "' using bootstrap servers: " + bootstrapServers + ".");
+            LOG.info("Initialized Kafka publisher for topic '" + topicName + "' using bootstrap servers: " + bootstrapServers + ".");
         } catch (Throwable t) {
             String msg = "Caught exception while initializing Kafka publisher.";
-            log.log(Level.SEVERE, msg, t);
+            LOG.log(Level.SEVERE, msg, t);
             throw new IllegalStateException(msg, t);
         } finally {
-            log.exiting(this.getClass().getName(), "init");
+            LOG.exiting(this.getClass().getName(), "init");
         }
     }
 
@@ -93,43 +95,50 @@ private void init(String topicName, Properties kafkaProps) {
      * Performs any necessary "shutdown" logic to disconnect from the topic.
      */
     public void shutdown() {
-        log.entering(this.getClass().getName(), "shutdown");
+        LOG.entering(this.getClass().getName(), "shutdown");
 
         try {
-            if (log.isLoggable(Level.FINE)) {
-                log.fine("Shutting down Kafka publisher for topic: '" + topicName + "'.");
+            if (LOG.isLoggable(Level.FINE)) {
+                LOG.fine("Shutting down Kafka publisher for topic: '" + topicName + "'.");
             }
             if (producer != null) {
                 producer.close();
             }
         } finally {
-            log.exiting(this.getClass().getName(), "shutdown");
+            LOG.exiting(this.getClass().getName(), "shutdown");
         }
     }
 
     @Override
     public void notify(FHIRNotificationEvent event) throws FHIRNotificationException {
-        log.entering(this.getClass().getName(), "notify");
+        LOG.entering(this.getClass().getName(), "notify");
         String topicId = "[" + this.kafkaProps.getProperty(ProducerConfig.BOOTSTRAP_SERVERS_CONFIG) + "]/" + topicName;
         String jsonString = null;
         try {
             jsonString = FHIRNotificationUtil.toJsonString(event, true);
 
-            if (log.isLoggable(Level.FINE)) {
-                log.fine("Publishing kafka notification event to topic '" + topicId + "',\nmessage: " + jsonString);
+            if (LOG.isLoggable(Level.FINE)) {
+                LOG.fine("Publishing kafka notification event to topic '" + topicId + "',\nmessage: " + jsonString);
             }
 
-            producer.send(new ProducerRecord<String, String>(topicName, jsonString), new KafkaPublisherCallback(event, jsonString, topicId));
-
-            if (log.isLoggable(Level.FINE)) {
-                log.fine("Returned from async kafka send...");
+            boolean sync = FHIRConfigHelper.getBooleanProperty(FHIRConfiguration.PROPERTY_KAFKA_SYNC, false);
+            if (!sync) {
+                producer.send(new ProducerRecord<String, String>(topicName, jsonString), new KafkaPublisherCallback(event, jsonString, topicId));
+                if (LOG.isLoggable(Level.FINE)) {
+                    LOG.fine("Returned from async kafka send...");
+                }
+            } else {
+                RecordMetadata metadata = producer.send(new ProducerRecord<String, String>(topicName, jsonString), new KafkaPublisherCallback(event, jsonString, topicId)).get();
+                if (LOG.isLoggable(Level.FINE)) {
+                    LOG.fine("Record Produced to Topic '" + metadata.topic() + "' at time " + metadata.timestamp());
+                }
             }
         } catch (Throwable e) {
             String msg = buildNotificationErrorMessage(topicId, (jsonString == null ? "<null>" : jsonString));
-            log.log(Level.SEVERE, msg , e);
+            LOG.log(Level.SEVERE, msg , e);
             throw new FHIRNotificationException(msg, e);
         } finally {
-            log.exiting(this.getClass().getName(), "notify");
+            LOG.exiting(this.getClass().getName(), "notify");
         }
     }
 
@@ -150,22 +159,20 @@ public KafkaPublisherCallback(FHIRNotificationEvent event, String notificationEv
          */
         @Override
         public void onCompletion(RecordMetadata recordMetadata, Exception exception) {
-            log.entering(this.getClass().getName(), "onCompletion");
+            LOG.entering(this.getClass().getName(), "onCompletion");
 
             try {
                 // No exception implies that the send operation succeeded, so log an info message.
                 if (exception == null) {
-                    log.info("Successfully published kafka notification event for resource: " + event.getLocation());
-                }
-
-                // If we detected a 'send' failure, then log an error message that includes the notification message
-                // that we tried to send.
-                else {
+                    LOG.info("Successfully published kafka notification event for resource: " + event.getLocation());
+                } else {
+                    // If we detected a 'send' failure, then log an error message that includes the notification message
+                    // that we tried to send.
                     String msg = buildNotificationErrorMessage(topicId, notificationEvent);
-                    log.log(Level.SEVERE, msg, exception);
+                    LOG.log(Level.SEVERE, msg, exception);
                 }
             } finally {
-                log.exiting(this.getClass().getName(), "onCompletion");
+                LOG.exiting(this.getClass().getName(), "onCompletion");
             }
         }
     }
diff --git a/notification/fhir-notification-nats/pom.xml b/notification/fhir-notification-nats/pom.xml
index 54e73296e3b..26b0b944ffe 100644
--- a/notification/fhir-notification-nats/pom.xml
+++ b/notification/fhir-notification-nats/pom.xml
@@ -4,7 +4,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
 
diff --git a/notification/fhir-notification-websocket/pom.xml b/notification/fhir-notification-websocket/pom.xml
index e7d2fb305dc..f2426e84dd6 100644
--- a/notification/fhir-notification-websocket/pom.xml
+++ b/notification/fhir-notification-websocket/pom.xml
@@ -4,7 +4,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
 
diff --git a/operation/fhir-operation-apply/pom.xml b/operation/fhir-operation-apply/pom.xml
index 24f86c13a27..bc181607055 100644
--- a/operation/fhir-operation-apply/pom.xml
+++ b/operation/fhir-operation-apply/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     
diff --git a/operation/fhir-operation-apply/src/main/java/com/ibm/fhir/operation/apply/ApplyOperation.java b/operation/fhir-operation-apply/src/main/java/com/ibm/fhir/operation/apply/ApplyOperation.java
index 7eec3df0fd8..28c870decc2 100644
--- a/operation/fhir-operation-apply/src/main/java/com/ibm/fhir/operation/apply/ApplyOperation.java
+++ b/operation/fhir-operation-apply/src/main/java/com/ibm/fhir/operation/apply/ApplyOperation.java
@@ -14,6 +14,7 @@
 
 import javax.ws.rs.core.MultivaluedMap;
 
+import com.ibm.fhir.core.FHIRConstants;
 import com.ibm.fhir.exception.FHIROperationException;
 import com.ibm.fhir.model.resource.ActivityDefinition;
 import com.ibm.fhir.model.resource.CarePlan;
@@ -68,8 +69,7 @@ public class ApplyOperation extends AbstractOperation {
     private static final String PARAM_SETTING = "setting";
     private static final String PARAM_SETTING_CONTEXT = "settingContext";
 
-    private static final String EXTENSION_BASE_URL =
-            "http://ibm.com/fhir/extension/apply/";
+    private static final String EXTENSION_BASE_URL = FHIRConstants.EXT_BASE + "apply/";
 
     @Override
     protected OperationDefinition buildOperationDefinition() {
@@ -290,20 +290,17 @@ private CarePlan transform(PlanDefinition planDefinition, List<String> subjects,
 
         // Setting
         if (setting != null) {
-            builder.extension(Extension.builder().value(setting).url(EXTENSION_BASE_URL
-                    + "/setting").build());
+            builder.extension(Extension.builder().value(setting).url(EXTENSION_BASE_URL + "setting").build());
         }
 
         // SettingContext
         if (settingContext != null) {
-            builder.extension(Extension.builder().value(settingContext).url(EXTENSION_BASE_URL
-                    + "/settingContext").build());
+            builder.extension(Extension.builder().value(settingContext).url(EXTENSION_BASE_URL + "settingContext").build());
         }
 
         // User Type
         if (userType != null) {
-            builder.extension(Extension.builder().value(userType).url(EXTENSION_BASE_URL
-                    + "/userType").build());
+            builder.extension(Extension.builder().value(userType).url(EXTENSION_BASE_URL + "userType").build());
         }
 
         // User Language
diff --git a/operation/fhir-operation-bulkdata/pom.xml b/operation/fhir-operation-bulkdata/pom.xml
index c629023ec50..1af5a6485c4 100644
--- a/operation/fhir-operation-bulkdata/pom.xml
+++ b/operation/fhir-operation-bulkdata/pom.xml
@@ -7,7 +7,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
 
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/OperationConstants.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/OperationConstants.java
index 243b7a3a432..0238e5cebcd 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/OperationConstants.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/OperationConstants.java
@@ -23,7 +23,8 @@ public class OperationConstants {
     public static final List<String> STORAGE_TYPES =
             Collections
                     .unmodifiableList(Arrays.asList(StorageType.HTTPS.value(), StorageType.FILE.value(),
-                            StorageType.AWSS3.value(), StorageType.IBMCOS.value()));
+                            StorageType.AWSS3.value(), StorageType.IBMCOS.value(),
+                            StorageType.AZURE.value()));
     public static final List<String> STORAGE_CONTENT_ENCODING =
             Collections.unmodifiableList(Arrays.asList("text", "text/plain"));
     public static final int IMPORT_MAX_DEFAULT_INPUTS = 5;
@@ -53,6 +54,8 @@ public class OperationConstants {
     public static final List<String> FAILED_STATUS = Collections.unmodifiableList(Arrays.asList("FAILED", "ABANDONED"));
     public static final List<String> STOPPED_STATUS = Collections.unmodifiableList(Arrays.asList("STOPPED"));
 
+    public static final String FAILED_BAD_SOURCE = "FAILED_BAD_SOURCE";
+
     // Import
     public static final String PARAM_INPUT_FORMAT = "inputFormat";
     public static final String PARAM_INPUT_SOURCE = "inputSource";
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/client/BulkDataClient.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/client/BulkDataClient.java
index 245e6c48df9..82f60b5e025 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/client/BulkDataClient.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/client/BulkDataClient.java
@@ -348,7 +348,11 @@ public PollingLocationResponse status(String job) throws Exception {
                  * error?
                  * What if we couldn't connect with S3 / Cloud object store in the first place?
                  */
-                throw export.buildOperationException("The job has failed", IssueType.EXCEPTION);
+                if (OperationConstants.FAILED_BAD_SOURCE.equals(bulkExportJobExecutionResponse.getExitStatus())) {
+                    throw export.buildOperationException("A bad source input was used during a call to $import", IssueType.INVALID);
+                } else {
+                    throw export.buildOperationException("The job has failed", IssueType.EXCEPTION);
+                }
             } else if (OperationConstants.STOPPED_STATUS.contains(batchStatus)) {
                 // If the job is stopped, then restart the job.
                 baseUrl = adapter.getCoreApiBatchUrl() + "/jobinstances/" + job + "?action=restart&reusePreviousParams=true";
@@ -687,7 +691,9 @@ private PollingLocationResponse process(JobExecutionResponse response) {
         // e.g, Patient[1000,1000,200]:Observation[1000,1000,200],
         // COMPLETED means no file exported.
         String exitStatus = response.getExitStatus();
-        log.fine(response.getJobXMLName() + " " + exitStatus);
+        log.fine(() -> "The Exit Status is '" + exitStatus + "'");
+
+        // Export Jobs
         if (!"COMPLETED".equals(exitStatus) && !"bulkimportchunkjob".equals(response.getJobName())) {
             List<String> resourceTypeInfs = Arrays.asList(exitStatus.split("\\s*:\\s*"));
             List<PollingLocationResponse.Output> outputList = new ArrayList<>();
@@ -696,17 +702,19 @@ private PollingLocationResponse process(JobExecutionResponse response) {
                 String[] resourceCounts =
                         resourceTypeInf.substring(resourceTypeInf.indexOf("[") + 1, resourceTypeInf.indexOf("]")).split("\\s*,\\s*");
                 for (int i = 0; i < resourceCounts.length; i++) {
-                    String region = adapter.getStorageProviderLocation(source);
-                    String bucketName = adapter.getStorageProviderBucketName(source);
-                    String objectKey = resourceType + "_" + (i + 1);
-                    String accessKey = adapter.getStorageProviderAuthTypeHmacAccessKey(source);
-                    String secretKey = adapter.getStorageProviderAuthTypeHmacSecretKey(source);
                     boolean parquet = adapter.isStorageProviderParquetEnabled(source);
-                    boolean presigned = adapter.isStorageProviderHmacPresigned(source);
                     StorageType storageType = adapter.getStorageProviderStorageType(source);
                     String sUrl;
-                    DownloadUrl url = new DownloadUrl(baseUrl, region, bucketName, cosBucketPathPrefix, objectKey, accessKey, secretKey, parquet, presigned);
+
+                    log.fine(() -> "Storage Type is " + storageType + " " + StorageType.IBMCOS.equals(storageType) + " " + StorageType.AWSS3.equals(storageType));
                     if (StorageType.IBMCOS.equals(storageType) || StorageType.AWSS3.equals(storageType)) {
+                        String region = adapter.getStorageProviderLocation(source);
+                        String bucketName = adapter.getStorageProviderBucketName(source);
+                        String objectKey = resourceType + "_" + (i + 1);
+                        String accessKey = adapter.getStorageProviderAuthTypeHmacAccessKey(source);
+                        String secretKey = adapter.getStorageProviderAuthTypeHmacSecretKey(source);
+                        boolean presigned = adapter.isStorageProviderHmacPresigned(source);
+                        DownloadUrl url = new DownloadUrl(baseUrl, region, bucketName, cosBucketPathPrefix, objectKey, accessKey, secretKey, parquet, presigned, adapter.getS3HostStyleByStorageProvider(source));
                         sUrl = url.getUrl();
                     } else {
                         // Must be File
@@ -725,6 +733,7 @@ private PollingLocationResponse process(JobExecutionResponse response) {
             result.setOutput(outputList);
         }
 
+        // Import Jobs
         if ("bulkimportchunkjob".equals(response.getJobName())) {
             // Currently there is no output
             log.fine("Hit the case where we don't form output with counts");
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/ConfigurationAdapter.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/ConfigurationAdapter.java
index 48264030c40..418353e1ca4 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/ConfigurationAdapter.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/ConfigurationAdapter.java
@@ -9,6 +9,7 @@
 import java.util.List;
 
 import com.ibm.fhir.exception.FHIRException;
+import com.ibm.fhir.operation.bulkdata.config.s3.S3HostStyle;
 import com.ibm.fhir.operation.bulkdata.model.type.StorageType;
 
 /**
@@ -381,6 +382,7 @@ public interface ConfigurationAdapter {
      * @param provider
      * @return
      */
+    @Deprecated
     boolean isStorageProviderExportPublic(String provider);
 
     /**
@@ -497,4 +499,30 @@ public interface ConfigurationAdapter {
      * @return
      */
     int getPresignedUrlExpiry();
+
+    /**
+     * get the connection string for the azure type account with a connection string.
+     * @param provider
+     * @return
+     */
+    String getStorageProviderAuthTypeConnectionString(String provider);
+
+    /**
+     * checks the provider to see if this is an azure connection string.
+     * @param provider
+     * @return true, if connectionString
+     */
+    boolean isStorageProviderAuthTypeConnectionString(String provider);
+
+    /**
+     * @return the status of skippable updates
+     */
+    boolean enableSkippableUpdates();
+
+    /**
+     * gets the storage type
+     * @param provider
+     * @return
+     */
+    S3HostStyle getS3HostStyleByStorageProvider(String provider);
 }
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/AbstractSystemConfigurationImpl.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/AbstractSystemConfigurationImpl.java
index 21303027b70..ad882f1cbc7 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/AbstractSystemConfigurationImpl.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/AbstractSystemConfigurationImpl.java
@@ -16,6 +16,7 @@
 import com.ibm.fhir.exception.FHIRException;
 import com.ibm.fhir.operation.bulkdata.OperationConstants;
 import com.ibm.fhir.operation.bulkdata.config.ConfigurationAdapter;
+import com.ibm.fhir.operation.bulkdata.config.s3.S3HostStyle;
 import com.ibm.fhir.operation.bulkdata.model.type.StorageType;
 
 /**
@@ -352,4 +353,26 @@ public String getOperationOutcomeProvider(String provider) {
     public boolean hasStorageProvider(String storageProvider) {
         return FHIRConfigHelper.getStringProperty("fhirServer/bulkdata/storageProviders/" + storageProvider + "/type", null) != null;
     }
+
+    @Override
+    public S3HostStyle getS3HostStyleByStorageProvider(String provider) {
+        String hostSyle = FHIRConfigHelper.getStringProperty("fhirServer/bulkdata/storageProviders/" + provider + "/accessType", "path");
+        return S3HostStyle.from(hostSyle);
+    }
+
+    @Override
+    public boolean enableSkippableUpdates() {
+        return FHIRConfigHelper.getBooleanProperty("fhirServer/bulkdata/core/enableSkippableUpdates", Boolean.TRUE);
+    }
+
+    @Override
+    public String getStorageProviderAuthTypeConnectionString(String provider) {
+        return FHIRConfigHelper.getStringProperty("fhirServer/bulkdata/storageProviders/" + provider + "/auth/connection", null);
+    }
+
+    @Override
+    public boolean isStorageProviderAuthTypeConnectionString(String provider) {
+        String auth = getStorageProviderAuthType(provider);
+        return "connection".equalsIgnoreCase(auth);
+    }
 }
\ No newline at end of file
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/LegacyConfigurationImpl.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/LegacyConfigurationImpl.java
index fda6ffd9584..1ac5e7c3e02 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/LegacyConfigurationImpl.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/LegacyConfigurationImpl.java
@@ -187,7 +187,7 @@ public boolean shouldStorageProviderValidateBaseUrl(String provider) {
 
     @Override
     public boolean isStorageProviderExportPublic(String provider) {
-        return FHIRConfigHelper.getBooleanProperty("fhirServer/bulkdata/isExportPublic", Boolean.FALSE);
+        return false;
     }
 
     @Override
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/V2ConfigurationImpl.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/V2ConfigurationImpl.java
index b9ae4afed6b..488e1cb26a8 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/V2ConfigurationImpl.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/impl/V2ConfigurationImpl.java
@@ -147,7 +147,7 @@ public boolean shouldStorageProviderValidateBaseUrl(String provider) {
 
     @Override
     public boolean isStorageProviderExportPublic(String provider) {
-        return FHIRConfigHelper.getBooleanProperty("fhirServer/bulkdata/storageProviders/" + provider + "/exportPublic", Boolean.FALSE);
+        return false;
     }
 
     @Override
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/preflight/impl/S3Preflight.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/preflight/impl/S3Preflight.java
index 9f70c4fdfc3..6fdf17b63b9 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/preflight/impl/S3Preflight.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/preflight/impl/S3Preflight.java
@@ -105,6 +105,8 @@ public void validate(String source) throws FHIROperationException {
             if (user == null || password == null || user.isEmpty() || password.isEmpty()) {
                 throw export.buildOperationException("bad configuration for the basic configuration", IssueType.EXCEPTION);
             }
+        } else if (adapter.getStorageProviderBucketName(source) == null || adapter.getStorageProviderBucketName(source).isEmpty()) {
+            throw export.buildOperationException("bad configuration for the basic configuration with bucketname", IssueType.EXCEPTION);
         } else {
             throw export.buildOperationException("Failed to specify the source or outcome bucket's authentication mechanism", IssueType.EXCEPTION);
         }
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/s3/S3HostStyle.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/s3/S3HostStyle.java
new file mode 100644
index 00000000000..735f18ac259
--- /dev/null
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/config/s3/S3HostStyle.java
@@ -0,0 +1,35 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.operation.bulkdata.config.s3;
+
+/**
+ * There are two types of hosts virtual-host and path.
+ * @see https://docs.aws.amazon.com/AmazonS3/latest/userguide/access-bucket-intro.html
+ */
+public enum S3HostStyle {
+    PATH("path"),
+    VIRTUAL_HOST("host");
+
+    private final String value;
+
+    S3HostStyle(String value) {
+        this.value = value;
+    }
+
+    public String value() {
+        return value;
+    }
+
+    public static S3HostStyle from(String value) {
+        for (S3HostStyle c : S3HostStyle.values()) {
+            if (c.value.equals(value)) {
+                return c;
+            }
+        }
+        throw new IllegalArgumentException(value);
+    }
+}
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobExecutionResponse.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobExecutionResponse.java
index 0f6b1419546..d9b7af0d7c9 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobExecutionResponse.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobExecutionResponse.java
@@ -17,14 +17,14 @@
 import java.util.ListIterator;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIROperationException;
 import com.ibm.fhir.operation.bulkdata.model.type.Input;
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobInstanceRequest.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobInstanceRequest.java
index b98e99cc396..ccb52d1fa41 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobInstanceRequest.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobInstanceRequest.java
@@ -14,12 +14,12 @@
 import java.util.List;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIROperationException;
 import com.ibm.fhir.operation.bulkdata.model.type.Input;
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobInstanceResponse.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobInstanceResponse.java
index aa279644409..f0ae581030e 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobInstanceResponse.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/JobInstanceResponse.java
@@ -17,14 +17,14 @@
 import java.util.ListIterator;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIROperationException;
 
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/PollingLocationResponse.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/PollingLocationResponse.java
index d4f66f5cd79..e44fb7da5f4 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/PollingLocationResponse.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/PollingLocationResponse.java
@@ -12,9 +12,9 @@
 import java.util.List;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.config.FHIRConfigHelper;
 import com.ibm.fhir.config.FHIRConfiguration;
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/BulkDataSource.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/BulkDataSource.java
index 228b531f65e..0d2d5d1a16c 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/BulkDataSource.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/BulkDataSource.java
@@ -13,6 +13,7 @@ public class BulkDataSource {
 
     private String type;
     private String url;
+    private String originalLocation = "";
 
     public BulkDataSource(String type, String url) {
         super();
@@ -36,8 +37,16 @@ public void setUrl(String url) {
         this.url = url;
     }
 
+    public String getOriginalLocation() {
+        return originalLocation;
+    }
+
+    public void setOriginalLocation(String originalLocation) {
+        this.originalLocation = originalLocation;
+    }
+
     @Override
     public String toString() {
-        return "BulkDataSource [type=" + type + ", url=" + url + "]";
+        return "BulkDataSource [type=" + type + ", url=" + url + ", originalLocation=" + originalLocation + "]";
     }
-}
+}
\ No newline at end of file
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/JobParameter.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/JobParameter.java
index a8e556268e5..48e68835872 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/JobParameter.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/JobParameter.java
@@ -18,14 +18,14 @@
 import java.util.ListIterator;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.JsonArray;
-import javax.json.JsonObject;
-import javax.json.JsonReader;
-import javax.json.JsonReaderFactory;
-import javax.json.JsonValue;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
+import jakarta.json.Json;
+import jakarta.json.JsonArray;
+import jakarta.json.JsonObject;
+import jakarta.json.JsonReader;
+import jakarta.json.JsonReaderFactory;
+import jakarta.json.JsonValue;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
 
 import com.ibm.fhir.exception.FHIROperationException;
 
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/OperationFields.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/OperationFields.java
index f1e452cf3b5..76eb25ad3c4 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/OperationFields.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/OperationFields.java
@@ -23,7 +23,13 @@ public final class OperationFields {
 
     // Partition
     public static final String PARTITION_RESOURCETYPE = "partition.resourcetype";
-    public static final String PARTITTION_WORKITEM = "partition.workitem";
+    public static final String PARTITION_WORKITEM = "partition.workitem";
+    /*
+     * Used to identify the original file imported when it matrixes to segments
+     * e.g. original import file is Patient.ndjson matrixes to
+     * Patient.ndjson_seg0, Patient.ndjson_seg1 which are individual partitions.
+     */
+    public static final String PARTITION_MATRIX = "partition.matrix";
 
     // Parameters
     public static final String FHIR_SEARCH_FROM_DATE = "fhir.search.fromdate";
@@ -90,5 +96,4 @@ public final class OperationFields {
 
     public static final String IMPORT_INPUT_RESOURCE_TYPE = "type";
     public static final String IMPORT_INPUT_RESOURCE_URL = "url";
-
 }
\ No newline at end of file
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/StorageType.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/StorageType.java
index 9df023f9150..8c5ed4e4e2c 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/StorageType.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/type/StorageType.java
@@ -10,8 +10,9 @@ public enum StorageType {
     HTTPS("https"),
     FILE("file"),
     AWSS3("aws-s3"),
-    IBMCOS("ibm-cos");
-    // We don't yet support gcp-bucket, azure-blob.
+    IBMCOS("ibm-cos"),
+    AZURE("azure-blob");
+    // We don't yet support gcp-bucket.
 
     private final String value;
 
diff --git a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/url/DownloadUrl.java b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/url/DownloadUrl.java
index a2a5f27ae38..278e79a6f57 100644
--- a/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/url/DownloadUrl.java
+++ b/operation/fhir-operation-bulkdata/src/main/java/com/ibm/fhir/operation/bulkdata/model/url/DownloadUrl.java
@@ -20,6 +20,7 @@
 import javax.ws.rs.HttpMethod;
 
 import com.ibm.fhir.operation.bulkdata.config.ConfigurationFactory;
+import com.ibm.fhir.operation.bulkdata.config.s3.S3HostStyle;
 
 /**
  * Based on the IBM Cloud Documentation
@@ -43,9 +44,10 @@ public class DownloadUrl {
     private String secretKey = null;
     private boolean parquet = false;
     private boolean presigned = false;
+    private boolean path = true;
     private ZonedDateTime time = ZonedDateTime.now(ZoneOffset.UTC);
 
-    public DownloadUrl(String server, String region, String bucketName, String cosBucketPathPrefix, String objectKey, String accessKey, String secretKey, boolean parquet, boolean presigned) {
+    public DownloadUrl(String server, String region, String bucketName, String cosBucketPathPrefix, String objectKey, String accessKey, String secretKey, boolean parquet, boolean presigned, S3HostStyle hostStyle) {
         this.server = server;
         this.region = region;
         this.bucketName = bucketName;
@@ -55,6 +57,7 @@ public DownloadUrl(String server, String region, String bucketName, String cosBu
         this.secretKey = secretKey;
         this.parquet = parquet;
         this.presigned = presigned;
+        this.path = S3HostStyle.PATH.equals(hostStyle);
     }
 
     /*
@@ -88,8 +91,10 @@ public String getUnsignedUrl() {
         builder.append(server);
         builder.append('/');
         builder.append(bucketName);
-        builder.append('/');
-        builder.append(cosBucketPathPrefix);
+        if (path) {
+            builder.append('/');
+            builder.append(cosBucketPathPrefix);
+        }
         builder.append('/');
         builder.append(objectKey);
         if(parquet) {
@@ -119,10 +124,15 @@ public String getSignedUrl() throws Exception {
                 "&X-Amz-Expires=" + expirySeconds +
                 "&X-Amz-SignedHeaders=host";
 
-        String standardizedResource = "/" + bucketName + "/" + cosBucketPathPrefix + "/"+ objectKey;
+        // VirtualHost/Path - we inline the bucket if it's path based access.
+        String bucketResource = "";
+        if (path) {
+            bucketResource = "/" + bucketName;
+        }
+        String standardizedResource = bucketResource + "/" + cosBucketPathPrefix + "/"+ objectKey;
 
         String payloadHash = "UNSIGNED-PAYLOAD";
-        String standardizedHeaders = "host:" + server.replaceAll("https://", "");
+        String standardizedHeaders = "host:" + server.replace("https://", "");
         String signedHeaders = "host";
 
         String standardizedRequest = HTTP_METHOD + "\n" +
@@ -145,9 +155,15 @@ public String getSignedUrl() throws Exception {
         byte[] signatureKey = createSignatureKey(secretKey, datestamp, region, "s3");
         String signature = toHexString(hash(signatureKey, sts));
 
+        // There are two styles of endpoint - virtual host and path.
+        // we now selectively generate the externalURL for the virtualhost endpoint.
+        String bucketSegment = "";
+        if (path) {
+            bucketSegment = bucketName + "/";
+        }
         // create and send the request
         return server + "/" +
-                bucketName + "/" +
+                bucketSegment +
                 cosBucketPathPrefix + "/" +
                 objectKey + "?" +
                 standardizedQuerystring +
diff --git a/operation/fhir-operation-bulkdata/src/test/java/com/ibm/fhir/operation/bulkdata/model/PollingLocationResponseTest.java b/operation/fhir-operation-bulkdata/src/test/java/com/ibm/fhir/operation/bulkdata/model/PollingLocationResponseTest.java
index 24dc0a04da9..f8778a85e5e 100644
--- a/operation/fhir-operation-bulkdata/src/test/java/com/ibm/fhir/operation/bulkdata/model/PollingLocationResponseTest.java
+++ b/operation/fhir-operation-bulkdata/src/test/java/com/ibm/fhir/operation/bulkdata/model/PollingLocationResponseTest.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2019, 2020
+ * (C) Copyright IBM Corp. 2019, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -17,15 +17,15 @@
 import java.util.List;
 import java.util.Map;
 
-import javax.json.Json;
-import javax.json.stream.JsonGenerator;
-import javax.json.stream.JsonGeneratorFactory;
-
 import org.testng.annotations.Test;
 
 import com.ibm.fhir.model.type.Instant;
 import com.ibm.fhir.operation.bulkdata.model.PollingLocationResponse.Output;
 
+import jakarta.json.Json;
+import jakarta.json.stream.JsonGenerator;
+import jakarta.json.stream.JsonGeneratorFactory;
+
 /**
  * Simple Test for the Rough Response defined in the BulkData Export
  */
@@ -41,7 +41,7 @@ public void testOuptutSerialization() throws IOException {
         PollingLocationResponse.Output output = new PollingLocationResponse.Output("test1", "test2", "3", "test4");
         String actual = null;
         String expected =
-                "\n{\n" + "    \"type\": \"test1\",\n" + "    \"url\": \"test2\",\n" + "    \"count\": 3,\n"
+                "{\n" + "    \"type\": \"test1\",\n" + "    \"url\": \"test2\",\n" + "    \"count\": 3,\n"
                         + "    \"inputUrl\": \"test4\"\n" + "}";
         try (StringWriter writerx = new StringWriter();) {
             try (JsonGenerator generator = PRETTY_PRINTING_GENERATOR_FACTORY.createGenerator(writerx);) {
@@ -59,7 +59,7 @@ public void testOuptutSerialization() throws IOException {
         output.setType("OperationOutcome");
 
         expected =
-                "\n{\n" + "    \"type\": \"OperationOutcome\",\n" + "    \"url\": \"3\",\n" + "    \"count\": 1,\n"
+                "{\n" + "    \"type\": \"OperationOutcome\",\n" + "    \"url\": \"3\",\n" + "    \"count\": 1,\n"
                         + "    \"inputUrl\": \"2\"\n" + "}";
         try (StringWriter writerx = new StringWriter();) {
             try (JsonGenerator generator = PRETTY_PRINTING_GENERATOR_FACTORY.createGenerator(writerx);) {
@@ -73,7 +73,7 @@ public void testOuptutSerialization() throws IOException {
         // Test $export
         output.setInputUrl(null);
         expected =
-                "\n" + "{\n" + "    \"type\": \"OperationOutcome\",\n" + "    \"url\": \"3\",\n"
+                "{\n" + "    \"type\": \"OperationOutcome\",\n" + "    \"url\": \"3\",\n"
                         + "    \"count\": 1\n" + "}";
         try (StringWriter writerx = new StringWriter();) {
             try (JsonGenerator generator = PRETTY_PRINTING_GENERATOR_FACTORY.createGenerator(writerx);) {
@@ -87,7 +87,7 @@ public void testOuptutSerialization() throws IOException {
         // Test $export
         output   = new PollingLocationResponse.Output("test1", "test2", "3");
         expected =
-                "\n" + "{\n" + "    \"type\": \"test1\",\n" + "    \"url\": \"test2\",\n" + "    \"count\": 3\n"
+                "{\n" + "    \"type\": \"test1\",\n" + "    \"url\": \"test2\",\n" + "    \"count\": 3\n"
                         + "}";
         try (StringWriter writerx = new StringWriter();) {
             try (JsonGenerator generator = PRETTY_PRINTING_GENERATOR_FACTORY.createGenerator(writerx);) {
@@ -102,7 +102,7 @@ public void testOuptutSerialization() throws IOException {
 
         // Empty
         output   = new PollingLocationResponse.Output(null, null, null);
-        expected = "\n{\n}";
+        expected = "{\n}";
         try (StringWriter writerx = new StringWriter();) {
             try (JsonGenerator generator = PRETTY_PRINTING_GENERATOR_FACTORY.createGenerator(writerx);) {
                 PollingLocationResponse.Output.Writer.generate(generator, output);
@@ -116,7 +116,7 @@ public void testOuptutSerialization() throws IOException {
     @Test
     public void testResponseMetadataJsonEmpty() throws IOException {
         PollingLocationResponse metadata = new PollingLocationResponse();
-        assertEquals(PollingLocationResponse.Writer.generate(metadata), "\n" + "{\n" + "}");
+        assertEquals(PollingLocationResponse.Writer.generate(metadata), "{\n" + "}");
     }
 
     @Test
@@ -130,7 +130,7 @@ public void testResponseMetadataJsonFull() throws IOException {
         assertEquals(
                 PollingLocationResponse.Writer.generate(metadata)
                         .replaceFirst(s, ""),
-                "\n" + "{\n" + "    \"transactionTime\": \"\",\n"
+                "{\n" + "    \"transactionTime\": \"\",\n"
                         + "    \"request\": \"request\",\n" + "    \"requiresAccessToken\": false\n" + "}");
     }
 
@@ -162,7 +162,7 @@ public void testResponseMetadataJsonFullWithOutput() throws IOException {
         assertEquals(
                 PollingLocationResponse.Writer.generate(metadata)
                         .replaceFirst(s, ""),
-                "\n" + "{\n" + "    \"transactionTime\": \"\",\n"
+                "{\n" + "    \"transactionTime\": \"\",\n"
                         + "    \"request\": \"request\",\n" + "    \"requiresAccessToken\": false,\n"
                         + "    \"output\": [\n" + "        {\n" + "            \"type\": \"type\",\n"
                         + "            \"url\": \"url\",\n" + "            \"count\": 1000\n" + "        },\n"
@@ -204,7 +204,7 @@ public void testResponseMetadataJsonFullWithOutputAndError() throws IOException
         assertEquals(
                 PollingLocationResponse.Writer.generate(metadata)
                         .replaceFirst(s, ""),
-                "\n" + "{\n" + "    \"transactionTime\": \"\",\n"
+                "{\n" + "    \"transactionTime\": \"\",\n"
                         + "    \"request\": \"request\",\n" + "    \"requiresAccessToken\": false,\n"
                         + "    \"output\": [\n" + "        {\n" + "            \"type\": \"type\",\n"
                         + "            \"url\": \"url\",\n" + "            \"count\": 1000\n" + "        },\n"
diff --git a/operation/fhir-operation-convert/pom.xml b/operation/fhir-operation-convert/pom.xml
index 8aa2b84934a..902c8a9493e 100644
--- a/operation/fhir-operation-convert/pom.xml
+++ b/operation/fhir-operation-convert/pom.xml
@@ -8,7 +8,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
 
diff --git a/operation/fhir-operation-document/pom.xml b/operation/fhir-operation-document/pom.xml
index 8b6fa85e1ef..4d1d9c68f0a 100644
--- a/operation/fhir-operation-document/pom.xml
+++ b/operation/fhir-operation-document/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     
diff --git a/operation/fhir-operation-erase/pom.xml b/operation/fhir-operation-erase/pom.xml
index ab069331f00..bae4e2e0f0e 100644
--- a/operation/fhir-operation-erase/pom.xml
+++ b/operation/fhir-operation-erase/pom.xml
@@ -7,7 +7,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
 
diff --git a/operation/fhir-operation-everything/pom.xml b/operation/fhir-operation-everything/pom.xml
index cd469e02e16..316b50a4aca 100644
--- a/operation/fhir-operation-everything/pom.xml
+++ b/operation/fhir-operation-everything/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     
diff --git a/operation/fhir-operation-everything/src/main/java/com/ibm/fhir/operation/everything/EverythingOperation.java b/operation/fhir-operation-everything/src/main/java/com/ibm/fhir/operation/everything/EverythingOperation.java
index 11b5b77da7d..49fecd992c1 100644
--- a/operation/fhir-operation-everything/src/main/java/com/ibm/fhir/operation/everything/EverythingOperation.java
+++ b/operation/fhir-operation-everything/src/main/java/com/ibm/fhir/operation/everything/EverythingOperation.java
@@ -151,6 +151,18 @@ protected OperationDefinition buildOperationDefinition() {
     protected Parameters doInvoke(FHIROperationContext operationContext, Class<? extends Resource> resourceType, String logicalId, String versionId, Parameters parameters, FHIRResourceHelpers resourceHelper) throws FHIROperationException {
         LOG.entering(this.getClass().getName(), "doInvoke");
 
+        /* Per the specification, If there is no nominated patient (GET /Patient/$everything) and the context is not associated with a single patient record,
+         * the actual list of patients is all patients that the user associated with the request has access to. This may be all patients
+         * in the family that the patient has access to, or it may be all patients that a care provider has access to, or all patients
+         * on the entire record system. In such cases, the server may choose to return an error rather than all the records.
+         *
+         * @implNote we do not currently support it. However, if we do, we can use Patient?link=Patient/<SmartLaunch Context Patient ID>
+         * @see Issue #2402 for more details.
+         */
+        if (logicalId == null) {
+            throw buildExceptionWithIssue("Search for Patients the Patient is related to is not supported", IssueType.NOT_SUPPORTED);
+        }
+
         Patient patient = null;
         try {
             patient = (Patient) resourceHelper.doRead(PATIENT, logicalId, false, false, null).getResource();
@@ -358,4 +370,4 @@ private static Uri uri(FHIROperationContext operationContext, String uriPath) {
                 .value(requestBaseURI + "/" + uriPath)
                 .build();
     }
-}
\ No newline at end of file
+}
diff --git a/operation/fhir-operation-healthcheck/pom.xml b/operation/fhir-operation-healthcheck/pom.xml
index 2310ea2647c..6c073702407 100644
--- a/operation/fhir-operation-healthcheck/pom.xml
+++ b/operation/fhir-operation-healthcheck/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     
diff --git a/operation/fhir-operation-reindex/pom.xml b/operation/fhir-operation-reindex/pom.xml
index 6e3a13bce39..9f47b0061aa 100644
--- a/operation/fhir-operation-reindex/pom.xml
+++ b/operation/fhir-operation-reindex/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     
diff --git a/operation/fhir-operation-reindex/src/main/java/com/ibm/fhir/operation/reindex/ReindexOperation.java b/operation/fhir-operation-reindex/src/main/java/com/ibm/fhir/operation/reindex/ReindexOperation.java
index b1e68cd42bc..0250367bade 100644
--- a/operation/fhir-operation-reindex/src/main/java/com/ibm/fhir/operation/reindex/ReindexOperation.java
+++ b/operation/fhir-operation-reindex/src/main/java/com/ibm/fhir/operation/reindex/ReindexOperation.java
@@ -1,5 +1,5 @@
 /*
- * (C) Copyright IBM Corp. 2020
+ * (C) Copyright IBM Corp. 2020, 2021
  *
  * SPDX-License-Identifier: Apache-2.0
  */
@@ -26,6 +26,7 @@
 import com.ibm.fhir.model.resource.Resource;
 import com.ibm.fhir.model.type.code.IssueSeverity;
 import com.ibm.fhir.model.type.code.IssueType;
+import com.ibm.fhir.model.util.ModelSupport;
 import com.ibm.fhir.server.operation.spi.AbstractOperation;
 import com.ibm.fhir.server.operation.spi.FHIROperationContext;
 import com.ibm.fhir.server.operation.spi.FHIRResourceHelpers;
@@ -71,7 +72,7 @@ protected Parameters doInvoke(FHIROperationContext operationContext, Class<? ext
         // Allow only POST because we're changing the state of the database
         String method = (String) operationContext.getProperty(FHIROperationContext.PROPNAME_METHOD_TYPE);
         if (!"POST".equalsIgnoreCase(method)) {
-            throw new FHIROperationException("HTTP method not supported: " + method);
+            throw FHIROperationUtil.buildExceptionWithIssue("HTTP method not supported: " + method, IssueType.NOT_SUPPORTED);
         }
 
         try {
@@ -79,6 +80,15 @@ protected Parameters doInvoke(FHIROperationContext operationContext, Class<? ext
             int resourceCount = 10;
             String resourceLogicalId = null;
 
+            boolean hasSpecificResourceType = false;
+            if (resourceType != null) {
+                resourceLogicalId = resourceType.getSimpleName();
+                if (logicalId != null) {
+                    resourceLogicalId +=  "/" + logicalId;
+                }
+                hasSpecificResourceType = true;
+            }
+
             if (parameters != null) {
                 for (Parameters.Parameter parameter : parameters.getParameter()) {
                     if (parameter.getValue() != null && logger.isLoggable(Level.FINE)) {
@@ -90,7 +100,6 @@ protected Parameters doInvoke(FHIROperationContext operationContext, Class<? ext
                             && parameter.getValue().is(com.ibm.fhir.model.type.String.class)) {
                         String val = parameter.getValue().as(com.ibm.fhir.model.type.String.class).getValue();
 
-
                         if (val.length() == 10) {
                             tstamp = DAY_FORMAT.parse(val, Instant::from);
                         } else {
@@ -101,14 +110,25 @@ protected Parameters doInvoke(FHIROperationContext operationContext, Class<? ext
                         Integer val = parameter.getValue().as(com.ibm.fhir.model.type.Integer.class).getValue();
                         if (val != null) {
                             if (val > MAX_RESOURCE_COUNT) {
-                                logger.info("Clamping resourceCount " + val + " to max allowed: " + MAX_RESOURCE_COUNT);
+                                logger.info("Clamping resourceCount '" + val + "' to max allowed: " + MAX_RESOURCE_COUNT);
                                 val = MAX_RESOURCE_COUNT;
                             }
                             resourceCount = val;
                         }
                     } else if (PARAM_RESOURCE_LOGICAL_ID.equals(parameter.getName().getValue())) {
-                        // reindex a specific resource (useful for debug/testing)
+                        if (hasSpecificResourceType) {
+                            throw FHIROperationUtil.buildExceptionWithIssue("resourceLogicalId already specified using call to Operation on Type or Instance", IssueType.INVALID);
+                        }
+                        // reindex a specific resource or resourceType
                         resourceLogicalId = parameter.getValue().as(com.ibm.fhir.model.type.String.class).getValue();
+                        String rt = resourceLogicalId;
+                        if (resourceLogicalId.contains("/")) {
+                            String[] parts = resourceLogicalId.split("/");
+                            rt = parts[0];
+                        }
+                        if (!ModelSupport.isConcreteResourceType(rt)) {
+                            throw FHIROperationUtil.buildExceptionWithIssue("ResourceType is not valid", IssueType.INVALID);
+                        }
                     }
                 }
             }
@@ -125,12 +145,18 @@ protected Parameters doInvoke(FHIROperationContext operationContext, Class<? ext
             if (totalProcessed == 0) {
                 // must have at least one issue for a valid OperationOutcome resource
                 final String diag = "Reindex complete";
-                result.issue(Issue.builder().code(IssueType.INFORMATIONAL).severity(IssueSeverity.INFORMATION).diagnostics(com.ibm.fhir.model.type.String.of(diag)).build());
+                result.issue(Issue.builder()
+                    .code(IssueType.INFORMATIONAL)
+                    .severity(IssueSeverity.INFORMATION)
+                    .diagnostics(com.ibm.fhir.model.type.String.of(diag))
+                    .build());
             }
 
             OperationOutcome operationOutcome = result.build();
             checkOperationOutcome(operationOutcome);
             return FHIROperationUtil.getOutputParameters(operationOutcome);
+        } catch (java.time.format.DateTimeParseException dtpe) {
+            throw FHIROperationUtil.buildExceptionWithIssue("Invalid format for 'tstamp' value, only 'yyyy-MM-dd' or ISO 8601 dateTime format is valid", IssueType.INVALID);
         } catch (FHIROperationException e) {
             throw e;
         } catch (Throwable t) {
diff --git a/operation/fhir-operation-reindex/src/main/resources/reindex.json b/operation/fhir-operation-reindex/src/main/resources/reindex.json
index 73b181597a7..237c1e9cb17 100644
--- a/operation/fhir-operation-reindex/src/main/resources/reindex.json
+++ b/operation/fhir-operation-reindex/src/main/resources/reindex.json
@@ -1,45 +1,49 @@
 {
-	"resourceType": "OperationDefinition",
-	"id": "reindex",
-	"text": {
-		"status": "generated",
-		"div": "<div xmlns='http://www.w3.org/1999/xhtml'><h2>Reindex</h2><p>OPERATION: Reindex existing resources in the database</p><p>The reindex operation reads resources from the database and extracts and stores search parameters according to the latest configuration of the server.</p><p>URL: [base]/$reindex</p><p>Parameters</p><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>OUT</td><td>return</td><td>1..1</td><td>OperationOutcome</td><td/><td><p>If the operation outcome does not list any errors, then the server expected to be healthy.</p></td></tr></table></div>"
-	  },
-	"url": "http://ibm.com/fhir/OperationDefinition/reindex",
-	"name": "Reindex",
-	"status": "draft",
-	"kind": "operation",
-	"publisher": "IBM FHIR Server",
-	"date": "2020-10-05",
-	"description": "The reindex operation recomputes and stores search parameters.",
-	"code": "reindex",
-	"system": true,
-	"type": false,
-	"instance": false,
-        "parameter": [
-          {
+    "resourceType": "OperationDefinition",
+    "id": "reindex",
+    "text": {
+        "status": "generated",
+        "div": "<div xmlns='http://www.w3.org/1999/xhtml'><h2>Reindex</h2><p>OPERATION: Reindex existing resources in the database</p><p>The reindex operation reads resources from the database and extracts and stores search parameters according to the latest configuration of the server.</p><p>URL: [base]/$reindex</p><p>Parameters</p><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>OUT</td><td>return</td><td>1..1</td><td>OperationOutcome</td><td/><td><p>If the operation outcome does not list any errors, then the server expected to be healthy.</p></td></tr></table></div>"
+    },
+    "url": "http://ibm.com/fhir/OperationDefinition/reindex",
+    "name": "reindex",
+    "status": "draft",
+    "kind": "operation",
+    "publisher": "IBM FHIR Server",
+    "date": "2021-06-14",
+    "description": "The reindex operation recomputes and stores search parameters.",
+    "code": "reindex",
+    "system": true,
+    "type": true,
+    "instance": true,
+    "resource": [
+        "Resource"
+    ],
+    "affectsState": true,
+    "parameter": [
+        {
             "name": "resourceCount",
             "use": "in",
             "min": 0,
             "max": "1",
             "documentation": "The maximum number of resources to reindex in this call. If this number is too large, the processing time might exceed the transaction timeout and fail.",
             "type": "integer"
-          },
-          {
+        },
+        {
             "name": "tstamp",
             "use": "in",
             "min": 0,
             "max": "1",
             "documentation": "Reindex any resource not previously reindexed before this timestamp. Format as a date YYYY-MM-DD or time YYYY-MM-DDTHH:MM:DDZ.",
             "type": "string"
-          },
-          {
+        },
+        {
             "name": "resourceLogicalId",
             "use": "in",
             "min": 0,
             "max": "1",
             "documentation": "Reindex only the specified resource or resources of the given resource type when no id is provided. Format as Patient/abc123 or Patient",
             "type": "string"
-          }
-        ]
+        }
+    ]
 }
\ No newline at end of file
diff --git a/operation/fhir-operation-term-cache/README.md b/operation/fhir-operation-term-cache/README.md
new file mode 100644
index 00000000000..a882bb6d094
--- /dev/null
+++ b/operation/fhir-operation-term-cache/README.md
@@ -0,0 +1,7 @@
+The FHIR terminology subsystem assumes that artifacts with the same canonical URL and version are stable and thus can be stored in long-living cache space. If there is a need to iterate the content of a CodeSystem or ValueSet resource without updating the business version, additional operations are needed to clear the cache.
+
+If you are in development mode and always want to reload data, the simplest mechanism is to use the `fhirServer/term/disableCaching`  configuration option. If you are in a hybrid or production mode and require both caching and dynamic content updates, the operations in this module can be used to clear specific cached resources.
+
+This module introduces a $clear-cache operation on the ValueSet and CodeSystem resources. Depending on the type of resource being changed, one or the other or both may need to be called in order to completely clear the cache. For instance, an intensional ValueSet that depends on a server CodeSystem resource, will require a call to both ValueSet/$clear-cache and CodeSystem/$clear-cache.
+
+FHIR terminology caching is done on a per-JVM, per-tenant basis, so the clear-cache operations must be called on every relevant tenant of every member of a FHIR server cluster after data changes are made.
diff --git a/operation/fhir-operation-term-cache/pom.xml b/operation/fhir-operation-term-cache/pom.xml
new file mode 100644
index 00000000000..6b4cafb55d0
--- /dev/null
+++ b/operation/fhir-operation-term-cache/pom.xml
@@ -0,0 +1,29 @@
+<project xmlns="http://maven.apache.org/POM/4.0.0"
+    xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
+    xsi:schemaLocation="http://maven.apache.org/POM/4.0.0 http://maven.apache.org/xsd/maven-4.0.0.xsd">
+    <modelVersion>4.0.0</modelVersion>
+    <parent>
+        <groupId>com.ibm.fhir</groupId>
+        <artifactId>fhir-parent</artifactId>
+        <version>4.9.0-SNAPSHOT</version>
+        <relativePath>../../fhir-parent</relativePath>
+    </parent>
+    <artifactId>fhir-operation-term-cache</artifactId>
+    <dependencies>
+        <dependency>
+            <groupId>${project.groupId}</groupId>
+            <artifactId>fhir-term</artifactId>
+            <version>${project.version}</version>
+        </dependency>
+        <dependency>
+            <groupId>${project.groupId}</groupId>
+            <artifactId>fhir-server</artifactId>
+            <version>${project.version}</version>
+        </dependency>
+        <dependency>
+            <groupId>${project.groupId}</groupId>
+            <artifactId>fhir-operation-term</artifactId>
+            <version>${project.version}</version>
+        </dependency>
+    </dependencies>
+</project>
diff --git a/operation/fhir-operation-term-cache/src/main/java/com/ibm/fhir/operation/term/cache/CodeSystemClearCacheOperation.java b/operation/fhir-operation-term-cache/src/main/java/com/ibm/fhir/operation/term/cache/CodeSystemClearCacheOperation.java
new file mode 100644
index 00000000000..5cf46c7d125
--- /dev/null
+++ b/operation/fhir-operation-term-cache/src/main/java/com/ibm/fhir/operation/term/cache/CodeSystemClearCacheOperation.java
@@ -0,0 +1,97 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.operation.term.cache;
+
+import java.io.InputStream;
+
+import com.ibm.fhir.cache.CacheKey;
+import com.ibm.fhir.cache.CacheManager;
+import com.ibm.fhir.config.FHIRRequestContext;
+import com.ibm.fhir.core.HTTPReturnPreference;
+import com.ibm.fhir.exception.FHIROperationException;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.parser.FHIRParser;
+import com.ibm.fhir.model.resource.CodeSystem;
+import com.ibm.fhir.model.resource.OperationDefinition;
+import com.ibm.fhir.model.resource.OperationOutcome;
+import com.ibm.fhir.model.resource.Parameters;
+import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.type.Code;
+import com.ibm.fhir.model.type.CodeableConcept;
+import com.ibm.fhir.model.type.Coding;
+import com.ibm.fhir.model.type.code.IssueSeverity;
+import com.ibm.fhir.model.type.code.IssueType;
+import com.ibm.fhir.operation.term.AbstractTermOperation;
+import com.ibm.fhir.server.operation.spi.FHIROperationContext;
+import com.ibm.fhir.server.operation.spi.FHIRResourceHelpers;
+import com.ibm.fhir.server.registry.ServerRegistryResourceProvider;
+import com.ibm.fhir.server.util.FHIROperationUtil;
+import com.ibm.fhir.term.util.CodeSystemSupport;
+
+public class CodeSystemClearCacheOperation extends AbstractTermOperation {
+ 
+    @Override
+    protected OperationDefinition buildOperationDefinition() {
+        try (InputStream in = getClass().getClassLoader().getResourceAsStream("operation-codesystem-clear-cache.json")) {
+            return FHIRParser.parser(Format.JSON).parse(in);
+        } catch (Exception e) {
+            throw new Error(e);
+        }
+    }
+    
+    @Override
+    protected Parameters doInvoke(
+            FHIROperationContext operationContext,
+            Class<? extends Resource> resourceType,
+            String logicalId,
+            String versionId,
+            Parameters parameters,
+            FHIRResourceHelpers resourceHelper) throws FHIROperationException {
+
+        CacheManager.invalidateAll(CodeSystemSupport.ANCESTORS_AND_SELF_CACHE_NAME);
+        CacheManager.invalidateAll(CodeSystemSupport.DESCENDANTS_AND_SELF_CACHE_NAME);
+
+        try {
+            if (FHIROperationContext.Type.INSTANCE.equals(operationContext.getType()) || parameters.getParameter().size() > 0 ) {
+                CodeSystem codeSystem = getResource(operationContext, logicalId, parameters, resourceHelper, CodeSystem.class );
+                clearServerRegistryCache(codeSystem);
+            }
+            
+            OperationOutcome operationOutcome = OperationOutcome.builder().issue(
+                OperationOutcome.Issue.builder()
+                    .severity(IssueSeverity.INFORMATION)
+                    .code(IssueType.INFORMATIONAL)
+                    .details(CodeableConcept.builder().coding(
+                        Coding.builder().code(Code.of("success")).build()
+                     ).build()).build()
+                ).build();
+            
+            if (FHIRRequestContext.get().getReturnPreference() == HTTPReturnPreference.OPERATION_OUTCOME) {
+                return FHIROperationUtil.getOutputParameters(operationOutcome);
+            } else {
+                return null;
+            }
+        } catch( Throwable t ) {
+            throw new FHIROperationException("Unexpected error occurred while processing request for operation '"
+                    + getName() + "': " + getCausedByMessage(t), t);
+        } 
+    }
+    
+    private String getCausedByMessage(Throwable throwable) {
+        return throwable.getClass().getName() + ": " + throwable.getMessage();
+    }
+    
+    private void clearServerRegistryCache(CodeSystem resource) {
+        String dataStoreId = FHIRRequestContext.get().getDataStoreId();
+        String url = resource.getUrl().getValue();
+        CacheManager.invalidate(ServerRegistryResourceProvider.REGISTRY_RESOURCE_CACHE_NAME, CacheKey.key(dataStoreId,url));
+        if( resource.getVersion() != null ) {
+            url = url + "|" + resource.getVersion().getValue();
+            CacheManager.invalidate(ServerRegistryResourceProvider.REGISTRY_RESOURCE_CACHE_NAME, CacheKey.key(dataStoreId,url));
+        }
+    }
+}
diff --git a/operation/fhir-operation-term-cache/src/main/java/com/ibm/fhir/operation/term/cache/ValueSetClearCacheOperation.java b/operation/fhir-operation-term-cache/src/main/java/com/ibm/fhir/operation/term/cache/ValueSetClearCacheOperation.java
new file mode 100644
index 00000000000..774cdeecbac
--- /dev/null
+++ b/operation/fhir-operation-term-cache/src/main/java/com/ibm/fhir/operation/term/cache/ValueSetClearCacheOperation.java
@@ -0,0 +1,79 @@
+/*
+ * (C) Copyright IBM Corp. 2021
+ *
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+package com.ibm.fhir.operation.term.cache;
+
+import java.io.InputStream;
+
+import com.ibm.fhir.config.FHIRRequestContext;
+import com.ibm.fhir.core.HTTPReturnPreference;
+import com.ibm.fhir.exception.FHIROperationException;
+import com.ibm.fhir.model.format.Format;
+import com.ibm.fhir.model.parser.FHIRParser;
+import com.ibm.fhir.model.resource.OperationDefinition;
+import com.ibm.fhir.model.resource.OperationOutcome;
+import com.ibm.fhir.model.resource.Parameters;
+import com.ibm.fhir.model.resource.Resource;
+import com.ibm.fhir.model.resource.ValueSet;
+import com.ibm.fhir.model.type.Code;
+import com.ibm.fhir.model.type.CodeableConcept;
+import com.ibm.fhir.model.type.Coding;
+import com.ibm.fhir.model.type.code.IssueSeverity;
+import com.ibm.fhir.model.type.code.IssueType;
+import com.ibm.fhir.operation.term.AbstractTermOperation;
+import com.ibm.fhir.server.operation.spi.FHIROperationContext;
+import com.ibm.fhir.server.operation.spi.FHIRResourceHelpers;
+import com.ibm.fhir.server.util.FHIROperationUtil;
+import com.ibm.fhir.term.util.ValueSetSupport;
+
+public class ValueSetClearCacheOperation extends AbstractTermOperation {
+    
+    @Override
+    protected OperationDefinition buildOperationDefinition() {
+        try (InputStream in = getClass().getClassLoader().getResourceAsStream("operation-valueset-clear-cache.json")) {
+            return FHIRParser.parser(Format.JSON).parse(in);
+        } catch (Exception e) {
+            throw new Error(e);
+        }
+    }
+    
+    @Override
+    protected Parameters doInvoke(
+            FHIROperationContext operationContext,
+            Class<? extends Resource> resourceType,
+            String logicalId,
+            String versionId,
+            Parameters parameters,
+            FHIRResourceHelpers resourceHelper) throws FHIROperationException {
+
+        try {
+            ValueSet valueSet = getResource(operationContext, logicalId, parameters, resourceHelper, ValueSet.class);
+            ValueSetSupport.clearCache(valueSet);
+            
+            OperationOutcome operationOutcome = OperationOutcome.builder().issue(
+                OperationOutcome.Issue.builder()
+                    .severity(IssueSeverity.INFORMATION)
+                    .code(IssueType.INFORMATIONAL)
+                    .details(CodeableConcept.builder().coding(
+                        Coding.builder().code(Code.of("success")).build()
+                     ).build()).build()
+                ).build();
+            
+            if (FHIRRequestContext.get().getReturnPreference() == HTTPReturnPreference.OPERATION_OUTCOME) {
+                return FHIROperationUtil.getOutputParameters(operationOutcome);
+            } else {
+                return null;
+            }
+        } catch( Throwable t ) {
+            throw new FHIROperationException("Unexpected error occurred while processing request for operation '"
+                    + getName() + "': " + getCausedByMessage(t), t);
+        } 
+    }
+    
+    private String getCausedByMessage(Throwable throwable) {
+        return throwable.getClass().getName() + ": " + throwable.getMessage();
+    }
+}
diff --git a/operation/fhir-operation-term-cache/src/main/resources/META-INF/services/com.ibm.fhir.server.operation.spi.FHIROperation b/operation/fhir-operation-term-cache/src/main/resources/META-INF/services/com.ibm.fhir.server.operation.spi.FHIROperation
new file mode 100644
index 00000000000..4b2e65c107c
--- /dev/null
+++ b/operation/fhir-operation-term-cache/src/main/resources/META-INF/services/com.ibm.fhir.server.operation.spi.FHIROperation
@@ -0,0 +1,2 @@
+com.ibm.fhir.operation.term.cache.CodeSystemClearCacheOperation
+com.ibm.fhir.operation.term.cache.ValueSetClearCacheOperation
diff --git a/operation/fhir-operation-term-cache/src/main/resources/operation-codesystem-clear-cache.json b/operation/fhir-operation-term-cache/src/main/resources/operation-codesystem-clear-cache.json
new file mode 100644
index 00000000000..26c36f9239f
--- /dev/null
+++ b/operation/fhir-operation-term-cache/src/main/resources/operation-codesystem-clear-cache.json
@@ -0,0 +1,52 @@
+{
+    "resourceType": "OperationDefinition",
+    "id": "ValueSet-clear-cache",
+    "text": {
+        "status": "generated",
+        "div": "<div xmlns='http://www.w3.org/1999/xhtml'><h2>clear-cache</h2><p>OPERATION: CodeSystem Clear Cache</p><p>The clear-cache operation removes codesystem expansion data that has been cached in memory, allowing the terminology subsystem to reload the data fresh on next use. Cache data is not shared between FHIR server instances, so this operation must be called separate for each instance as needed by the application.</p><p>URL: [base][base]/CodeSystem/$clear-cache</p><p>Parameters</p><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>OUT</td><td>return</td><td>1..1</td><td>OperationOutcome</td><td/><td><p>If the operation outcome is not present or is present but lists no errors, then the operation completed successfully.</p></td></tr></table></div>"
+      },
+    "url": "http://ibm.com/fhir/OperationDefinition/CodeSystem-clear-cache",
+    "name": "clear-cache",
+    "status": "draft",
+    "kind": "operation",
+    "publisher": "IBM FHIR Server",
+    "date": "2021-04-15",
+    "description": "The clear-cache operation removes codesystem expansion data that has been cached in memory, allowing the terminology subsystem to reload the data fresh on next use. Cache data is not shared between FHIR server instances, so this operation must be called separate for each instance as needed by the application.",
+    "code": "clear-cache",
+    "resource": ["CodeSystem"],
+    "system": false,
+    "type": true,
+    "instance": true,
+    "parameter": [    {
+      "name": "url",
+      "use": "in",
+      "min": 0,
+      "max": "1",
+      "documentation": "CodeSystem URL. The server must know the code system (e.g. it is defined explicitly in the server's code systems, or it is known implicitly by the server",
+      "type": "uri"
+    },
+    {
+      "name": "codeSystem",
+      "use": "in",
+      "min": 0,
+      "max": "1",
+      "documentation": "The codeSystem is provided directly as part of the request.",
+      "type": "CodeSystem"
+    },
+    {
+      "name": "version",
+      "use": "in",
+      "min": 0,
+      "max": "1",
+      "documentation": "The version of the code system, if one was provided in the source data",
+      "type": "string"
+    },
+    {
+        "name": "return",
+        "use": "out",
+        "min": 0,
+        "max": "1",
+        "documentation": "If the operation outcome is not present or is present but lists no errors, then the cached data has been cleared.",
+        "type": "OperationOutcome"
+    }]
+}
diff --git a/operation/fhir-operation-term-cache/src/main/resources/operation-valueset-clear-cache.json b/operation/fhir-operation-term-cache/src/main/resources/operation-valueset-clear-cache.json
new file mode 100644
index 00000000000..e738e9641d2
--- /dev/null
+++ b/operation/fhir-operation-term-cache/src/main/resources/operation-valueset-clear-cache.json
@@ -0,0 +1,42 @@
+{
+    "resourceType": "OperationDefinition",
+    "id": "ValueSet-clear-cache",
+    "text": {
+        "status": "generated",
+        "div": "<div xmlns='http://www.w3.org/1999/xhtml'><h2>clear-cache</h2><p>OPERATION: ValueSet Clear Cache</p><p>The ValueSet-clear-cache operation clears the server's cached copy of the codeset expansion of a ValueSet.</p><p>URL: [base]/ValueSet/$clear-cache</p><p>Parameters</p><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>IN</td><td>url</td><td>0..1</td><td>string</td><td/><td><p>A canonical reference to a value set. The server must know the value set (e.g. it is defined explicitly in the server's value sets, or it is defined implicitly by some code system known to the server.</p></td></tr><tr><td>IN</td><td>valueSetVersion</td><td>0..1</td><td>string</td><td/><td><p>The identifier that is used to identify a specific version of the value set to be used when generating the expansion. This is an arbitrary value managed by the value set author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available.</p></td></tr><tr><td>OUT</td><td>return</td><td>1..1</td><td>OperationOutcome</td><td/><td><p>If the operation outcome is not present or is present but lists no errors, then the operation completed successfully.</p></td></tr></table></div>"
+      },
+    "url": "http://ibm.com/fhir/OperationDefinition/ValueSet-clear-cache",
+    "name": "clear-cache",
+    "status": "draft",
+    "kind": "operation",
+    "publisher": "IBM FHIR Server",
+    "date": "2021-04-15",
+    "description": "The clear-cache operation removes valueset data that has been cached in memory, allowing the terminology subsystem to reload the data fresh on next use. Cache data is not shared between FHIR server instances, so this operation must be called separate for each instance as needed by the application.",
+    "code": "clear-cache",
+    "resource": ["ValueSet"],
+    "system": false,
+    "type": true,
+    "instance": true,
+    "parameter": [{
+        "name": "url",
+        "use": "in",
+        "min": 0,
+        "max": "1",
+        "documentation" : "A canonical reference to a value set. The server must know the value set (e.g. it is defined explicitly in the server's value sets, or it is defined implicitly by some code system known to the server",
+        "type": "uri"
+    },{
+        "name": "valueSetVersion",
+        "use": "in",
+        "min": 0,
+        "max": "1",
+        "documentation": "The identifier that is used to identify a specific version of the value set to be used when generating the expansion. This is an arbitrary value managed by the value set author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available.",
+        "type": "string"
+    },{
+        "name": "return",
+        "use": "out",
+        "min": 0,
+        "max": "1",
+        "documentation": "If the operation outcome is not present or is present but lists no errors, then the cached data has been cleared.",
+        "type": "OperationOutcome"
+    }]
+}
diff --git a/operation/fhir-operation-term/pom.xml b/operation/fhir-operation-term/pom.xml
index d67cbbb84ab..2760ad2198b 100644
--- a/operation/fhir-operation-term/pom.xml
+++ b/operation/fhir-operation-term/pom.xml
@@ -5,7 +5,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
     <artifactId>fhir-operation-term</artifactId>
diff --git a/operation/fhir-operation-term/src/main/java/com/ibm/fhir/operation/term/LookupOperation.java b/operation/fhir-operation-term/src/main/java/com/ibm/fhir/operation/term/LookupOperation.java
index 7b463775554..d09ba95f189 100644
--- a/operation/fhir-operation-term/src/main/java/com/ibm/fhir/operation/term/LookupOperation.java
+++ b/operation/fhir-operation-term/src/main/java/com/ibm/fhir/operation/term/LookupOperation.java
@@ -8,6 +8,7 @@
 
 import static com.ibm.fhir.model.type.String.string;
 
+import com.ibm.fhir.core.FHIRConstants;
 import com.ibm.fhir.exception.FHIROperationException;
 import com.ibm.fhir.model.resource.CodeSystem;
 import com.ibm.fhir.model.resource.OperationDefinition;
@@ -23,7 +24,6 @@
 import com.ibm.fhir.registry.FHIRRegistry;
 import com.ibm.fhir.server.operation.spi.FHIROperationContext;
 import com.ibm.fhir.server.operation.spi.FHIRResourceHelpers;
-import com.ibm.fhir.server.util.FHIRRestHelper;
 import com.ibm.fhir.term.service.LookupOutcome;
 import com.ibm.fhir.term.service.LookupParameters;
 import com.ibm.fhir.term.service.exception.FHIRTermServiceException;
@@ -53,7 +53,7 @@ protected Parameters doInvoke(
                         .severity(IssueSeverity.ERROR)
                         .code(IssueType.NOT_FOUND.toBuilder()
                             .extension(Extension.builder()
-                                .url(FHIRRestHelper.EXTENSION_URL + "/not-found-detail")
+                                .url(FHIRConstants.EXT_BASE + "not-found-detail")
                                 .value(Code.of("coding"))
                                 .build())
                             .build())
diff --git a/operation/fhir-operation-test/pom.xml b/operation/fhir-operation-test/pom.xml
index a48a983c95a..adb3b471262 100644
--- a/operation/fhir-operation-test/pom.xml
+++ b/operation/fhir-operation-test/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>
 
diff --git a/operation/fhir-operation-validate/pom.xml b/operation/fhir-operation-validate/pom.xml
index 6f4df418659..de155ae5eef 100644
--- a/operation/fhir-operation-validate/pom.xml
+++ b/operation/fhir-operation-validate/pom.xml
@@ -6,7 +6,7 @@
     <parent>
         <groupId>com.ibm.fhir</groupId>
         <artifactId>fhir-parent</artifactId>
-        <version>4.8.0-SNAPSHOT</version>
+        <version>4.9.0-SNAPSHOT</version>
         <relativePath>../../fhir-parent</relativePath>
     </parent>